Sleep Related Determinants of Gestational Diabetes
Dates: 9/17/14 - 5/31/17
Abstract: Over a quarter of pregnant women develop sleep-disordered breathing (SDB). Many pregnant women experience poor sleep quality and continuity. Nonpregnant studies showed associations between sleep disturbances and medical conditions (e.g., type 2 diabetes). Preliminary studies in pregnancy have also found a relationship between sleep problems (SDB and short sleep duration) and gestational diabetes mellitus (GDM). We have found that SDB symptoms (e.g. snoring and breathing pauses) and daytime napping are associated with hyperglycemia during pregnancy. Thus, sleep disturbances may constitute a class of novel MODIFIABLE risk factors for GDM. GDM is associated with adverse maternal-fetal outcomes and is also a predictor of type 2 diabetes, cardiovascular disease and obesity in both mother and child. The proposed study in the K99 phase aimed to evaluate changes in delta power and their association with SDB using archival polysomnography (PSG) gathered from pregnant women in their first and third trimesters. This study is nearing completion and found that delta power does not differ significantly between two trimesters (b=-0.13, p=0.051). However, PSG-confirmed SDB (AHI=5) was significantly associated with delta power changes, after adjusting for age, race, parity, body mass index (BMI) gain and changes in sleep duration between trimesters (b=-0.019, p=0.019). Additionally the awardee successfully completed the planned training program during K99 phase as was detailed in the progress report. In the R00 phase, a case-control study will be conducted (1) to determine if sleep-disordered breathing is independently associated with an increased risk of GDM, (2) to evaluate if there is an independent association between short sleep duration (<6 hours) and GDM, and (3) to examine if a low percentage of slow wave sleep (delta power) is a modifier of the risk for GDM. This study will recruit 36 cases and 36 controls (1:1 match for age, race, parity and BMI) from the University of Illinois Medical Center. Data will be collected from laboratory polysomnography, sleep diary, wrist actigraphy and questionnaires. For the exploratory aim, serum samples before and after sleep will be collected. A sleep technologist blinded to case status and BMI will perform all sleep scoring.