Diabetes in pregnancy tied to poor sleep quality, excessive daytime sleepiness: Study
Brazil: Women with diabetic pregnancy frequently experience excessive daytime sleepiness and poor sleep quality, according to a recent study in the Journal of the Brazilian Medical Association. The findings were similar among those with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). However, metformin therapy and higher parity were associated with poor sleep quality only in GDM patients.
High blood sugar levels (hyperglycemia) complicates about 20% of pregnancies and may be secondary to T2DM, T1DM, or GDM. So, the priority should be diagnosing and providing care to women with hyperglycemia in pregnancy, given that diabetes during gestation is associated with adverse neonatal and maternal outcomes.
In pregnancy, sleep alterations are also frequent and poor sleep quality is reported in about 45.7% of pregnant women. However, not much is known about sleep in T1DM and even little knowledge exists on sleep in pregnancy associated with T1DM.
Cristina Façanha, Integrated Diabetes and Hypertension Center, Fortaleza (CE), Brazil, and colleagues aimed to investigate sleep alterations and associated factors in pregnant diabetic women (n=141).
For this purpose, patient's details on sleep profile, sociodemographic, and clinical information were collected. The researchers assessed poor sleep quality (Pittsburgh Sleep Quality Index >5) and excessive daytime sleepiness (Epworth Sleepiness Scale ≥10), sleep duration (h), sleep latency (min), frequent sleep interruption, and short sleep (≤6 h) in type 1 diabetes mellitus (16.3%), type 2 diabetes mellitus (25.5%) and gestational diabetes mellitus (58.2%).
Key findings of the study include:
· Poor sleep quality was found in 58.8% of patients and daytime sleepiness in 25.7%, regardless of hyperglycemia etiology.
· No correlation existed between daytime sleepiness and poor sleep quality.
· Short sleep duration occurred in 1/3 of patients (31.2%).
· Sleep interruptions due to frequent urination affected 72% of all and sleep interruptions due to any cause 71.2%.
· Metformin was used by 65.7% of type 2 diabetes mellitus and 28.7% of gestational diabetes mellitus.
· In gestational diabetes mellitus, parity number was independently associated with poor sleep quality and metformin use was also independently associated with poor sleep quality.
"Our study originally shows that poor sleep quality and excessive daytime sleepiness are frequent in diabetic pregnancy due to different etiologies," wrote the authors. "Interestingly, only in gestational diabetes mellitus, metformin therapy and higher parity were associated with poor sleep quality."
The study titled, "Hyperglycemia in pregnancy: sleep alterations, comorbidities and pharmacotherapy," is published in the Journal of the Brazilian Medical Association.