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Neuroimmunology of Pregnancy-Related Sleep Disturbances

  • Michele L. Okun
  • Mary E. Coussons-Read

Abstract

Sleep is undoubtedly disturbed during pregnancy. The disturbances include an increase in nocturnal awakenings and greater periods of time spent awake during the night, as well as complaints of fatigue during the day. Although nausea (i.e., morning sickness) is most commonly expected in the first trimester, an increase in fatigue, which is often a consequence of disturbed sleep, is actually the first symptom of pregnancy (Lee 2006). Various contributors have been suggested or implicated in the magnitude of sleep disturbances in pregnancy, including hormonal, physiologic, physical (Baratte-Beebe and Lee 1999), and behavioral changes (Buster and Carson 2003; Challis and Lye 2003). As pregnancy progress, other symptoms contribute to sleep disturbances, some of them being fetal movements, leg cramps, shortness of breath, and an inability to get comfortable (Baratte-Beebe et al. 1999). This review will extend beyond the description of how sleep patterns change during pregnancy to suggest that there is an important relationship between pregnancy-associated sleep disturbances and cytokine and hormone changes that may have relevance to maternal and fetal health. Discussion will include how disturbances experienced during pregnancy are associated with cytokine alterations and hormonal changes, and how these relationships could add to a woman’s risk for developing pregnancy complications or experiencing poor pregnancy outcomes.

Keywords

Sleep Disturbance Obstet Gynecol Sleep Deprivation Sleep Pattern Preterm Labor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Afshari, J.T., Ghomian, N., Shameli, A., Shakeri, M.T., Fahmidehkar, M.A., Mahajer, E. et al. (2005). Determination of interleukin-6 and tumor necrosis factor-alpha concentrations in Iranian-Khorasanian patients with preeclampsia. BMC Pregnancy Childbirth 5, 14.PubMedCrossRefGoogle Scholar
  2. American Sleep Disorders Association (1997) The International Classification of Sleep Disorders: A Diagnostic and Coding Manual. (Rev. Edn.). Author, Rochester, MN.Google Scholar
  3. Astle, S., Slater, D.M., and Thornton, S. (2003). The involvement of progesterone in the onset of human labour. Eur J Obstet Gynecol Reprod Biol 108, 177–181.PubMedGoogle Scholar
  4. Baker, A., Simpson, S., and Dawson, D. (1997). Sleep disruption and mood changes associated with menopause. J Psychosom Res 43, 359–369.PubMedCrossRefGoogle Scholar
  5. Baratte-Beebe, K.R., and Lee, K. (1999). Sources of midsleep awakenings in childbearing women. Clin Nurs Res 8, 386–397.PubMedCrossRefGoogle Scholar
  6. Blyton, D.M., Sullivan, C.E., and Edwards, N. (2004). Reduced nocturnal cardiac output associated with preeclampsia is minimized with the use of nocturnal nasal CPAP. Sleep 27, 79–84.PubMedGoogle Scholar
  7. Born, J., Lange, T., Hansen, K., Molle, M., and Fehm, H.L. (1997). Effects of sleep and circadian rhythm on human circulating immune cells. J Immunol 158, 4454–4464.PubMedGoogle Scholar
  8. Branchey, M., and Branchey, L. (1970). Sleep and wakefulness in female rats during pregnancy. Physiol Behav 5, 365–368.PubMedCrossRefGoogle Scholar
  9. Branchey, M., and Petre-Quadens, O. (1968). A comparative study of sleep parameters during pregnancy. Acta Neurol Psychiatr Belg 68, 453–459.PubMedGoogle Scholar
  10. Brunner, D.P., Munch, M., Biedermann, K., Huch, R., Huch, A., and Borbely, A.A. (1994). Changes in sleep and sleep electroencephalogram during pregnancy. Sleep 17, 576–582.PubMedGoogle Scholar
