OBJECTIVE: To investigate sleep alterations and associated factors in pregnant diabetic women (n=141). METHODS: Sleep profile, sociodemographics and clinical information were collected. Poor sleep quality (Pittsburgh Sleep Quality Index >5) and excessive daytime sleepiness (Epworth Sleepiness Scale ≥10), sleep duration (h), sleep latency (min), frequent sleep interruption and short sleep (≤6 h) were assessed in type 1 diabetes mellitus (16.3%), type 2 diabetes mellitus (25.5%) and gestational diabetes mellitus (58.2%). RESULTS: Poor sleep quality was found in 58.8% of patients and daytime sleepiness in 25.7%, regardless of hyperglycemia etiology. No correlation existed between daytime sleepiness and poor sleep quality (Pearson correlation r=0.02, p=0.84). Short sleep duration occurred in 1/3 of patients (31.2%). Sleep interruptions due to frequent urination affected 72% of all and sleep interruptions due to any cause 71.2%. Metformin was used by 65.7% of type 2 diabetes mellitus and 28.7% of gestational diabetes mellitus. In gestational diabetes mellitus, parity number was independently associated with poor sleep quality (p=0.02; OR=1.90; 95%CI 1.07-3.36) and metformin use was also independently associated with poor sleep quality (p=0.03; OR=2.36; 95%CI 1.05-5.29).CONCLUSIONS: Our study originally shows that poor sleep quality and excessive daytime sleepiness are frequent in diabetic pregnancy due to different etiologies. Interestingly, only in gestational diabetes mellitus, metformin therapy and higher parity were associated with poor sleep quality.

Background: Sleep disturbances have been associated with poor glycemic control in differential clinical settings. Both short and long sleep duration, influence insulin resistance and blood glucose in diabetic patients. Pregnancy is an additional risk for reduced sleep quality and quantity, and the presence of hyperglycemia, as a complicating factor, has being increasingly frequent. Different measures of sleep evaluation, both objectively and subjectively, can provide additional information about the influence of sleep in metabolic control in Gestational Diabetes Mellitus (GDM). Objective: To investigate the influence of sleep quality and objective sleep measures on glycated hemoglobin (HBA1C) in patients with GDM. Methodology: This is a cross-sectional study examining patients with GDM from 2nd to 3rd trimester of pregnancy. Clinical data and behavior questionnaires were collected by a face-to-face interview. Self-Rated Sleep Quality was evaluated by Pittsburgh Sleep Quality Index- (PSQI). In order to improve the accuracy of the information, a 14-day sleep log was obtained, and objective sleep measurements were registered by actigraphic record (5 to 7 days). Results: Overall, GDM patients (N=311), aged from 20 to 46 y (33.1±5.6) were evaluated. Sleep duration ≤6 hours/night was found in 43.4%, and 63.9% reported poor sleep quality (PSQI>5). Sleep duration measured by actigraphy was correlated with sleep duration registered by sleep log (r=.45, p=.04), and with PSQI (r=-.33, p=.002). Sleep quality and sleep duration registered by either actigraphy or sleep log were not correlated with Hba1c. Amongst all, Hba1c varied from 4.3 to 7.0 mg/dL (5.9 ±.53). Sleep fragmentation, measured by the length of time patient spends awake after sleep onset (WASO) was correlated withHba1c level in patients with GDM (r=.41, p=0.04). Conclusion: Sleep duration obtained from the sleep log was a reliable measure correlating with objective sleep parameters registered by actigraphy and with sleep quality. In GDM patients, increased wake time after sleep onset was correlated with higher Hba1c.

Sleep disturbances in pregnancy are associated with depression, preterm delivery, hypertension, hyperglycemic disorders, and higher rate of cesarean as well as adverse perinatal outcomes. Diabetes is other prevalent condition in pregnancy related to these adverse outcomes, and insulin resistance is a common disruptor. As such, it is important to evaluate the quality of sleep and daytime somnolence in diabetic pregnancy. Aim: Evaluate sleep quality and excessive daytime sleepiness in pregnancy complicated by diabetes mellitus. This is a cross-sectional study involving 115 pregnant women with diabetes (PWD), gestational age from 10 to 39 weeks. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI-BR) and daytime sleepiness by the Epworth Sleepiness Scale (ESS). The study was approved by IPADE ethic board (1.801.860). Statistical analysis was performed using the software IBM SPSS. Results: Poor sleep quality (PSQI>5) was observed in60,4% of PWD, which is higher them most reported rates for normal pregnancy (60,4% vs. 45% p: 0.01, CI99%. SEDOV, 2017) but similar to reported data on Brazilian overweight pregnant women (65,9%; RIBEIRO 2015). The mean PSQI score was 6.91. Short sleep duration was present in 35,8% (mean sleep duration: 7,2 hours/night). Sleep was disturbed by frequent urination in 66,1% of PWD. Daytime somnolence reported in 20.8% of PWD, and was not related with the quality of sleep. The higher number of parity was independently associated with poor sleep quality [p=0.03; 0R=1.74; CI=1.03-2.97]. The presence of obesity, hypertension, educational level, type of diabetes or treatment were non-influential to sleep quality or daytime sleepiness. Conclusion: Poor sleep quality and excessive daytime sleepiness are frequent in PWD and a higher number of parity is independently associated with poor sleep quality. Given that sleep disturbances are related to adverse outcomes in PWD, we suggest that this group of patients should be the focus of therapeutic measures to improve sleep. Disclosure C. Facanha: None. F.L. Sousa: None. A.S. Facanha: None. A.C. Forti: None. H.L. Rocha: None. M. de Araujo: None. V.M.S. Bruin: None.