IMPACT OF SLEEP QUALITY ON ANXIETY LEVELS IN THIRD TRIMESTER PREGNANT WOMEN AT LIAQUAT UNIVERSITY HOSPITAL HYDERABAD

Abstract

Background: Sleep disturbance and anxiety symptoms are important concerns in late pregnancy. Local evidence can support antenatal assessment, provided that subjective sleep ratings and anxiety screening scores are distinguished from clinical diagnoses. Objectives: To identify common sleep disturbances, determine the association between self-rated sleep quality and anxiety symptom severity, and assess anxiety symptom severity among third-trimester pregnant women at Liaquat University Hospital Hyderabad. Methods: An analytical cross-sectional study recruited 248 women at 28–40 weeks of gestation through purposive sampling over six months. An adapted sleep questionnaire assessed disturbances and overall sleep quality using Question 8; no global Pittsburgh Sleep Quality Index score was calculated. Anxiety symptoms were measured using the Generalized Anxiety Disorder 7-item scale (GAD-7). SPSS version 20 was used for descriptive statistics, Spearman correlation and a supporting chi-square comparison. Sleep ratings and GAD-7 scores each had 247 valid records; paired analyses included 246 women. Results: Thermal discomfort (61.3%), fetal movements (60.5%) and night waking (59.7%) were the most frequently reported disturbances occurring at least weekly. Poor self-rated sleep was reported by 127/247 women (51.4%). The mean GAD-7 score was 9.64 (SD 4.44); 34 women (13.8%) had minimal, 89 (36.0%) mild, 84 (34.0%) moderate and 40 (16.2%) severe symptoms. Poorer sleep ratings correlated with higher GAD-7 scores (rho = 0.395, p < 0.001). Moderate/severe symptoms occurred in 64.3% of the poor-sleep group and 35.0% of the good-sleep group (χ² = 21.086, df = 1, p < 0.001; unadjusted OR = 3.34, 95% CI 1.98–5.64). Conclusion: Sleep disturbances and anxiety symptoms were common and associated in this hospital sample. Antenatal care should consider both concerns, with appropriate assessment and referral. The cross-sectional design, purposive sampling and subjective measurements limit causal interpretation and generalisability.