  11. Burguet, A., Kaminski, M., Abraham-Lerat, L., Schaal, J.P., Cambonie, G., Fresson, J. et al. (2004). The complex relationship between smoking in pregnancy and very preterm delivery. Results of the Epipage study. BJOG 111, 258–265.PubMedCrossRefGoogle Scholar
  12. Buster, J.E., and Carson, S.A. (2003) Endocrinology and diagnosis of pregnancy. In: S.G. Gabbe, J.R. Niebyl, and J.L. Simpson (Eds.), Obstetrics: Normal and Problem Pregnancies (4th Edn.). Churchill Livingstone, New York, pp. 3–34.Google Scholar
  13. Carrier, J., Land, S., Buysse, D.J., Kupfer, D.J., and Monk, T.H. (2001). The effects of age and gender on sleep EEG power spectral density in the middle years of life (ages 20–60 years old). Psychophysiology 38, 232–242.PubMedCrossRefGoogle Scholar
  14. Challis, J.R.G., and Lye, S.J. (2003) Physiology and endocrinology of term and preterm labor. In: S.G. Gabbe, J.R. Niebyl, and J.L. Simpson (Eds.), Obstetrics: Normal and Problem Pregnancies (4th Edn.). Churchill Livingstone, New York, pp. 93–106.Google Scholar
  15. Chaouat, G., Zourbas, S., Ostojic, S., Lappree-Delage, G., Dubanchet, S., Ledee, N. et al. (2002). A brief review of recent data on some cytokine expressions at the materno-foetal interface which might challenge the classical Th1/Th2 dichotomy. J Reprod Immunol 53, 241–256.PubMedCrossRefGoogle Scholar
  16. Chegini, N., and Williams, R.S. (2000) Cytokines and growth factor networks in human endometrium from menstruation to embryo implantation. In: J.A. Hill (Ed.), Cytokines in Human Reproduction. John Wiley and Sons, New York, pp. 93–132.Google Scholar
  17. Clark, D.A., Arck, P.C., Jalali, R., Merali, F.S., Manuel, J., Chaouat, G. et al. (1996). Psychoneuro-cytokine/endocrine pathways in immunoregulation during pregnancy. Am J Reprod Immunol, 35, 330–337.PubMedGoogle Scholar
  18. Coble, P.A., Reynolds, C.F., III, Kupfer, D.J., Houck, P.R., Day, N.L., and Giles, D.E. (1994). Childbearing in women with and without a history of affective disorder. II. Electroencephalographic sleep. Comp Psychiatry 35, 215–224.CrossRefGoogle Scholar
  19. Colrain, I.M., Trinder, J., and Swan, G.E. (2004). The impact of smoking cessation on objective and subjective markers of sleep: Review, synthesis, and recommendations. Nicotine Tob Res 6, 913–925.PubMedCrossRefGoogle Scholar
  20. Coulam, C.B. (2000). Understanding the immunobiology of pregnancy and applying it to treatment of recurrent pregnancy loss. Early Pregnancy 4, 19–29.PubMedGoogle Scholar
  21. Coussons-Read, M.E., Okun, M.L., Schmitt, M.P., and Giese, S. (2005). Prenatal stress alters cytokine levels in a manner that may endanger human pregnancy. Psychosom Med 67, 625–631.PubMedCrossRefGoogle Scholar
  22. Dekker, G.A., and Sibai, B.M. (1999). The immunology of preeclampsia. Semin Perinatol 23, 24–33.PubMedCrossRefGoogle Scholar
  23. Dinges, D.F., Douglas, S.D., Hamarman, S., Zaugg, L., and Kapoor, S. (1995). Sleep deprivation and human immune function. Adv Neuroimmunol 5, 97–110.PubMedCrossRefGoogle Scholar
  24. Dinges, D.F., Douglas, S.D., Zaugg, L., Campbell, D.E., McMann, J.M., Whitehouse, W.G. et al. (1994). Leukocytosis and natural killer cell function parallel neurobehavioral fatigue induced by 64 hours of sleep deprivation. J Clin Invest 93, 1930–1939.PubMedGoogle Scholar
  25. Driver, H.S., and Shapiro, C.M. (1992). A longitudinal study of sleep stages in young women during pregnancy and postpartum. Sleep 15, 449–453.PubMedGoogle Scholar
