Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia.
OBJECTIVE
Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes.


METHODS
This is a case-control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed.


RESULTS
Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT < 135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT ≥ 135) had habitual snoring (p < 0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50-5.41; p = 0.001) and total nap duration (OR 1.48; 95 % CI 0.96-2.28; p = 0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44-8.32; p = 0.005) and nap duration (OR 1.64; 95 % CI 1.00-2.681.02; p = 0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83-1.28; p = 0.77).


CONCLUSIONS
Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes.
Centre for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA. Bilgay.Izci-Balserak@uphs.upenn.edu
Bilgay
B
Izci Balserak
Nicholas
N
Jackson
Sarah A
SA
Ratcliffe
Allan I
AI
Pack
Grace W
GW
Pien
D000328:Adult; D016022:Case-Control Studies; D002940:Circadian Rhythm; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis*; D017286:Polysomnography; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D055815:Young Adult