Higher Risk of Gestational Diabetes in Women With a Greater Variety of Sleep Disturbances

Sleep disturbances and gestational diabetes mellitus (GDM) are both common during pregnancy. However, it remains unclear whether sleep disturbances are independent risk factors for the development of GDM. This study examined subjectively reported sleep disturbances during the second trimester and their association with GDM and related maternal factors.

A total of 5055 pregnant women from the Finnish Kuopio Birth Cohort completed an online questionnaire assessing sleep disturbances (sleep quality, sleep duration, weekly snoring, difficulties in falling asleep, daytime sleepiness, and nighttime or early morning awakenings) during the second trimester. Among the 4976 women with completed follow-up to delivery, GDM was detected in 23.1% (N = 1151) according to the Finnish National Current Care Guidelines. Adjusted logistic regression analyses (controlling for maternal age, body mass index [BMI], smoking, physical activity, and gestational weight gain) were used to examine the associations between sleep disturbances and GDM.

Difficulty falling asleep (aOR 1.35; 95% CI 1.05-1.72), nighttime or early morning awakenings (aOR 1.16; 95% CI 1.00-1.34), and frequent (aOR 1.21; 95% CI 1.02-1.44) and daily daytime sleepiness (aOR 1.52; 95% CI 1.14-2.03) remained significant risk factors for GDM after adjusting for covariates. Furthermore, the risk of GDM increased in a linear manner with the number of reported sleep disturbances (aORs 1.07-1.41). A higher first-trimester BMI was the strongest predictor of experiencing multiple sleep disturbances. Among women with GDM, sleep problems were more frequent in those requiring pharmacological treatment compared with those managed with lifestyle interventions.

Sleep disturbances are strongly associated with the development of GDM. Screening for and managing sleep disturbances should be considered part of routine maternity care; improving sleep quality may support healthier overall lifestyle habits and better glucose balance during pregnancy.