title: Sleep disturbances and their relationship to glucose tolerance in pregnancy.
abstract: OBJECTIVE
  To explore relationships among sleep disturbances, glucose tolerance, and pregnancy outcomes.
  
  
  METHODS
  Four validated sleep questionnaires were administered to 169 pregnant women at the time of 50-g oral glucose tolerance testing (OGTT) during the second trimester. Pregnancy outcomes were analyzed in 108 women with normal glucose tolerance (NGT).
  
  
  RESULTS
  Of the participants, 41% had excessive daytime sleepiness (Epworth Sleepiness Scale [ESS] >8); 64% had poor sleep quality; 25% snored frequently; 29% had increased risk of sleep-disordered breathing (SDB); 52% experienced short sleep (SS); 19% had both increased SDB risk and SS (SDB/SS); and 14% had daytime dysfunction. Reported sleep duration inversely correlated with glucose values from 50-g OGTT (r = -0.21, P < 0.01). Each hour of reduced sleep time was associated with a 4% increase in glucose levels. Increased likelihood of gestational diabetes mellitus (GDM) was found in subjects with increased SDB risk (odds ratio 3.0 [95% CI 1.2-7.4]), SS (2.4 [1.0-5.9]), SDB/SS (3.4 [1.3-8.7]), and frequent snoring (3.4 [1.3-8.8], after adjustment for BMI). Among NGT subjects, preterm delivery was more frequent in those with increased ESS (P = 0.02), poor sleep quality (P = 0.02), and SS (P = 0.03). Neonatal intensive care unit admissions were associated with increased ESS (P = 0.03), SDB/SS (P = 0.03), and daytime dysfunction (P < 0.01) in mothers.
  
  
  CONCLUSIONS
  Pregnant women experience significant sleep disturbances that are associated with increased risk of GDM and unfavorable pregnancy outcomes. Pregnant women with increased SDB risk, frequent snoring, and sleep duration of <7 h/night have increased risk of developing GDM.
authors.affiliation: Section of Adult and Pediatric Endocrinology, Diabetes, andMetabolism, Department of Medicine, University of Chicago, Chicago, Illinois, USA. sirimon_reutrakul@rush.edu
authors.forename: Sirimon
authors.initials: S
authors.lastname: Reutrakul
authors.forename: Nausheen
authors.initials: N
authors.lastname: Zaidi
authors.forename: Kristen
authors.initials: K
authors.lastname: Wroblewski
authors.forename: Helen H
authors.initials: HH
authors.lastname: Kay
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Ismail
authors.forename: David A
authors.initials: DA
authors.lastname: Ehrmann
authors.forename: Eve
authors.initials: E
authors.lastname: Van Cauter
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D018149:Glucose Intolerance; D005951:Glucose Tolerance Test; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose