Relationship Between Posttraumatic Stress Disorder and Sleep Quality
                    in Pregnant Earthquake Survivors

Hatice Gül Öztaş; Emine Aksüt Akçay; Gülnaz Erdī

doi:10.1055/a-2717-1246

Zeitschrift für Geburtshilfe und Neonatologie, Inhaltsverzeichnis

Z Geburtshilfe Neonatol
DOI: 10.1055/a-2717-1246

Original Article

Relationship Between Posttraumatic Stress Disorder and Sleep Quality in Pregnant Earthquake Survivors

Autoren

Hatice Gül Öztaş

¹Midwifwery, Kahramanmaraş Sütçü İmam University, Kahramanmaras, Türkiye
Emine Aksüt Akçay

¹Midwifwery, Kahramanmaraş Sütçü İmam University, Kahramanmaras, Türkiye
Gülnaz Erdī

¹Midwifwery, Kahramanmaraş Sütçü İmam University, Kahramanmaras, Türkiye

Abstract

Objectives

This study aims to investigate the relationship between posttraumatic stress disorder (PTSD) and sleep quality among pregnant earthquake survivors.

Method

A cross-sectional study was designed. The sample consisted of 272 pregnant earthquake survivors who were admitted to a hospital in southern Türkiye. Data were collected using “The Personal Information Disclosure Form,” “The Impact of Event Scale (IES),” and the “Pittsburgh Sleep Quality Index (PSQI)”. Statistical analyses included descriptive statistics, independent samples t-test, one-way ANOVA, Pearson correlation, and multiple linear regression.

Results

The mean IES total score was 41.37±19.73. The mean scores for the IES subscales were: Intrusion 15.17±8.19, Avoidance 15.25±6.74, and Hyperarousal 10.95±6.40. Considering the diagnostic cut-off value of 33 for PTSD on the IES, the mean IES score among the pregnant women in this study (41.37±19.73) indicates that their PTSD levels were above average and they were found to be at risk for PTSD. In general, positive, significant, but weak correlations were observed between the scale scores. A non-significant, positive, and very weak correlation was found between the IES and PSQI total scores (p>0.05).

Conclusion

Pregnant earthquake survivors exhibited elevated PTSD levels and poor sleep quality. Although the association between PTSD and sleep quality was weak, the findings highlight the need for psychological screening and supportive interventions in antenatal care following disasters.

