Sleep and Breathing

, Volume 17, Issue 3, pp 1093–1102 | Cite as

Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia

  • Bilgay Izci Balserak
  • Nicholas Jackson
  • Sarah A. Ratcliffe
  • Allan I. Pack
  • Grace W. Pien
Original Article



Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes.


This is a case–control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed.


Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT < 135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT ≥ 135) had habitual snoring (p < 0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50–5.41; p = 0.001) and total nap duration (OR 1.48; 95 % CI 0.96–2.28; p = 0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44–8.32; p = 0.005) and nap duration (OR 1.64; 95 % CI 1.00–2.681.02; p = 0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83–1.28; p = 0.77).


Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes.


Apnea symptom score Gestational diabetes Glucose dysregulation Sleep duration Snoring Hyperglycemia 



This study was supported by grants from the National Institutes of Health (T32 HL07713 and 5K23HD041465).

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Bilgay Izci Balserak
    • 1
    • 5
  • Nicholas Jackson
    • 1
  • Sarah A. Ratcliffe
    • 3
  • Allan I. Pack
    • 1
    • 2
  • Grace W. Pien
    • 1
    • 2
    • 4
  1. 1.Centre for Sleep and Circadian NeurobiologyUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  2. 2.Sleep Medicine Division, Department of MedicineUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  3. 3.Centre for Clinical Epidemiology and BiostatisticsUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  4. 4.Pulmonary, Allergy and Critical Care Division, Department of MedicineUniversity of Pennsylvania School of MedicinePhiladelphiaUSA
  5. 5.Department of Biobehavioral Health SciencesUniversity of Pennsylvania School of NursingPhiladelphiaUSA

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