title: Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus.
abstract: To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population.
  
  
  
  A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score).
  
  
  
  In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66).
  
  
  
  During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM.
authors.affiliation: Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.
authors.forename: Shirong
authors.initials: S
authors.lastname: Cai
authors.affiliation: Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore.
authors.forename: Sara
authors.initials: S
authors.lastname: Tan
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.|Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Gluckman
authors.affiliation: MRC Lifecourse Epidemiology Unit & NIHR Southampton Biomedical Research Centre, University of Southampton & University Hospital Southampton NHS Foundation Trust Southampton, England.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Godfrey
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
authors.affiliation: Department of Pediatrics, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Oon Hoe
authors.initials: OH
authors.lastname: Teoh
authors.affiliation: Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore.|Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
authors.forename: Yap-Seng
authors.initials: YS
authors.lastname: Chong
authors.affiliation: Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Canada.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Meaney
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University Faculty of Medicine, Montreal, Canada.|Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Canada.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kramer
authors.affiliation: Program in Neuroscience and Behavioral Disorders, Duke-NUS Medical School, Singapore, Singapore.|Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Gooley
mesh_terms: D000328:Adult; D044466:Asian People; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D003624:Darkness; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000209:etiology*; D005006:Ethnicity; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D007194:India / Q000208:ethnology; D016015:Logistic Models; D008296:Malaysia / Q000208:ethnology; D008423:Maternal Age; D016017:Odds Ratio; D011247:Pregnancy; D012307:Risk Factors; D012846:Singapore; D012890:Sleep / Q000502:physiology*; D013997:Time Factors
chemical_list: D005947:Glucose
keywords: Asian women; gestational diabetes mellitus; sleep duration; sleep quality