Keywords

Stress Disorders - Post-Traumatic - Earthquakes - Midwifery

Volltext

Referenzen

References
1 Farooqui M, Quadri SA, Suriya SS. et al. Posttraumatic stress disorder: a serious post-earthquake complication. Trends Psychiatry Psychother 2017; 39: 135-143
2 Kulakoğlu B, Uzunay Z, Pota K. et al. Evaluation of musculoskeletal injuries after the 2023 Kahramanmaras earthquake: A local hospital experience. Jt Dis Relat Surg 2023; 34: 509
3 Hussain E, Kalaycıoğlu S, Milliner CW. et al. Preconditioning the 2023 Kahramanmaraş (Türkiye) earthquake disaster. Nat Rev Earth Environ 2023; 4: 287-289
4 Guo J, He H, Qu Z. et al. Post-traumatic stress disorder and depression among adult survivors 8 years after the 2008 Wenchuan earthquake in China. J Affect Disord 2017; 210: 27-34
5 American Psychological Association. Posttraumatic stress disorder. Available online https://www.apa.org/topics/ptsd Accessed 20 July 2023
6 Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. J Affect Disord 2017; 208: 634-645
7 Khoramroudi R. The prevalence of posttraumatic stress disorder during pregnancy and postpartum period. J Family Med Prim Care 2018; 7: 220-223
8 Hong C, Efferth T. Systematic review on post-traumatic stress disorder among survivors of the Wenchuan earthquake. Trauma Violence Abuse 2016; 17: 542-561
9 Gelaye G, Addae B, Neway GT. et al. Poor sleep quality, antepartum depression and suicidal ideation among pregnant women. J Affect Disord 2017; 209: 195-200
10 Watanabe Z, Iwama N, Nishigori H. et al. Psychological distress during pregnancy in Miyagi after the great East Japan earthquake: the Japan Environment and Children's Study. J Affect Disord 2016; 190: 341-348
11 Tempesta D, Curcio G, De Gennaro L. et al. Long-term impact of earthquakes on sleep quality. PLoS One 2013; 8: e55936
12 Bavafa A, Khazaie H, Khaledi-Paveh B. et al. The relationship of severity of symptoms of depression, anxiety, and stress with sleep quality in earthquake survivors in Kermanshah. J Inj Violence Res 2019; 11: 225-232
13 Sedov ID, Cameron EE, Madigan S. et al. Sleep quality during pregnancy: A meta-analysis. Sleep Med Rev 2018; 38: 168-176
14 Peters AEJ, Verspeek LB, Nieuwenhuijze M. et al. The relation between sleep quality during pregnancy and health-related quality of life – A systematic review. J Matern Fetal Neonatal Med 2023; 36: 2212829
15 Zhou X, Kang L, Sun X. et al. Prevalence and risk factors of post-traumatic stress disorder among adult survivors six months after the Wenchuan earthquake. Compr Psychiatry 2013; 54: 493-499
16 Meng L, Chen Y, Xu X. et al. The neurobiology of brain recovery from traumatic stress: A longitudinal DTI study. J Affect Disord 2018; 225: 577-584
17 Tang W, Lu Y, Xu J. Post-traumatic stress disorder, anxiety and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors. Soc Psychiatry Psychiatr Epidemiol 2018; 53: 1241-1251
18 International Confederation of Midwives. Role of the midwife in disaster/emergency preparedness. 2014 Available online: https://www.internationalmidwives.org/assets/files/statement-files/2018/04/role-ofthe-midwife-in-disaster-preparednesseng.pdf (Accessed 15 November 2023)
19 Faul F, Erdfelder E, Lang AG. et al. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175-191
20 Cohen J. Statistical Power Analysis For The Behavioral Sciences. 2^nd ed. Hillsdale, NJ: Erlbaum; 1988
21 Polit DF, Beck CT. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 10^th ed. Philadelphia: Wolters Kluwer Health; 2017
22 Aktoz F, Gunes AC, Yakin K. The effect of earthquake experience on pregnancy outcomes: A systematic review and meta-analysis. J Obstet Gynecol Reprod Biol 2023; 291: 70-75
23 Ataya J, Soqia J, Ataya J. et al. Sleep quality and mental health differences following Syria-Turkey earthquakes: A cross-sectional study. Int J Soc Psychiatry 2024; 70: 700-708
24 Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med 1979; 41: 209-218
25 Weiss DS, Marmar CR. The Impact Of Event Scale – Revised. In: Wilson JP, Keane TM, eds. Assessing psychological trauma and PTSD. New York: Springer; 1997: 399-411
26 Cacciatore J, Radestad I, Froen JF. Effects of contact with stillborn babies on maternal anxiety and depression. Birth 2008; 35: 313-320
