Interactions between pregnancy, obstructive sleep apnea, and gestational diabetes mellitus
Sirimon Reutrakul1, Nausheen Zaidi, Kristen Wroblewski
1MD, Section of Endocrinology, Department of Medicine, Rush University Medical Center, 1725 West Harrison Street, Suite 250, Chicago, Illinois 60612. sreutrak10800@gmail.com.
The Journal of Clinical Endocrinology and Metabolism
|August 23, 2013
Summary
Pregnancy disrupts sleep, increasing the risk of obstructive sleep apnea (OSA). Gestational diabetes mellitus (GDM) is strongly associated with OSA, with higher prevalence and sleep disturbances observed in pregnant women with GDM.
Area of Science:
- Reproductive Medicine
- Sleep Medicine
- Endocrinology
Background:
- Previous studies suggested a link between obstructive sleep apnea (OSA) symptoms and gestational diabetes mellitus (GDM) risk.
- Objective assessment of OSA using polysomnography in relation to GDM is not well-established.
Purpose of the Study:
- To investigate the relationship between pregnancy, obstructive sleep apnea (OSA), and gestational diabetes mellitus (GDM).
Main Methods:
- Observational case-control study using polysomnography.
- Three groups: nonpregnant, normal glucose tolerance (NP-NGT); pregnant, normal glucose tolerance (P-NGT); pregnant, GDM (P-GDM).
- Groups frequency-matched for age and race/ethnicity; pregnant women studied in late second to early third trimester.
Main Results:
- Pregnant women (P-NGT) exhibited higher apnea-hypopnea index (AHI) and sleep disruption than nonpregnant women (NP-NGT).
- Pregnant women with GDM (P-GDM) showed significantly lower total sleep time, higher AHI, and increased OSA prevalence (73% vs. 27%) compared to P-NGT.
- GDM diagnosis was associated with OSA diagnosis (OR 6.60) after adjusting for prepregnancy BMI. Higher microarousal and oxygen desaturation indices correlated with poorer glucose control.
Conclusions:
- Pregnancy is linked to sleep disturbances.
- Sleep is significantly more disturbed in pregnant women with GDM compared to those with normal glucose tolerance.
- A strong association exists between gestational diabetes mellitus and obstructive sleep apnea.
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