Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study.
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.
Qiu
Chunfang
C
Center for Perinatal Studies, Swedish Medical Center, Seattle, Washington, USA. Chun-fang.Qiu@Swedish.org
Enquobahrie
Daniel
D
Frederick
Ihunnaya O
IO
Abetew
Dejene
D
Williams
Michelle A
MA
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
Sleep. 2004 May 1;27(3):440-4
15164896
J Appl Physiol (1985). 2004 Feb;96(2):754-61
14555683
Diabetes Care. 2004 Jan;27 Suppl 1:S88-90
14693936
Am J Respir Crit Care Med. 2004 Jun 1;169(11):1231-7
15044204
Arch Intern Med. 2003 Jan 27;163(2):205-9
12546611
Semin Immunopathol. 2009 Jun;31(1):113-25
19404644
Prog Cardiovasc Dis. 2009 Mar-Apr;51(5):434-51
19249449
Chest. 2008 Feb;133(2):496-506
18252916
Sleep. 2009 Apr;32(4):447-70
19413140
J Clin Endocrinol Metab. 2009 Dec;94(12):4801-9
19850688
Int J Epidemiol. 1993 Jun;22(3):439-44
8359959
J Clin Endocrinol Metab. 2009 Dec;94(12):5169-73
19837925
Sleep Med. 2002 Jan;3(1):37-42
14592252
Diabetologia. 2007 Nov;50(11):2298-304
17717644
J Cardiometab Syndr. 2006 Summer;1(3):204-8
17679802
Paediatr Perinat Epidemiol. 2004 Sep;18(5):377-84
15367325
Diabetologia. 2005 Feb;48(2):235-41
15645205
Ann N Y Acad Sci. 2008;1129:287-304
18591489
Diabetes Care. 2006 Mar;29(3):657-61
16505522
Reprod Sci. 2007 Sep;14(6):560-7
17959884
J Appl Physiol (1985). 2005 Nov;99(5):2008-19
16227462
J Intern Med. 2001 Feb;249(2):153-61
11240844
J Clin Sleep Med. 2007 Aug 15;3(5):467-72
17803009
J Am Coll Cardiol. 2004 Feb 18;43(4):678-83
14975482
Lancet. 1999 Oct 23;354(9188):1435-9
10543671
J Physiol. 2003 Oct 1;552(Pt 1):253-64
12878760
Diabetes Care. 2003 Feb;26(2):380-4
12547866
Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):566-70
10934088
Sleep. 2007 Dec;30(12):1667-73
18246976
J Reprod Immunol. 2007 Apr;73(2):158-165
17074396
J Clin Endocrinol Metab. 2004 Nov;89(11):5762-71
15531540
J Intern Med. 2003 Jul;254(1):32-44
12823641
Diabetes Care. 2003 Mar;26(3):702-9
12610025
Eur Respir J. 2009 Jul;34(1):243-60
19567607
Diabetes Care. 2005 Nov;28(11):2762-7
16249553
Respir Med. 2007 Jun;101(6):1283-90
17127049
Chest. 1993 Apr;103(4):1147-51
8131455
Chest. 1995 Jul;108(1):138-42
7606948
Am J Respir Crit Care Med. 2002 Mar 1;165(5):670-6
11874812
Epidemiology. 2008 Nov;19(6):838-45
18854708
Sleep. 2004 Nov 1;27(7):1405-17
15586794
J Clin Endocrinol Metab. 2007 Aug;92(8):3044-51
17519315
Chest. 1991 Mar;99(3):600-8
1995215
Am J Epidemiol. 2002 Mar 1;155(5):387-93
11867347
Am J Respir Crit Care Med. 2007 Apr 15;175(8):851-7
17272786
J Clin Hypertens (Greenwich). 2008 Jul;10(7):549-55
18607146