Poor Sleep Quality, Short Duration May Increase Risk of Gestational Diabetes

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Addressing problems with sleep health may help prevent gestational diabetes.
Addressing problems with sleep health may help prevent gestational diabetes.

Poor sleep quality or an insufficient amount of sleep during pregnancy may increase the risk of developing gestational diabetes, according to findings published in Sleep.1

Insufficient sleep has been shown to disrupt glucose metabolism2 and be linked to prediabetes3 and type 2 diabetes mellitus.4 As gestational diabetes is also a risk factor for type 2 diabetes, Shirong Cai, PhD, of the National University of Singapore, and colleagues sought to examine the effects of sleep quality and duration on the development of gestational diabetes.

The study included 686 women of Asian descent with a singleton pregnancy. The participants self-reported sleep quality and sleep duration using the Pittsburgh Sleep Quality Index (PSQI) during a clinic visit at 26-weeks to 28-weeks gestation. Gestational diabetes was determined through a 75-g oral glucose tolerance test (OGTT) following an 8-hour to 10-hour fasting period. Poor sleep quality was defined as a PSQI score ˃5, and short sleep duration was defined as <6 hours. Gestational diabetes was defined as ≥7.0 mmol/L (126 mg/dL) for fasting glucose and/or ≥7.8 mmol/L (140 mg/dL) for 2-hour OGTT glucose based on 1999 World Health Organization criteria.5

Ultimately, 296 women (43.1%) reported poor sleep quality (PSQI lower than 5) and 77 reported short sleep duration (<6 hours). Approximately 19% of participants (131 women) were diagnosed with gestational diabetes. Women with gestational diabetes were older (32.1 vs 30.3 years), had a higher body mass index at <14 weeks of pregnancy (24.6 vs 23.6), and had lower anxiety (State-Trait Anxiety Inventory score) scores (66.5 vs 70.6) compared with women who did not develop gestational diabetes.

In multivariate analysis, women who reported poor sleep quality or reported sleeping <6 hours per night had a greater risk of developing gestational diabetes than women who reported better sleep quality or longer sleep duration (adjusted odds ratio [OR]= 1.75; 95% CI, 1.11-2.76; adjusted OR = 1.96, 95% CI, 1.05 to 3.66).

Overall, the study findings suggest that early screening and intervention for sleep problems in women who are pregnant may help reduce the risk of developing gestational diabetes, as well as related adverse effects on maternal and fetal health. Future research should explore the “pathways by which sleep disturbances in pregnancy contribute to hyperglycemia and other adverse maternal health outcomes,” the investigators wrote.

References

  1. Cai S, Tan S, Gluckman PD, et al. Sleep quality and nocturnal sleep duration in pregnancy and risk of gestational diabetes mellitus [published online December 9, 2016]. Sleep. doi: 10.1093/sleep/zsw058
  2. Knutson KL, Ryden AM, Mander BA, Van cauter E. Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med. 2006;166(16):1768-1774.
  3. Engeda J, Mezuk B, Ratliff S, Ning Y. Association between duration and quality of sleep and the risk of pre-diabetes: evidence from NHANES. Diabet Med. 2013;30(6):676-680.
  4. Kita T, Yoshioka E, Satoh H, et al. Short sleep duration and poor sleep quality increase the risk of diabetes in Japanese workers with no family history of diabetes. Diabetes Care. 2012;35(2):313-318.
  5. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539-53.
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