Browsing by Author "Imran, Haleemah"

Background and aims: Caffeine is a widely known psychoactive compound with pharmacological effects including mild central nervous system stimulation, wakefulness, and decreased reaction time. The average caffeine consumption in Finnish adults is more than 400 mg per day. However, the Nordic Nutrition Recommendations (NNR) 2023 and EFSA have set the limit for pregnant women at 200 mg of caffeine per day. Feeling fatigued in the morning results in increased caffeine consumption, which is followed by sleep impairment, which may be referred to as a “coffee cycle. Increased caffeine consumption is known to cause adverse birth outcomes. Therefore, the aim was to examine the association of caffeine intake during pregnancy with maternal sleep and fatigue. Methods: This study used the baseline data from the Finnish Institute for Health and Welfare (THL) CHILD-SLEEP study (2011-2013), which was conducted in the Pirkanmaa Hospital District, Finland. 1667 women in the 32nd week of their pregnancy were included in the study. Sleep parameters were measured using the Basic Nordic Sleep Questionnaire (BNSQ), tiredness was measured using the Epworth Sleepiness Scale (ESS) and caffeine consumption was measured using a food frequency questionnaire (FFQ). Logistic regression models were used to examine the association of sleep variables with caffeine consumption and the Chi Square test was carried out to see the prevalence of sleep problems in the low and high caffeine consumption groups. Results: Sleep latency > 20 min was reported by 22.1% of the women and poor sleep quality by 27.2%. Only 4.5%, 9.7%, and 4.6% of the women reported sleep times less than 6 hours, insomnia score >4, and severe daytime somnolence (ESS>11), respectively. 67.3% women kept their caffeine consumption within the 200 mg per day recommendations while 32.7% reported higher caffeine consumption. When the 200 mg caffeine cut-off was used, a statistically significant association between high caffeine intake and better sleep quality was seen (AOR 0.75, 95% CI: 0.57-0.99, p-value= 0.039). When a more stringent cut-off of 257.65 mg was used, there was a significant association (OR 1.61, 95% CI: 1.00-2.59, p-value= 0.046) between high caffeine intake and higher insomnia score (≥ 4). Conclusions: Poor sleep quality, less duration of sleep, insomnia, and fatigue were quite prevalent. Additionally, increased caffeine consumption may lead to more insomnia and daytime tiredness. This shows that the recommendations set by NNR 2023 and EFSA are quite beneficial, as higher caffeine consumption not only adversely affects sleep and tiredness but also results in negative birth outcomes. Therefore, it may be beneficial to study sleep quality during pregnancy and the factors that may affect it, to establish causal relationships and formulate specific healthcare guidelines.