Sleep Duration and Blood Glucose Control in Women With Gestational Diabetes Mellitus

Abstract

Objective: To describe the relationship between objectively assessed sleep and blood glucose in a prospective cohort of women recently diagnosed with gestational diabetes mellitus (GDM).

Methods: Women with GDM were enrolled immediately after attending a GDM education class. All patients were recruited during their first week of attempted dietary management of GDM. They were instructed on the use of a glucometer and on the principles of a GDM diet. Women wore an actigraph and completed a sleep log for 7 consecutive days. Glucose records were compared against the objective sleep data. Linear mixed model analysis was used to estimate the association of sleep duration on morning fasting and 1-hour postprandial blood glucose concentrations.

Results: Thirty-seven participants provided data for 213 sleep intervals that corresponded to at least one glucose reading. Sleep duration was negatively associated with fasting and 1-hour postprandial blood glucose concentrations In analyses adjusted for age, gestational age, and body mass index, a 1-hour increase in sleep time was associated with statistically significant reductions in fasting glucose (-2.09 mg/dL, 95% confidence interval [CI] -3.98 to -0.20) as well as postprandial glucose concentrations (lunch -4.62 mg/dL, 95% CI -8.75 to -0.50; dinner -6.07 mg/dL, 95% CI -9.40 to -2.73).

Conclusion: Short sleep durations are associated with worsened glucose control in women with gestational diabetes. Educating women on healthy sleep and screening for and treating sleep disorders during pregnancy may have a role in optimizing blood glucose control in gestational diabetes.

Level of evidence: II.

Figures

Figure 1

Actiwatch Spectrum actigraphy device.

Figure 2

Representative actigraphy recording from a study participant. Rest or sleep intervals are marked in light blue, off-wrist time is indicated by dark purple, activity counts are indicated by black bars, and recorded light exposure is shown by the yellow lines.