# The impact of a digital self-care intervention based on mHealth on reducing sleep disorders during pregnancy: a quasi-experimental controlled study

## TL;DR

A mobile health intervention based on traditional medicine improved sleep quality and health literacy in pregnant women in Iran.

## Contribution

A culturally tailored mHealth program integrating traditional Iranian practices for sleep and maternal health.

## Key findings

- The intervention group showed significant improvement in sleep quality compared to the control group.
- Maternal health literacy increased significantly in the intervention group.
- The program was effective in a low-resource setting, offering an affordable solution for pregnant women.

## Abstract

Sleep disorders affect up to 80% of pregnant women, leading to risks such as preeclampsia and preterm birth, especially in low- and middle-income countries such as Iran. Mobile health (mHealth) digital self-care interventions can provide accessible solutions; however, few incorporate traditional medicine. This study assessed the effectiveness of a digital self-care intervention utilizing mobile health (mHealth) to enhance sleep quality and improve health literacy in pregnant women.

This quasi-experimental controlled trial was conducted from April to August 2025 in Qom, Iran, and involved 72 pregnant women from a community health center. Participants were randomly assigned to either the intervention (n = 36) or control (n = 36) groups.

The intervention included twice-weekly digital sessions via messaging apps (Eita and Telegram), focusing on six areas of Iranian traditional medicine for pregnancy: nutrition, mental health, physical activity, sleep, environmental factors, and bodily substance retention. The sessions featured audio files, videos, pamphlets, reminders, and question-and-answer sessions over three months.

Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and health literacy was assessed using the Maternal Health Literacy Questionnaire at baseline and three months post-intervention. Data analysis was performed using SPSS version 26 with t-tests and chi-square tests (p<0.05).

Baseline demographics and outcomes were comparable between the groups (p>0.05). Post-intervention, the intervention group's global PSQI score improved significantly from 7.22±3.29 to 4.41±2.75 (p < 0.001), indicating better sleep quality, whereas the control group’s score worsened from 6.58±3.02 to 7.11±3.45 (p=0.32). Improvements were observed in most PSQI subscales in the intervention group. Maternal health literacy increased from 59.94±8.23 to 68.16±4.76 in the intervention group (p < 0.001) compared to a minor increase from 61.38±5.89 to 63.89±4.69 in controls (p=0.02). The between-group differences were significant for all improved outcomes (p<0.05).

This culturally tailored mHealth intervention can improve sleep quality and health literacy in pregnant women by integrating traditional Iranian practices with digital tools. It offers an affordable model for pregnant women to enhance their maternal well-being.