27 Çorapçıoğlu A, Yargıç İ, Geyran P. et al. Validity and reliability of the Turkish version of the “Impact of Events Scale-Revised”. New Symposium 2006; 44: 14-22
28 Buysse DJ, Reynolds CF, Monk TH. et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28: 193-213
29 Agargün MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh Sleep Quality Index. Turkish J Psychiatry 1996; 7: 107-115
30 Özhüner Y, Çelik N. Sleep quality and quality of life in pregnant women. J Health Sci Prof 2019; 6: 25-33
31 Di Bucci D, Del Missier F, Dolce M. et al. Life satisfaction during temporary housing after an earthquake: Comparing three cases in Italy. IJDRR 2023; 91: 103697
32 Shiba K, Hikichi H, Okuzono SS. et al. Long-term associations between disaster-related home loss and health and well-being of older survivors: nine years after the 2011 Great East Japan earthquake and tsunami. Environ Health Perspect 2022; 130: 077001
33 Anwar J, Mpofu E, Matthews LR. et al. Risk factors of posttraumatic stress disorder after an earthquake disaster. J Nerv Ment Dis 2013; 201: 1045-1052
34 Toffol E, Koponen P, Partonen T. Miscarriage and mental health: results of two population-based studies. Psychiatry Res 2013; 205: 151-158
35 Keten HS, Gençoğlan S, Dalgacı AF. et al. Evaluation of acute stress disorder after pregnancy loss. Cukurova Med J 2015; 40: 226-232
36 Lu B, Zeng W, Li Z. et al. Risk factors of post-traumatic stress disorder 10 years after Wenchuan earthquake: A population-based case–control study. Epidemiol Psychiatr Sci 2021; 30: e25
37 Bromet EJ, Atwoli L, Kawakami N. et al. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys. Psychol Med 2017; 47: 227-241
38 Tanoue K, Watanabe Z, Nishigori H. et al. The prevalence of psychological distress during pregnancy in Miyagi Prefecture for 3 years after the Great East Japan Earthquake. Environ Health Prev Med 2021; 26: 1-13
39 Qu Z, Tian D, Zhang Q. et al. The impact of the catastrophic earthquake in China's Sichuan province on the mental health of pregnant women. J Affect Disord 2012; 136: 117-123
40 Futterman ID, Grace H, Weingarten S. et al. Maternal anxiety, depression and posttraumatic stress disorder (PTSD) after natural disasters: a systematic review. J Matern Fetal Neonatal Med 2023; 36: 2199345
41 Li G, Kong L, Zhou H. et al. Relationship between prenatal maternal stress and sleep quality in Chinese pregnant women: the mediation effect of resilience. Sleep Med 2016; 25: 8-12
42 Jiang S, Yan Z, Jing P. et al. Relationships between sleep problems and psychiatric comorbidities among China's Wenchuan earthquake survivors remaining in temporary housing camps. Front Psychol 2016; 7: 1552
43 Yabe Y, Hagiwara Y, Sugawara Y. et al. Low back pain is associated with sleep disturbance: a 3-year longitudinal study after the Great East Japan Earthquake. BMC Musculoskelet Disord 2022; 23: 1132
44 Sanchez SE, Friedman LE, Rondon MB. et al. Association of stress-related sleep disturbance with psychiatric symptoms among pregnant women. Sleep Med 2020; 70: 27-32
45 Pınar SE, Arslan S, Polat K. et al. Examination of the relationship between sleep quality and perceived stress in pregnant women. E-Journal of Dokuz Eylül University Faculty 2014; 7: 171-177
46 Silvestri R, Aricò I. Sleep disorders in pregnancy. Sleep Sci 2019; 12: 232-239
47 Yazawa A, Shiba K, Okuzono SS. et al. Bidirectional associations between post-traumatic stress symptoms and sleep quality among older survivors of the 2011 Great East Japan Earthquake and Tsunami. Sleep 2023; 46: zsad106
48 Bakker LP, Småstuen MC, Reichelt JG. et al. Sleep quality problems three decades post-disaster. Nord J Psychiatry 2019; 73: 104-110
49 Hu X, Cao X, Wang H. et al. Probable post-traumatic stress disorder and its predictors in disaster-bereaved survivors: a longitudinal study after the Sichuan earthquake. Arch Psychiatr Nurs 2016; 30: 192-197
50 Kim Y, Lee H. Sleep problems among disaster victims: a long-term survey on the life changes of disaster victims in Korea. Int J Environ Res Public Health 2021; 18: 3294
51 Miller KE, Brownlow JA, Woodward S. et al. Sleep and dreaming in posttraumatic stress disorder. Curr Psychiatry Rep 2017; 19: 71