  26. Dudley, D.J. (1996) The immunobiology of nidation and implantation: Novel regulation of innate and adaptive immunity. In: R.A. Bronson, N.J. Alexander, D. Anderson, D.W. Branch, and W.H. Kutteh (Eds.), Reproductive Immunology. Blackwell Science, Cambridge, pp. 359–382.Google Scholar
  27. Dudley, D.J. (1999). Immunoendocrinology of preterm labor: The link between corticotropinreleasing hormone and inflammation. Am J Obstet Gynecol 180, S251–S256.PubMedCrossRefGoogle Scholar
  28. Edwards, N., Blyton, C.M., Kesby, G.J., Wilcox, I., and Sullivan, C.E. (2000). Pre-eclampsia is associated with marked alterations in sleep architecture. Sleep 23, 619–625.PubMedGoogle Scholar
  29. Ehlers, C.L., and Kupfer, D.J. (1997). Slow-wave sleep: Do young adult men and women age differently? J Sleep Res 6, 211–215.PubMedCrossRefGoogle Scholar
  30. Ekholm, E.M., Polo, O., Rauhala, E.R., and Ekblad, U.U. (1992). Sleep quality in preeclampsia. Am J Obstet Gynecol 167, 1262–1266.PubMedGoogle Scholar
  31. Florio, P., Cobellis, L., Woodman, J., Severi, F.M., Linton, E.A., and Petraglia, F. (2002). Levels of maternal plasma corticotropin-releasing factor and urocortin during labor. J Soc Gynecol Invest 9, 233–237.CrossRefGoogle Scholar
  32. Fujino, Y., Shirata, K., Imanaka, M., Nishio, J., Ogita, S., and Park, Y.K. (1995). Sleeping habits of pregnant women: A questionnaire study. Appl Human Sci 14, 305–307.PubMedGoogle Scholar
  33. Gaunt, G., and Ramin, K. (2001). Immunological tolerance of the human fetus. Am J Perinatol 18, 299–312.PubMedCrossRefGoogle Scholar
  34. Gennaro, S., and Fehder, W.P. (1996). Stress, immune function, and relationship to pregnancy outcome. Nurs Clin North Am 31, 293–303.PubMedGoogle Scholar
  35. Goodwin, T.M. (1999). A role for estriol in human labor, term and preterm. Am J Obstet Gynecol 180, S208-S213.PubMedCrossRefGoogle Scholar
  36. Hall, M., Vasko, R., Buysse, D., Ombao, H., Chen, Q., Cashmere, J.D. et al. (2004). Acute stress affects heart rate variability during sleep. Psychosom Med 66, 56–62.PubMedCrossRefGoogle Scholar
  37. Hanson, L.A. (2000). The mother-offspring dyad and the immune system. Acta Paediatr 89, 252–258.PubMedCrossRefGoogle Scholar
  38. Hartmann, E. (1966). Dreaming sleep (the D-state) and the menstrual cycle. J Nerv Ment Dis 143, 406–416.PubMedCrossRefGoogle Scholar
  39. Hedman, C., Pohjasvaara, T., Tolonen, U., Suhonen-Malm, A.S., and Myllyla, V.V. (2002). Effects of pregnancy on mothers' sleep. Sleep Med 3, 37–42.PubMedCrossRefGoogle Scholar
  40. Heiser, P., Dickhaus, B., Schreiber, W., Clement, H.W., Hasse, C., Hennig, J. et al. (2000). White blood cells and cortisol after sleep deprivation and recovery sleep in humans. Eur Arch Psychiatry Clin Neurosci 250, 16–23.PubMedCrossRefGoogle Scholar
  41. Hertz, G., Fast, A., Feinsilver, S.H., Albertario, C.L., Schulman, H., and Fein, A.M. (1992). Sleep in normal late pregnancy. Sleep 15, 246–251.PubMedGoogle Scholar
  42. Heuser, G., Kales, A., and Jacobson, A. (1968). Human sleep patterns after progesterone administration. Psychophysiology 4, 378.Google Scholar
  43. Hill, J.A. (2000) Cytokines in early pregnancy success and failure. In: J.A. Hill (Ed.), Cytokines in Human Reproduction. John Wiley and Sons, New York, pp. 161–169.Google Scholar
  44. Hill, J.A., Polgar, K., and Anderson, D.J. (1995). T-Helper 1-type immunity to trophoblast in women with recurrent spontaneous abortion. JAMA 273, 1933–1936.PubMedCrossRefGoogle Scholar
  45. Hong, S., Mills, P.J., Loredo, J.S., Adler, K.A., and Dimsdale, J.E. (2005). The association between interleukin-6, sleep, and demographic characteristics. Brain Behav Immun 19, 165–172.PubMedCrossRefGoogle Scholar
