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Obstetrics
Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism

Presented at the 23rd Annual Meeting of the Associated Professional Sleep Societies, Seattle, WA, June 6-11, 2009, and the 30th Annual Meeting of the Society for Maternal-Fetal Medicine, Chicago, IL, Feb. 1-6, 2010.
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Objective

We sought to evaluate the impact of short sleep duration (SSD) and frequent snoring (FS) on glucose metabolism during pregnancy.

Study Design

We conducted a prospective cohort study of healthy nulliparas who participated in a sleep survey study. SSD was defined as <7 hours of sleep per night and FS, as snoring ≥3 nights per week. Outcomes included 1-hour oral glucose tolerance results and the presence of gestational diabetes mellitus (GDM). Univariate and multivariate analyses were performed.

Results

A total of 189 women participated; 48% reported an SSD and 18.5% reported FS. SSD and FS were associated with higher oral glucose tolerance values: SSD (116 ± 31 vs 105 ± 23; P = .008) and FS (118 ± 34 vs 108 ± 25; P = .04). Both SSD (10.2% vs 1.1%; P = .008) and FS (14.3% vs 3.3%; P = .009) were associated with a higher incidence of GDM. Even after controlling for potential confounders, SSD and FS remained associated with GDM.

Conclusion

SSD and FS are associated with glucose intolerance in pregnancy.

Section snippets

Materials and Methods

This study was a planned secondary analysis of data from a prospective, observational study designed to evaluate the prevalence of and trends in sleep disturbances across pregnancy.25 The study was approved by the institutional review board of Northwestern University, Chicago, IL. Patients were recruited in the outpatient setting from among women who received care at Northwestern Memorial Hospital affiliated practices. These practices serve women who have both government-based and private

Results

Of the 224 eligible women who were approached, 202 (90%) agreed to participate and completed the baseline survey. In all, 189 of these women participated in the third-trimester survey as well. The mean gestational age was 13.8 ± 3.8 and 30.0 ± 2.2 weeks at the first and second survey, respectively. Demographic characteristics of the study population, as a whole, and stratified by sleep complaints, are provided in Table 1. Results of 1-hour OGT screening were available for 182 women. For 6 women

Comment

This study examined glucose metabolism and risk of GDM in healthy nulliparous women reporting SSD and FS during pregnancy. Our findings suggest that women with these sleep disturbances are at increased risk of impaired glucose tolerance and GDM. Studies of nonpregnant individuals have linked SSD and SDB to fasting hyperglycemia, impaired glucose tolerance, and type 2 diabetes.14, 15, 16, 17, 18, 19, 20, 21 Yet, evidence for the association between sleep and pregnancy abnormalities has been

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      Pooled results indicated that pregnant women with poor sleep quality were more likely to suffer from GDM, with little heterogeneity (RR with 95% CI = 1.26 [1.11, 1.44], I2 = 0.00%, P-heterogeneity = 0.52) (Fig. 2). Seven studies (8,291 pregnant women with 1,085 GDM cases) investigated the relationship between snoring and the risk of GDM [31,36,37,49–52]. A detrimental effect of snoring on the risk of GDM was found, with high heterogeneity (RR with 95% CI = 1.45 [1.12, 1.87], I2 = 50.10%, P-heterogeneity = 0.06) (Fig. 2).

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    Supported in part by research Grant 1K12HD050121 from the National Institutes of Health, National Institute of Child Health and Human Development.

    Cite this article as: Facco FL, Grobman WA, Kramer J, et al. Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism. Am J Obstet Gynecol 2010;203:142.e1-5.

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