title: Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A cohort of 1,290 women was interviewed during early pregnancy. We 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.
  
  
  RESULTS
  After adjusting for maternal age and race/ethnicity, GDM risk was increased among women sleeping < or = 4 hours compared with those sleeping 9 hours per night (RR = 5.56; 95% CI 1.31-23.69). The corresponding RR for lean women (<25 kg/m2) was 3.23 (95% CI 0.34-30.41) and 9.83 (95% CI 1.12-86.32) for overweight women (> or = 25 kg/m2). 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 2.87-16.6).
  
  
  CONCLUSIONS
  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 studies that include objective measures of sleep duration, quality and apnea are needed to obtain more precise estimates of observed associations.
authors.affiliation: Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, USA. Chun-fang.Qiu@Swedish.org
authors.forename: Chunfang
authors.initials: C
authors.lastname: Qiu
authors.forename: Daniel
authors.initials: D
authors.lastname: Enquobahrie
authors.forename: Ihunnaya O
authors.initials: IO
authors.lastname: Frederick
authors.forename: Dejene
authors.initials: D
authors.lastname: Abetew
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000378:metabolism*; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D010865:Pilot Projects; D011247:Pregnancy; D012307:Risk Factors; D012892:Sleep Deprivation / Q000378:metabolism*; D012913:Snoring / Q000378:metabolism*; D013997:Time Factors
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