  46. Hunt, J.S. (2000) Cytokine networks in the human placenta. In: J.A.Hill (Ed.), Cytokines in Human Reproduction. John Wiley and Sons, New York, pp. 203–220.Google Scholar
  47. Inder, W.J., Prickett, T.C., Ellis, M.J., Hull, L., Reid, R., Benny, P.S. et al. (2001). The utility of plasma CRH as a predictor of preterm delivery. J Clin Endocrinol Metab 86, 5706–5710.PubMedCrossRefGoogle Scholar
  48. Irwin, M., Clark, C., Kennedy, B., Christian, G.J., and Ziegler, M. (2003). Nocturnal catecholamines and immune function in insomniacs, depressed patients, and control subjects. Brain Behav Immun 17, 365–372.PubMedCrossRefGoogle Scholar
  49. Irwin, M., Rinetti, G., Redwine, L., Motivala, S., Dang, J., and Ehlers, C. (2004). Nocturnal proinflammatory cytokine-associated sleep disturbances in abstinent African American alcoholics. Brain Behav Immun 18, 349–360.PubMedCrossRefGoogle Scholar
  50. Irwin, M., Thompson, J., Miller, C., Gillin, J.C., and Ziegler, M. (1999). Effects of sleep and sleep deprivation on catecholamine and interleukin- 2 levels in humans: Clinical implications. J Clin Endocrinol Metab 84, 1979–1985.PubMedCrossRefGoogle Scholar
  51. Izci, B., Martin, S.E., Dundas, K.C., Liston, W.A., Calder, A.A., and Douglas, N.J. (2005). Sleep complaints: Snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Med 6, 163–169.PubMedCrossRefGoogle Scholar
  52. Kaneita, Y., Ohida, T., Takemura, S., Sone, T., Suzuki, K., Miyake, T. et al. (2005). Relation of smoking and drinking to sleep disturbance among Japanese pregnant women. Prev Med 41, 877–882.PubMedCrossRefGoogle Scholar
  53. Karacan, I., Heine, M.W., and Agnew, H. (1968). Characteristics of sleep patterns during late pregnancy and the postpartum periods. Am J Obstet Gynecol 101, 579–586.Google Scholar
  54. Karacan, I., and Williams, R.L. (1970). The relationship of sleep disturbances to psychopathology. Int Psychiatry Clin 7, 93–111.PubMedGoogle Scholar
  55. Karacan, I., Williams, R.L., Hursch, C.J., McCaulley, M., and Heine, M.W. (1969). Some implications of the sleep patterns of pregnancy for postpartum emotional disturbances. Br J Psychiatry 115, 929–935.PubMedCrossRefGoogle Scholar
  56. Kimura, M., Zhang, S.Q., and Inoue, S. (1996). Pregnancy-associated sleep changes in the rat. Am J Physiol 271, R1063–R1069.PubMedGoogle Scholar
  57. Krueger, J.M., and Majde, J.A. (1995). Cytokines and sleep. Int Arch Allergy Immunol 106, 97–100.PubMedCrossRefGoogle Scholar
  58. Lange, T., Perras, B., Fehm, H.L., and Born, J. (2003). Sleep enhances the human antibody response to hepatitis A vaccination. Psychosom Med 65, 831–835.PubMedCrossRefGoogle Scholar
  59. Lee, K.A. (1992). Self-reported sleep disturbances in employed women. Sleep 15, 493–498.PubMedGoogle Scholar
  60. Lee, K.A. (2006) Sleep during pregnancy and postpartum. In: T. Lee-Chiong (Ed.), Encyclopedia of Sleep Medicine. John Wiley and Sons, New Yord, pp. 629–635.Google Scholar
  61. Lee, K.A., Zaffke, M.E., and McEnany, G. (2000). Parity and sleep patterns during and after pregnancy. Obstet Gynecol 95, 14–18.PubMedCrossRefGoogle Scholar
  62. Liu, J.H. (2004) Endocrinology of pregnancy. In: R.K. Creasey, R. Resnik, and J.D. Iams (Eds.), Maternal-Fetal Medicine: Principles and Practice. 5th Edn. W.B. Saunders, Philadelphia, pp. 121–134.Google Scholar
  63. Lockley, S.W., Skene, D.J., and Arendt, J. (1999). Comparison between subjective and actigraphic measurement of sleep and sleep rhythms. J Sleep Res 8, 175–183.PubMedCrossRefGoogle Scholar
