Poor Sleep Quality Is Associated with Higher Hemoglobin A1c in Pregnant Women: A Pilot Observational Study

Abstract

We hypothesized that poor sleep quality exacerbates glucose intolerance manifested as elevated glycosylated hemoglobin (HbA1c), which increases the risk for gestational diabetes. To test this, 38 pregnant and 22 non-pregnant (age, 18–35 years; body-mass index, 20–35 kg/m2) otherwise healthy women were enrolled in the study. Sleep quality was assessed during gestational week 24 (pregnant), or outside of the menstrual period (non-pregnant), using qualitative (Pittsburgh Sleep Quality Index) and objective (actigraphic wrist-watch) measures. Blood glucose, total cortisol, and depression status were evaluated. Eight pregnant and one non-pregnant women were lost to follow-up, or withdrew from the study. There was a higher incidence of poor sleep quality in pregnant (73%) relative to non-pregnant women (43%). Although actigraphic data revealed no differences in actual sleep hours between pregnant and non-pregnant women, the number of wake episodes and sleep fragmentation were higher in pregnant women. Poor sleep quality was positively correlated with higher HbA1c in both pregnant (r = 0.46, n = 26, p = 0.0151) and non-pregnant women (r = 0.50, n = 19, p = 0.0217), reflecting higher average blood glucose concentrations. In contrast, poor sleep was negatively correlated with cortisol responses in pregnant women (r = −0.46, n = 25, p = 0.0167). Three pregnant women had elevated one-hour oral glucose tolerance test results (>153 mg/dL glucose). These same pregnant women exhibited poor sleep quality. These results support the suggestion that poor sleep quality is an important risk factor that is associated with glucose intolerance and attendant health complications in pregnancy.

The Effect of Endocrinological Parameters on Sleep Quality, Life Quality, Depression and Anxiety Levels in Pregnancy

“…When the literature is examined, it is seen that many studies show that sleep quality is impaired in pregnant women. This situation was attributed to many factors like weight gain during pregnancy, insufficient physical activity, fetal growth, pain, cramps and hormonal changes (19,20,29,30). In our results, no significant relations were detected between fasting blood sugar, glucose loading values and PSQS sub-dimensions or total scores.…”

“…In the literature, it was shown in a study that sleep quality was worse in pregnant women who had higher fasting glucose levels. In the same study the hemoglobin A1c values were measured and it was determined that the sleep quality of pregnant women who had high hemoglobin A1c was worse (29). In another retrospective study, it was reported that the blood sugar values of pregnant women who had impaired sleep quality and low sleep periods were more likely to be higher (31).…”

Syndrome Metabolic Markers, Fitness and Body Fat Is Associated with Sleep Quality in Women with Severe/Morbid Obesity

“…The evidence also showed that women have lower sleep quality than men [8]. Chirwa et al [36] reported that worse sleep quality was linked to higher HbA1c and attendant health complications in pregnant women. In addition, Morselli et al [37] indicated that sleep loss affects insulin sensitivity, leading to increased diabetes risk.…”

Pregnancy Status Is Associated with Lower Hemoglobin A1c among Nondiabetes Women in the United States from NHANES 2005–2016

“…Researchers have reported that several factors are associated with the HbA1c levels during pregnancy. Poor sleep quality during gestational week 24 was reported to exacerbate glucose intolerance and be associated with higher HbA1c levels in pregnant women in a pilot observational study [ 20 ]. HbA1c is well known to show falsely high levels in patients with an iron-deficient state.…”