Actigraphy-based measures of sleep quality and duration are associated with maternal glycemia in mid-pregnancy

Studies in nonpregnant populations have linked insufficient and poor-quality sleep with hyperglycemia. However, this association is not well characterized in pregnancy, mainly due to challenges with self-reported measures of sleep. In this exploratory analysis, we examined associations of actigraphy-measured sleep duration and sleep efficiency with post-challenge glucose levels in mid-pregnancy.

Pregnant women (n = 67) recruited via convenience sampling from an outpatient clinic wore an Actigraph GTX3+ sleep monitor for 7-days prior to their 75g oral glucose tolerance test. Hourly glucose concentrations were used to calculate the incremental area-under-the-curve (iAUC) for glucose. Multivariate linear regression analyses examined associations of sleep and glucose outcomes after adjustment for potential confounders (age, pre-pregnancy BMI and ethnicity).

Actigraphy-measured shorter sleep was associated with a higher post-challenge glucose response (iAUC; β = -0.78 [95 % CI: -1.38, -0.12] mmol.L^-1, P = 0.018), and lower sleep efficiency with higher 2-h glucose (β = -0.074 [95 % CI: -0.121, -0.027] mmol.L^-1, P = 0.003). These relationships persisted after adjustment for potential confounders.

We found that shorter sleep duration and lower sleep efficiency were associated with maternal hyperglycemia during mid-gestation. These findings highlight the potential importance of considering sleep quality and duration for managing glycemic risk in routine antenatal care.