Browsing by Author "Sedov, Ivan"

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    Insomnia During Pregnancy
    (2020-07-16) Sedov, Ivan; Tomfohr-Madsen, Lianne M.; Dobson, Keith; Noel, Melanie; Green, Sheryl; Kopala-Sibley, Daniel
    The problem: Sleep has long been noted to be disturbed during pregnancy; however, investigations of insomnia as it occurs during the prenatal period have been limited. The goal of this dissertation was to develop the existing knowledge base of prenatal insomnia prevalence, course, and risk factors.Methods: A meta-analysis of prenatal insomnia literature was conducted to establish a prevalence of insomnia and moderating variables including trimester, gestational age, maternal age, depression, and anxiety. Additionally, 142 women were recruited in early-pregnancy and followed until early-postpartum. Measures of insomnia symptoms as well as mental health variables were taken every 10 weeks for a total of 40 weeks. Semiparametric group-based modeling was used to construct trajectories of insomnia symptomology over the course of pregnancy. Cross-lagged panel analysis was used to test the strength of the relationship between generalized anxiety and insomnia symptoms.Results: The results of the meta-analysis indicated that 36.7% of pregnant women reported clinically significant insomnia symptoms. Trimester moderated the prevalence such that the prevalence of insomnia symptoms was higher during the third relative to the second trimester. The trajectory analysis resulted in three groups: stable-low (42.2%), dynamic-medium (44.3%), and decreasing-high (13.4%). Women in the decreasing-high group reported clinically elevated symptoms through the course of pregnancy which decreased slightly in the postpartum. The stable-low group demonstrated consistently low insomnia symptoms. The dynamic-medium group demonstrated sub-clinical insomnia symptoms that worsened in the third trimester before decreasing in the postpartum. Anxiety and depression symptoms at baseline were predictive of trajectory membership. Additionally, experiencing consistently high insomnia symptoms throughiiithe course of pregnancy was related to higher symptoms of anxiety and depression in the postpartum. The cross-lagged panel analysis indicated that generalized anxiety symptoms predicted subsequent insomnia symptoms but not vice versa. Anxiety symptoms in late-pregnancy were not predictive of insomnia symptoms in early-postpartum.General conclusion: Insomnia symptoms are prevalent during pregnancy and characterized by several different trajectory patterns. Generalized anxiety symptoms are an important predictor of subsequent insomnia symptoms. This body of work helps to develop the current understanding of insomnia as it occurs during pregnancy.
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    Insomnia Treatment Preferences of Expectant Couples
    (2016) Sedov, Ivan; Tomfohr-Madsen, Lianne; Campbell, Tavis; von Ranson, Kristin; Este, David
    Client treatment preferences are recognized as a key factor in delivery of evidence based practice. The current study investigated pregnant couples’ treatment preferences for insomnia; the modalities assessed included pharmacotherapy and cognitive behavioral therapy for insomnia (CBT-I). Method: Expectant couples completed an online questionnaire asking them to read expert validated treatment descriptions of pharmacotherapy and CBT-I; they then indicated their preference and perceptions of each approach. Results: Pregnant women indicated that if they were experiencing insomnia they would prefer CBT-I to pharmacotherapy (p < .001). Women rated CBT-I as more credible and indicated stronger positive reactions to it than pharmacotherapy (p < .001). Expectant fathers indicated that they would prefer CBT-I to pharmacotherapy for both their own (p < .001) and the mother’s insomnia (p < .001). Conclusion: The current findings suggest that expectant mothers and father prefer CBT-I to pharmacotherapy as a treatment for insomnia.