Association between sleep impairment and gestational diabetes mellitus subtypes: A prospective cohort study

To examine the association of sleep impairment with gestational diabetes mellitus (GDM) and its subtypes.

29,183 pregnant women from the Born in Guangzhou Cohort Study were included. Information on sleep quality, sleep duration and sleep-disordered breathing (SDB) symptoms were collected. GDM was diagnosed using a 75 g, 2h oral glucose tolerance test and medical records. GDM was categorised into three subtypes. Poisson regression models were performed.

In total, 4713 (16.2%) were diagnosed with GDM. Poor sleep quality, short nighttime sleep duration and SDB symptoms were associated with increased risks of GDM, with adjusted RR of 1.07 (95% CI 1.01, 1.13), 1.12 (95% CI 1.04, 1.22) and 1.19 (95% CI 1.10, 1.30), respectively. Short nighttime sleep duration and SDB symptoms were also associated with higher risks of the subtype of combined impaired fasting glucose and impaired glucose tolerance (IFG + IGT) (RR 1.55, 95% CI 1.22, 1.96; RR 1.80, 95% CI 1.42, 2.29, respectively). Long nighttime sleep duration was associated with lower risks of the subtype of isolated impaired glucose tolerance (i-IGT) (RR 0.89, 95% CI 0.80, 0.99).

Our findings indicate that pregnant women with sleep impairment are more likely to develop GDM, especially the IFG + IGT subtype. Reducing sleep impairment, particularly SDB symptoms, may be a target for intervention to prevent GDM.