Sleep conditions and sleep hygiene behaviors in early pregnancy are associated with gestational diabetes mellitus: A propensity-score matched study

Abstract

Purpose To explore the influence of sleep conditions and sleep hygiene behaviors in early pregnancy on gestational diabetes mellitus (GDM) development. Methods This 1:1 propensity-score matched study included 1216 pregnant women divided into GDM and control groups based on GDM diagnosis via the oral glucose tolerance test (OGTT) at 24–28 gestational weeks. Sleep conditions and hygiene behaviors were evaluated using structural questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Sleep Hygiene Practice Scale (SHPS). Univariate and multivariate logistic regression analyses and Spearman’s correlation were conducted to identify the associations. Results After adjusting for baseline clinical characteristics, women with GDM were more likely to have poor sleep quality (adjusted odds ratio [AOR] = 1.585, 95% confidence interval [CI]: 1.261–1.992) and higher scores for subjective sleep quality, latency, duration, efficiency, and sleep disturbances (all P < 0.01). Mild sleepiness (AOR = 1.311, 95% CI: 1.012–1.699) and worrying about not being able to fall asleep in bed (AOR = 1.123, 95% CI: 1.005–1.255) were more likely to occur in the GDM group. Sleep quality and hygiene behaviors such as sleep-irrelevant activities, staying in bed after waking up, weekend catch-up sleep, and eating too much before sleep were significantly correlated with gestational diabetes variables. Conclusion Poor sleep conditions and specific sleep hygiene behaviors in early pregnancy may be independent risk factors for GDM, suggesting that sleep assessment and sleep behavior education can be used as new approaches for the early implementation of surveillance and prevention.