  64. MacLean, M.A., Wilson, R., Jenkins, C., Miller, H., and Walker, J.J. (2002). Interleukin-2 receptor concentrations in pregnant women with a history of recurrent miscarriage. Hum Reprod 17, 219–220.PubMedCrossRefGoogle Scholar
  65. Manber, R., Colrain, I.M., and Lee, K. (2001) Sleep disorders. In: S.Kornstein and A. Clayton (Eds.), Women's Mental Health: A Comprehensive Textbook. Guilford Press, New York.Google Scholar
  66. Mauri, M. (1990). Sleep and the reproductive cycle: A review. Health Care Women Int 11, 409–421.PubMedCrossRefGoogle Scholar
  67. McGregor, J.A., Jackson, G.M., Lachelin, G.C., Goodwin, T.M., Artal, R., Hastings, C. et al. (1995). Salivary estriol as risk assessment for preterm labor: A prospective trial. Am J Obstet Gynecol 173, 1337–1342.PubMedCrossRefGoogle Scholar
  68. Mindell, J.A., and Jacobson, B.J. (2000). Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs 29, 590–597.PubMedCrossRefGoogle Scholar
  69. Moldofsky, H., Lue, F.A., Davidson, J.R., and Gorczynski, R. (1989). Effects of sleep deprivation on human immune functions. FASEB J 3, 1972–1977.PubMedGoogle Scholar
  70. Moldofsky, H., Lue, F.A., Shahal, B., Jiang, C.G., and Gorczynski, R.M. (1995). Diurnal sleep/wake-related immune functions during the menstrual cycle of healthy young women. J Sleep Res 4, 150–159.PubMedCrossRefGoogle Scholar
  71. Narahara, H., and Johnston, J.M. (1993). Smoking and preterm labor: Effect of a cigarette smoke extract on the secretion of platelet-activating factor-acetylhydrolase by human decidual macrophages. Am J Obstet Gynecol 169, 1321–1326.PubMedGoogle Scholar
  72. Nishina, H., Honda, K., Okai, T., Kozuma, S., Inoue, S., and Taketani, Y. (1996). Characteristic changes in sleep patterns during pregnancy in rats. Neurosci Lett 203, 5–8.PubMedCrossRefGoogle Scholar
  73. Okun, M.L., Giese, S., Lin, L., Einen, M., Mignot, E., and Coussons-Read, M.E. (2004). Exploring the cytokine and endocrine involvement in narcolepsy. Brain Behav Immun 18, 326–332.PubMedCrossRefGoogle Scholar
  74. Palmer, C.D., Harrison, G.A., and Hiorns, R.W. (1980). Association between smoking and drinking and sleep duration. Ann Hum Biol 7, 103–107.PubMedCrossRefGoogle Scholar
  75. Paulsen, V.M., and Shaver, J.L. (1991). Stress, support, psychological states and sleep. Soc Sci Med 32, 1237–1243.PubMedCrossRefGoogle Scholar
  76. Phillips, B.A., and Danner, F.J. (1995). Cigarette smoking and sleep disturbance. Arch Intern Med 155, 734–737.PubMedCrossRefGoogle Scholar
  77. Piccinni, M.P., Scaletti, C., Maggi, E., and Romagnani, S. (2000). Role of hormone-controlled Th1- and Th2-type cytokines in successful pregnancy. J Neuroimmunol 109, 30–33.PubMedCrossRefGoogle Scholar
  78. Porterfield, S.P. (2001) Endocrinology of pregnancy. In: W.Schmitt (Ed.), Endocrine Physiology (2nd Edn.). Mosby, St. Louis, pp. 201–225.Google Scholar
  79. Raghupathy, R. (2001). Pregnancy: Success and failure within the Th1/Th2/Th3 paradigm. Semin Immunol 13, 219–227.PubMedCrossRefGoogle Scholar
  80. Redline, S., Kirchner, H.L., Quan, S.F., Gottlieb, D.J., Kapur, V., and Newman, A. (2004). The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture. Arch Intern Med 164, 406–418.PubMedCrossRefGoogle Scholar
  81. Redwine, L., Dang, J., Hamano, N., and Irwin, M. (2003). Disordered sleep, nocturnal cytokines, and immunity in alcoholics. Psychosom Med 65, 75–85.PubMedCrossRefGoogle Scholar
  82. Redwine, L., Hauger, R.L., Gillin, J.C., and Irwin, M. (2000). Effects of sleep and sleep deprivation on interleukin-6, growth hormone, cortisol, and melatonin levels in humans. J Clin Endocrinol Metab 85, 3597–3603.PubMedCrossRefGoogle Scholar
