{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:03:55Z","timestamp":1784073835151,"version":"3.55.0"},"reference-count":46,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72204117"],"award-info":[{"award-number":["72204117"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["West J Nurs Res"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Insomnia is highly prevalent during pregnancy, but the role of modifiable cognitive and behavioral factors remains understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We aimed to investigate factors associated with insomnia symptoms in pregnant women, with a focus on sleep-related psychological and behavioral factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted among 545 pregnant women recruited from 2 tertiary hospitals in Eastern China (December 2023-March 2024). Participants completed self-reported questionnaires assessing insomnia severity, pregnancy-related rumination, physical discomfort, anxiety symptoms, depressive symptoms, presleep arousal, dysfunctional sleep-related cognitions, maladaptive sleep habits, and demographic information. Univariable and binary logistic regression were used to identify factors associated with insomnia symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among the 545 participants (mean age\u2009=\u200929.1\u2009years), 27.0% reported insomnia symptoms. In the regression model, insomnia was significantly associated with prepregnancy insomnia symptoms (OR\u2009=\u20092.82; 95% CI, 1.69-4.70;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), increased physical discomfort (OR\u2009=\u20091.05; 95% CI, 1.01-1.09;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.012), higher presleep arousal (OR\u2009=\u20091.13; 95% CI, 1.07-1.20;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), dysfunctional sleep-related cognitions (OR\u2009=\u20090.95; 95% CI, 0.92-0.98;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and maladaptive sleep habits (OR\u2009=\u20091.03; 95% CI, 1.01-1.05;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Insomnia during pregnancy is associated with prepregnancy insomnia, physical discomfort, and key modifiable perpetuating factors including presleep arousal, dysfunctional sleep-related cognitions, and maladaptive sleep behaviors. Interventions targeting these modifiable factors are needed to improve insomnia symptoms in pregnant women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01939459261451229","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T10:55:10Z","timestamp":1781088910000},"page":"876-886","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dysfunctional Sleep-Related Cognitions and Maladaptive Behaviors Perpetuating Insomnia During Pregnancy: A Cross-Sectional Study"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-9054","authenticated-orcid":false,"given":"Xingchen","family":"Shang","sequence":"first","affiliation":[{"name":"School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, China"},{"name":"School of Nursing, Faculty of Medicine, Yangzhou University, 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