Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia

被引:45
作者
Balserak, Bilgay Izci [1 ,5 ]
Jackson, Nicholas [1 ]
Ratcliffe, Sarah A. [3 ]
Pack, Allan I. [1 ,2 ]
Pien, Grace W. [1 ,2 ,4 ]
机构
[1] Univ Penn, Ctr Sleep & Circadian Neurobiol, Sch Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Sleep Med Div, Sch Med, Dept Med, Philadelphia, PA 19104 USA
[3] Univ Penn, Ctr Clin Epidemiol & Biostat, Sch Med, Philadelphia, PA 19104 USA
[4] Univ Penn, Pulm Allergy & Crit Care Div, Sch Med, Dept Med, Philadelphia, PA 19104 USA
[5] Univ Penn, Dept Biobehav Hlth Sci, Sch Nursing, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
Apnea symptom score; Gestational diabetes; Glucose dysregulation; Sleep duration; Snoring; Hyperglycemia; INSULIN-RESISTANCE; DIABETES-MELLITUS; GLUCOSE-INTOLERANCE; UPPER AIRWAY; RISK-FACTOR; NASAL CPAP; PREGNANCY; APNEA; DURATION; PREECLAMPSIA;
D O I
10.1007/s11325-013-0809-4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes. This is a case-control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed. Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT < 135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT a parts per thousand yenaEuro parts per thousand 135) had habitual snoring (p < 0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50-5.41; p = 0.001) and total nap duration (OR 1.48; 95 % CI 0.96-2.28; p = 0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44-8.32; p = 0.005) and nap duration (OR 1.64; 95 % CI 1.00-2.681.02; p = 0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83-1.28; p = 0.77). Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes.
引用
收藏
页码:1093 / 1102
页数:10
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