  83. Reichert, J.A., Bloch, D.A., Cundiff, E., and Votteri, B.A. (2003). Comparison of the NovaSom QSG, a new sleep apnea home-diagnostic system, and polysomnography. Sleep Med 4, 213–218.PubMedCrossRefGoogle Scholar
  84. Roberts, J.M. (2004) Pregnancy-Related hypertension. In: R.K.Creasey and R. Resnik (Eds.), Maternal-Fetal Medicine (5th Edn.). Saunders, Philadelphia, pp. 859–899.Google Scholar
  85. Sacks, G.P., Studena, K., Sargent, K., and Redman, C.W. (1998). Normal pregnancy and preeclampsia both produce inflammatory changes in peripheral blood leukocytes akin to those of sepsis. Am J Obstet Gynecol 179, 80–86.PubMedCrossRefGoogle Scholar
  86. Saito, S., Sakai, M., Sasaki, Y., Tanebe, K., Tsuda, H., and Michimata, T. (1999). Quantitative analysis of peripheral blood Th0, Th1, Th2 and the Th1:Th2 cell ratio during normal human pregnancy and preeclampsia. Clin Exp Immunol 117, 550–555.PubMedCrossRefGoogle Scholar
  87. Saletu-Zyhlarz, G., Anderer, P., Gruber, G., Mandl, M., Gruber, D., Metka, M. et al. (2003). Insomnia related to postmenopausal syndrome and hormone replacement therapy: Sleep laboratory studies on baseline differences between patients and controls and double-blind, placebo-controlled investigations on the effects of a novel estrogen-progestogen combination (Climodien, Lafamme) versus estrogen alone. J Sleep Res 12, 239–254.PubMedCrossRefGoogle Scholar
  88. Santiago, J.R., Nolledo, M.S., Kinzler, W., and Santiago, T.V. (2001). Sleep and sleep disorders in pregnancy. Ann Intern Med 134, 396–408.PubMedGoogle Scholar
  89. Sateia, M.J., Doghramji, K., Hauri, P.J., and Morin, C.M. (2000). Evaluation of chronic insomnia. An American Academy of Sleep Medicine review. Sleep 23, 243–308.PubMedGoogle Scholar
  90. Schorr, S.J., Chawla, A., Devidas, M., Sullivan, C.A., Naef, R.W., and Morrison, J.C. (1998). Sleep patterns in pregnancy: A longitudinal study of polysomnography recordings during pregnancy. J Perinatol 18, 427–430.PubMedGoogle Scholar
  91. Schweiger, M.S. (1972). Sleep disturbance in pregnancy. A subjective survey. Am J Obstet Gynecol 114, 879–882.PubMedGoogle Scholar
  92. Sekine, M., Chandola, T., Martikainen, P., Marmot, M., and Kagamimori, S. (2006). Work and family characteristics as determinants of socioeconomic and sex inequalities in sleep: The Japanese Civil Servants Study. Sleep 29, 206–216.PubMedGoogle Scholar
  93. Shinkoda, H., Matsumoto, K., and Park, Y.M. (1999). Changes in sleep-wake cycle during the period from late pregnancy to puerperium identified through the wrist actigraph and sleep logs. Psychiatry Clin Neurosci 53, 133–135.PubMedCrossRefGoogle Scholar
  94. Siler-Khodr, T.M., Forthman, G., Khodr, C., Matyszczyk, S., Khodr, Z., and Khodr, G. (2003). Maternal serum corticotropin-releasing hormone at midgestation in Hispanic and white women. Obstet Gynecol 101, 557–564.PubMedCrossRefGoogle Scholar
  95. Silver, R.M., Peltier, M.R., and Branch, D.W. (2004) The immunology of pregnancy. In: R.K.Creasey and R. Resnik (Eds.), Maternal-Fetal Medicine: Principles and Practices (5th Edn.). Saunders, Philadelphia, pp. 89–109.Google Scholar
  96. Simhan, H.N., Caritis, S.N., Hillier, S.L., and Krohn, M.A. (2005). Cervical anti-inflammatory cytokine concentrations among first-trimester pregnant smokers. Am J Obstet Gynecol 193, 1999–2003.PubMedCrossRefGoogle Scholar
  97. Spiegel, K., Sheridan, J.F., and Van Cauter, E. (2002). Effect of sleep deprivation on response to immunization. JAMA 288, 1471–1472.PubMedCrossRefGoogle Scholar
