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Gestational Diabetes Risk in Relation to Sleep Duration and Snoring during Pregnancy

Findings suggest associations of short sleep duration and snoring with glucose intolerance and GDM…. 

Insufficient sleep and poor sleep quality, considered endemic in modern society, are associated with obesity, impaired glucose tolerance and diabetes. Little, however, is known about the consequences of insufficient sleep and poor sleep quality during pregnancy on glucose tolerance and gestational diabetes.

A cohort of 1,290 women was interviewed during early pregnancy. They collected information about sleep duration and snoring during early pregnancy. Results from screening and diagnostic testing for gestational diabetes mellitus (GDM) were abstracted from medical records.

Generalized linear models were fitted to derive relative risk (RR) and 95% confidence intervals (95% CIs) of GDM associated with sleep duration and snoring, respectively.

Overall, snoring was associated with a 1.86-fold increased risk of GDM (RR = 1.86; 95% CI 0.88–3.94). The risk of GDM was particularly elevated among overweight women who snored. Compared with lean women who did not snore, those who were overweight and snored had a 6.9-fold increased risk of GDM (95% CI). Using sleep duration and snoring information, provided in early pregnancy, researchers were able to detect associations between sleep characteristics and maternal plasma 1-hour glucose concentrations after a 50-gram oral glucose challenge screening test later in pregnancy. Curvilinear relations were observed across nocturnal sleep duration categories. Additionally, glucose concentrations were statistically significantly elevated among women who snored during pregnancy; and the relative risk of GDM among overweight women who snored, compared to their non-snoring and lean counterparts was 6.91 (95% CI 2.87–16.6). Collectively, the findings from this pilot study provides evidence consistent with the notion that glucose homeostasis in pregnancy is sensitive to maternal habitual short sleep duration and snoring during pregnancy. “To our knowledge, this is the first examination of the relation between plasma glucose concentrations, GDM risk and sleep parameters (i.e., snoring and habitual sleep duration) during pregnancy,” researchers commented.

These preliminary findings suggest associations of short sleep duration and snoring with glucose intolerance and GDM. Though consistent with studies of men and non-pregnant women, larger prospective studies that include objective measures of sleep duration, sleep quality, and sleep apnea during pregnancy are needed to confirm these findings. Enhanced knowledge of possible metabolic consequences of sleep disturbances in pregnancy will likely have important clinical implications in the prevention and treatment of impaired glucose tolerance and GDM among pregnant women.

BMC Women’s Health. 2010;10(17)