Related Experiment Videos
Translating Evidence into Obstetric Care: Developing a Best Practice-Informed Stepped-Care Clinical Algorithm for the
Fei-Yi Zhao1,2,3,4, Li-Ping Yue1, Yuen-Shan Ho5
1Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, 201209, People's Republic of China.
Nature and Science of Sleep
|June 25, 2026
Summary
Pregnancy insomnia can lead to adverse outcomes. This study synthesizes evidence to create a stepped-care algorithm for managing gestational insomnia, prioritizing lifestyle changes, cognitive behavioral therapy for insomnia (CBT-i), and pharmacotherapy or CAM as needed.
Area of Science:
- Obstetrics and Gynecology
- Sleep Medicine
- Evidence-Based Medicine
Background:
- Insomnia during pregnancy is linked to adverse maternal and fetal outcomes.
- Potential complications include gestational diabetes, pre-eclampsia, and preterm birth.
Purpose of the Study:
- To synthesize evidence on managing gestational insomnia.
- To develop a clinical algorithm for obstetric care.
Main Methods:
- Systematic literature search following the 6S evidence pyramid.
- Independent screening and appraisal by four reviewers.
- Evidence synthesis using the JBI Grading of Evidence and Recommendation System.
Main Results:
- Nineteen publications yielded 31 practice recommendations.
- Recommendations cover principles, lifestyle, CBT-i, pharmacotherapy, and CAM.
- A stepped-care pathway progresses from lifestyle to CBT-i, then pharmacotherapy or CAM.
Conclusions:
- A stepped-care algorithm for gestational insomnia is proposed.
- Clinical validation and tailored implementation are needed.
- Algorithm aims to inform obstetric practice for better pregnancy outcomes.
Related Concept Videos
01:19Management of Insomnia
The sleep cycle, an integral part of human health, consists of several stages with distinct characteristics and functions. It begins with a transition from wakefulness to sleep, known as the light sleep phase, followed by the restorative deep sleep phase, essential for physical recovery and growth. The cycle concludes with the Rapid Eye Movement (REM) phase, characterized by high brain activity and vivid dreaming. Insomnia, a prevalent sleep disorder, involves difficulty falling asleep, staying...
01:27Insomnia
Insomnia is a prevalent sleep disorder characterized by difficulty falling asleep, frequent awakenings during the night, and waking up too early without being able to return to sleep. People with insomnia often experience these disruptions at least three nights a week for at least one month. Chronic insomnia, which lasts for at least three months, can lead to increased anxiety, which in turn can worsen sleep difficulties, creating a cycle of sleeplessness and stress.
Multiple factors contribute...
Multiple factors contribute...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
Creating and executing a nursing diagnosis helps nurses plan care and guide patient, family, and community interventions. They are developed based on a patient's physical evaluation and support measuring the outcomes. It is not recommended to select random interventions throughout the planning process. Instead, consider the following six essential factors when choosing interventions:
01:27Nursing Clinical Information System
Nursing Clinical Information System (NCIS)
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:20Angina V: Nursing Management
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...