  98. Stenuit, P., and Kerkhofs, M. (2005). Age modulates the effects of sleep restriction in women. Sleep 28, 1283–1288.PubMedGoogle Scholar
  99. Stepnowsky, C.J., Jr., Moore, P.J., and Dimsdale, J.E. (2003). Effect of ethnicity on sleep: Complexities for epidemiologic research. Sleep 26, 329–332.PubMedGoogle Scholar
  100. Stinson, J.C., and Lee, K.A. (2003). Premature labor and birth: Influence of rank and perception of fatigue in active duty military women. Mil Med 168, 385–390.PubMedGoogle Scholar
  101. Suzuki, S., Dennerstein, L., Greenwood, K.M., Armstrong, S.M., and Satohisa, E. (1994). Sleeping patterns during pregnancy in Japanese women. J Psychosom Obstet Gynaecol 15, 19–26.PubMedGoogle Scholar
  102. Taylor, R.N., Lebovic, D.I., and Martin-Cadieux, M.C. (2001) Endocriniology of pregnancy. In: F.S.Greenspan and D.G. Gardner (Eds.), Basic and Clinical Endocrinology (6th Edn.). Lange Medical Books/McGraw-Hill, New York, pp. 575–604.Google Scholar
  103. Torchinsky, A., Shepshelovich, J., Orenstein, H., Zaslavsky, Z., Savion, S., Carp, H. et al. (2003). TNF-alpha protects embryos exposed to developmental toxicants. Am J Reprod Immunol 49, 159–168.PubMedCrossRefGoogle Scholar
  104. Tworoger, S.S., Davis, S., Vitiello, M.V., Lentz, M.J., and McTiernan, A. (2005). Factors associated with objective (actigraphic) and subjective sleep quality in young adult women. J Psychosom Res 59, 11–19.PubMedCrossRefGoogle Scholar
  105. Uthgenannt, D., Schoolmann, D., Pietrowsky, R., Fehm, H.L., and Born, J. (1995). Effects of sleep on the production of cytokines in humans. Psychosom Med 57, 97–104.PubMedGoogle Scholar
  106. Vgontzas, A.N., Papanicolaou, D.A., Bixler, E.O., Kales, A., Tyson, K., and Chrousos, G.P. (1997). Elevation of plasma cytokines in disorders of excessive daytime sleepiness: Role of sleep disturbance and obesity. J Clin Endocrinol Metab 82, 1313–1316.PubMedCrossRefGoogle Scholar
  107. Vgontzas, A.N., Zoumakis, E., Bixler, E.O., Lin, H.M., Follett, H., Kales, A. et al. (2004). Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab 89, 2119–2126.PubMedCrossRefGoogle Scholar
  108. Vgontzas, A.N., Zoumakis, M., Papanicolaou, D.A., Bixler, E.O., Prolo, P., Lin, H.M. et al. (2002). Chronic insomnia is associated with a shift of interleukin-6 and tumor necrosis factor secretion from nighttime to daytime. Metabolism 51, 887–892.PubMedCrossRefGoogle Scholar
  109. Wadhwa, P.D., Culhane, J.F., Rauh, V., and Barve, S.S. (2001). Stress and preterm birth: Neuroendocrine, immune/inflammatory, and vascular mechanisms. Matern Child Health J 5, 119–125.PubMedCrossRefGoogle Scholar
  110. Wadhwa, P.D., Sandman, C.A., Chicz-DeMet, A., and Porto, M. (1997). Placental CRH modulates maternal pituitary adrenal function in human pregnancy. Ann N Y Acad Sci 814, 276–281.PubMedCrossRefGoogle Scholar
  111. Wolfson, A.R., Crowley, S.J., Anwer, U., and Bassett, J.L. (2003). Changes in sleep patterns and depressive symptoms in first-time mothers: Last trimester to 1-year postpartum. Behav Sleep Med 1, 54–67.PubMedCrossRefGoogle Scholar
  112. Wood, G.W. (1997) Cytokines in Reproduction: Molecular Mechanism of Fetal Allograft Survival. Chapman and Hill, New York.Google Scholar
  113. Yinon, D., Lowenstein, L., Suraya, S., Beloosesky, R., Zmora, O., Malhotra, A. et al. (2006). Pre-eclampsia is associated with sleep-disordered breathing and endothelial dysfunction. Eur Respir J 27, 328–333.PubMedCrossRefGoogle Scholar

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  • Michele L. Okun
  • Mary E. Coussons-Read

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