Sleep Disturbances and Their Relationship to Glucose Tolerance in Pregnancy

• Published in: Diabetes care Vol. 34; no. 11; pp. 2454 - 2457
• Main Authors: Reutrakul, Sirimon, Zaidi, Nausheen, Wroblewski, Kristen, Kay, Helen H, Ismail, Mahmoud, Ehrmann, David A, Van Cauter, Eve
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.11.2011
• Subjects: Adult; Biological and medical sciences; Blood Glucose; Blood Glucose - metabolism; body mass index; breathing; Case-Control Studies; complications; Data collection; Dextrose; Diabetes; Diabetes, Gestational; Diabetes, Gestational - epidemiology; Diabetes, Gestational - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; epidemiology; Family medical history; Female; gestational diabetes; Glucose; Glucose Intolerance; glucose tolerance; Glucose Tolerance Test; Glucose tolerance tests; Humans; Hypertension; Logistic Models; Medical sciences; Metabolic diseases; metabolism; Miscellaneous; mothers; odds ratio; Original Research; physiopathology; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second; Pregnant women; Public health. Hygiene; Public health. Hygiene-occupational medicine; Questionnaires; risk; Risk Factors; Shift work; sleep; Sleep disorders; Sleep Wake Disorders; Sleep Wake Disorders - complications; Surveys and Questionnaires; Time Factors; Womens health; Young Adult; Illinois; Pregnancy; Human; Nervous system diseases; Nutrition; Tolerance; Sleep disorder; Female; Metabolic diseases; Glucose; Neurological disorder; Woman; Endocrinology
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc11-0780

OBJECTIVE: To explore relationships among sleep disturbances, glucose tolerance, and pregnancy outcomes. RESEARCH DESIGN AND METHODS: Four validated sleep questionnaires were administered to 169 pregnant women at the time of 50-g oral glucose tolerance testing (OGTT) during the second trimester. Pregnancy outcomes were analyzed in 108 women with normal glucose tolerance (NGT). RESULTS: Of the participants, 41% had excessive daytime sleepiness (Epworth Sleepiness Scale [ESS] >8); 64% had poor sleep quality; 25% snored frequently; 29% had increased risk of sleep-disordered breathing (SDB); 52% experienced short sleep (SS); 19% had both increased SDB risk and SS (SDB/SS); and 14% had daytime dysfunction. Reported sleep duration inversely correlated with glucose values from 50-g OGTT (r = –0.21, P < 0.01). Each hour of reduced sleep time was associated with a 4% increase in glucose levels. Increased likelihood of gestational diabetes mellitus (GDM) was found in subjects with increased SDB risk (odds ratio 3.0 [95% CI 1.2–7.4]), SS (2.4 [1.0–5.9]), SDB/SS (3.4 [1.3–8.7]), and frequent snoring (3.4 [1.3–8.8], after adjustment for BMI). Among NGT subjects, preterm delivery was more frequent in those with increased ESS (P = 0.02), poor sleep quality (P = 0.02), and SS (P = 0.03). Neonatal intensive care unit admissions were associated with increased ESS (P = 0.03), SDB/SS (P = 0.03), and daytime dysfunction (P < 0.01) in mothers. CONCLUSIONS: Pregnant women experience significant sleep disturbances that are associated with increased risk of GDM and unfavorable pregnancy outcomes. Pregnant women with increased SDB risk, frequent snoring, and sleep duration of <7 h/night have increased risk of developing GDM.