Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus

Cai, Shirong; Tan, Sock Hwee; Gluckman, Peter D.; Godfrey, Keith M.; Saw, Seang‐Mei; Teoh, Oon Hoe; Chong, Yap Seng; Meaney, Michael J.; Kramer, Michael S.; Gooley, Joshua J.

doi:10.1093/sleep/zsw058

Cited by 133 publications

(86 citation statements)

References 64 publications

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“…[8, 9] Data from pregnancy cohorts, both prospective and retrospective, using self-reported sleep duration have also suggested that short sleep is a risk factor for GDM. [35–37] In one study of 63 pregnant women who wore an actigraph in mid-pregnancy, objectively measured short sleep was associated with higher values on 1-hour GTT screening tests. [21] Our data are consistent with and extend the findings of these previous reports, confirming that short sleep duration, as objectively measured by actigraphy, is associated with incident GDM in a large population of nulliparous women.…”

Section: Discussionmentioning

confidence: 99%

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Facco

Grobman²,

Reid³

et al. 2017

American Journal of Obstetrics and Gynecology

148

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Background Experimental and epidemiologic data suggest that among non-pregnant adults, sleep duration may be an important risk factor for chronic disease. Although pregnant women commonly complain of poor sleep, few studies have objectively evaluated the quality of sleep in pregnancy or have explored the relationship between sleep disturbances and maternal and perinatal outcomes. Objectives Our objective was to examine the relationship between objectively assessed sleep duration, timing and continuity (measured via wrist actigraphy) and maternal cardiovascular and metabolic morbidity specific to pregnancy. Study Design This was a prospective cohort study of nulliparous women. Women were recruited between 16 0/7 and 21 6/7 weeks’ gestation. They were asked to wear a wrist actigraphy monitor and to complete a daily sleep log for a seven consecutive-day period. The primary sleep exposure variables were the averages of the following over the total valid nights (minimum 5, maximum 7 nights): short sleep duration during the primary sleep period (< 7 hours/night), late sleep midpoint (midpoint between sleep onset and sleep offset > 5 AM), and top quartile of minutes of wake time after sleep onset (WASO) and sleep fragmentation index. The primary outcomes of interest were a composite of hypertensive disorders of pregnancy (mild, severe, or superimposed preeclampsia; eclampsia; or antepartum gestational hypertension) and gestational diabetes (GDM). Chi-square tests were used to assess associations between sleep variables and categorical baseline characteristics. Crude odds ratios and 95% confidence intervals were estimated from univariate logistic regression models to characterize the magnitude of the relationship between sleep characteristics and hypertensive disorders of pregnancy and GDM. For associations that were significant in univariate analysis, multiple logistic regression was used to explore further the association of sleep characteristics with pregnancy outcomes. Results Nine-hundred and one eligible women consented to participate. Of these women 782 submitted valid actigraphy studies. Short sleep duration and a later sleep midpoint were associated with an increased risk of GDM (OR 2.24, 95% CI 1.11, 4.53; OR 2.58, 95% CI 1.24, 5.36, respectively) but not of hypertensive disorders. A model with both sleep duration and sleep midpoint as well as their interaction term revealed that while there was no significant interaction between these exposures, the main effects of both short sleep duration and later sleep midpoint with GDM remained significant (aOR 2.06, 95% CI 1.01, 4.19; aOR 2.37, 95% CI 1.13, 4.97, respectively). Additionally, after adjusting separately for age, BMI and race/ethnicity, both short sleep duration and later sleep midpoint remained associated with GDM. No associations were demonstrated between the sleep quality measures (WASO, sleep fragmentation) and hypertensive disorders or GDM. Conclusions Our results demonstrate a relationship between short sleep duration and later sleep midpoin...

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Section: Discussionmentioning

confidence: 99%

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Facco

Grobman²,

Reid³

et al. 2017

American Journal of Obstetrics and Gynecology

148

View full text Add to dashboard Cite

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“…Current data suggest that poor sleep quality is associated with an enhanced proinflammatory profile 22 and preterm birth 23 as well as an increased risk of metabolic outcomes. 24 Hence, conditions that result in poor sleep such as RLS, as demonstrated in this study, become critical to identify and possibly important to treat pharmacologically. The research by Dunietz et al 18 and others 14 elevate the diagnosis of RLS in pregnancy from a self-limited condition that would likely resolve postpartum to one with potential adverse obstetric events and beg for studies evaluating the efficacy and outcome of treating RLS in pregnancy.…”

Section: Commentary Shaking Up Perspectives Of Restless Legs Syndromementioning

confidence: 87%

Shaking Up Perspectives of Restless Legs Syndrome in Pregnancy

Tan

Bourjeily

2017

Journal of Clinical Sleep Medicine

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“…These items are scored from 0 to 3, and then added together to calculate a total PSQI global score ranging from 0 to 21. It was reported in past studies that the PSQI has similar psychometric properties in both non-pregnant populations and pregnant women [26]. The PSQI has been used on pregnant Asian women in previous studies [26][27][28].…”

Section: Salivary Melatonin and Cortisol Rhythmmentioning

confidence: 99%

“…It was reported in past studies that the PSQI has similar psychometric properties in both non-pregnant populations and pregnant women [26]. The PSQI has been used on pregnant Asian women in previous studies [26][27][28]. A validated Malay version of PSQI will be used in the study [29].…”

Section: Salivary Melatonin and Cortisol Rhythmmentioning

confidence: 99%

Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study

Kaur

Teoh

Shukri

et al. 2020

BMC Pregnancy Childbirth

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Background: Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes. Methods: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements. Discussion: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.

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Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus

Abstract: 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.

Cited by 133 publications

References 64 publications

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Objectively measured short sleep duration and later sleep midpoint in pregnancy are associated with a higher risk of gestational diabetes

Shaking Up Perspectives of Restless Legs Syndrome in Pregnancy

Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study

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