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Gestational Diabetes Mellitus and Sleep-Disordered Breathing

Bisson, Michèle Bsc; Sériès, Frédéric MD; Giguère, Yves MD; Pamidi, Sushmita MD; Kimoff, John MD; Weisnagel, S. John MD; Marc, Isabelle MD, PhD

doi: 10.1097/AOG.0000000000000143
Contents: Original Research

OBJECTIVE: To examine the link between gestational diabetes mellitus (GDM) and sleep-disordered breathing using complete polysomnography and questionnaires in a case–control study of pregnant women.

METHODS: Pregnant women (body mass index [BMI] less than 35, no prior diabetes or hypertension) were eligible as cases (n=26) if diagnosed with GDM by routine 75-g oral glucose tolerance test. Women in the control group without GDM (n=26) were matched for gestational age at polysomnography, BMI, and age. Polysomnography were conducted at home at 24–32 weeks of gestation. Sleepiness score (Epworth Sleepiness Scale), subjective sleep quality (Pittsburgh Sleep Quality Index), risk for depression (Edinburgh Postnatal Depression Scale), and restless legs syndrome were assessed by questionnaire.

RESULTS: Primary outcome apnea–hypopnea index (4.2±3.9 events per hour in women in the case group compared with 3.8±2.3 events per hour in women in the control group) as well as other objective and subjective sleep measures, including oxygen desaturation index, snoring, and flow limitation, were not significantly different between groups. Sleepiness was greater in women in the case group than in women in the control group (9.8±3.6 compared with 7.2±3.6, P=.05). Additionally, 23% of women in the case group compared with 0% of women in the control group (P<.01) reported an Edinburgh Scale score of at least 10 (suggesting significant depression) and 46% of women with GDM reported restless legs syndrome compared to 19% of women in the control group (P=.07).

CONCLUSION: There was no association between GDM and sleep-disordered breathing in pregnant women with prepregnancy BMIs under 35 and no medical comorbidities.

LEVEL OF EVIDENCE: II

In women with prepregnancy body mass indexes (BMIs) under 35 and no medical comorbidities, gestational diabetes mellitus is not associated with an increased prevalence of sleep-disordered breathing.

Department of Pediatrics, Centre hospitalier universitaire de Québec, the Research Centre, Institut universitaire de cardiologie et pneumologie de Québec, and the Departments of Medical Biology and Endocrinology, CHU de Québec, Université Laval, Quebec City, and the Sleep Laboratory, Royal Victoria Hospital, McGill University Health Centre, Montreal, Quebec, Canada.

Corresponding author: Isabelle Marc, MD, PhD, Department of Pediatrics, CHU de Québec, 2705 Laurier Blvd., Quebec, QC, Canada G1V 4G2; e-mail: isabelle.marc@crchul.ulaval.ca.

Supported by grants from the Respiratory Health Network of Fonds de la recherche du Québec en santé (FRQ-S) and Fondation des Étoiles. M.B. is the recipient of a PhD bursary from the Canadian Institutes of Health Research. I.M. is the recipient of a FRQ-S clinician scientist award. All salaries were supported by a grant from the Fondation des Étoiles to I. Marc.

The authors thank Serge Simard, biostatistician at the Institut universitaire de cardiologie et pneumologie de Québec.

Presented at the 2013 International Conference of the American Thoracic Society, May 22, 2013, Philadelphia, Pennsylvania, and at the 2013 International Symposium on Sleep and Breathing, October 18, 2013, Montreal, Quebec, Canada.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2014 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.