Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia
- 437 Downloads
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.
KeywordsApnea 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.
- 13.Izci-Balserak B (2008) Sleep-disordered breathing in pregnancy. Int J Sleep Wakefulness 1(3):98–108Google Scholar
- 16.Izci-Balserak B, Lee KA (2010) Sleep disturbances and sleep-related disorders in pregnancy. In: Kryger M, Roth T, Dement W (eds) Principles and practice of sleep medicine, vol 5th. Saunders, Philadelphia, pp 1572–1586Google Scholar
- 19.Cai XH, Xie YP, Li XC, Qu WL, Li T, Wang HX, Lv JQ, Wang LX (2012) The prevalence and associated risk factors of sleep disorder-related symptoms in pregnant women in China. Sleep Breath. doi: 10.1007/s11325-012-0783-2
- 20.Frederick IO, Qiu C, Sorensen TK, Enquobahrie DA, Williams MA (2013) The prevalence and correlates of habitual snoring during pregnancy. Sleep Breath. doi: 10.1007/s11325-012-0717-z
- 27.Moore RT (2004) Diabetes in pregnancy. In: Creasy RK, Resnik R, Lams JD (eds) Maternal-fetal medicine: principles and practice, 5th edn. W. B. Saunders, Philadelphia, pp 1023–1062Google Scholar
- 31.Metzger BE, Buchanan TA, Coustan DR, de Leiva A, Dunger DB, Hadden DR, Hod M, Kitzmiller JL, Kjos SL, Oats JN, Pettitt DJ, Sacks DA, Zoupas C (2007) Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care 30(Suppl 2):S251–S260PubMedCrossRefGoogle Scholar
- 35.Jomeen J, Martin CR (2007) Assessment and relationship of sleep quality to depression in early pregnancy. J Psychosom Res 25:87–99Google Scholar