Association between nighttime sleep duration, midday napping, and sleep quality during early pregnancy and risk of gestational diabetes mellitus: A prospective cohort study in China

Yuwei Lai; Can Wang; Jing Ouyang; Linjing Wu; Yi Wang; Ping Wu; Yi-Xiang Ye; Xue Yang; Yanyu Gao; Yi-Xin Wang; Xingyue Song; Shijiao Yan; Chuanzhu Lv; Gang Liu; An Pan; Xiong-Fei Pan

doi:10.1016/j.sleep.2024.04.003

Association between nighttime sleep duration, midday napping, and sleep quality during early pregnancy and risk of gestational diabetes mellitus: A prospective cohort study in China

Sleep Med. 2024 Apr 16:119:164-171. doi: 10.1016/j.sleep.2024.04.003. Online ahead of print.

Authors

Yuwei Lai¹, Can Wang², Jing Ouyang¹, Linjing Wu¹, Yi Wang¹, Ping Wu¹, Yi-Xiang Ye¹, Xue Yang³, Yanyu Gao⁴, Yi-Xin Wang¹, Xingyue Song⁵, Shijiao Yan⁶, Chuanzhu Lv⁷, Gang Liu⁸, An Pan⁹, Xiong-Fei Pan¹⁰

Affiliations

¹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Office of Administration & Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, China.
³ Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China.
⁴ Department of Obstetrics and Gynecology, Shuangliu Maternal and Child Health Hospital, Chengdu, China.
⁵ Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
⁶ School of Public Health, Hainan Medical University, Haikou, China; Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, Hainan, China.
⁷ Research Unit of Island Emergency Medicine, Chinese Academy of Medical Sciences, Hainan Medical University, Haikou, Hainan, China; Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.
⁸ Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁹ Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address: panan@hust.edu.cn.
¹⁰ Section of Epidemiology and Population Health & Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China; Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. Electronic address: pxiongfei@scu.edu.cn.

PMID: 38685163
DOI: 10.1016/j.sleep.2024.04.003

Abstract

Aim: To evaluate the prospective associations of nighttime sleep duration, midday napping, and sleep quality during early pregnancy with gestational diabetes mellitus (GDM) risk among Chinese pregnant women.

Methods: Sleep-related information was assessed by the Pittsburgh Sleep Quality Index in baseline surveys during the 6-15 (mean 10.3) gestational weeks. GDM was diagnosed during 24-28 gestational weeks according to the Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy (2022). Multivariable logistic regression models with adjustments for socio-demographic and lifestyle factors were used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for the associations of sleep traits with GDM risk.

Results: We identified 503 incident GDM cases among 6993 participants. Compared with women who slept for 7-9 hours/night in early pregnancy, those who slept <7 hours/night showed a higher risk of GDM (OR, 1.75; 95 % CI: 1.20-2.54), whereas those who slept >9 hours/night showed no significant association for GDM risk (OR, 1.01; 95 % CI: 0.78-1.30). Compared with women with absolutely no napping, those with ≤60 and > 60 min/day midday napping showed no significant association for GDM risk (OR, 0.82; 95 % CI: 0.64-1.05 for ≤60 min/day midday napping; OR, 0.87; 95 % CI: 0.66-1.15 for >60 min/day midday napping). Poor sleep quality was not associated with GDM risk compared with good quality (OR, 0.90; 95 % CI: 0.72-1.12).

Conclusion: A short nighttime sleep duration during early pregnancy was associated with a higher risk of GDM, which was independent of midday napping, sleep quality and lifestyle factors.

Keywords: Chinese women; Gestational diabetes mellitus; Midday napping; Nighttime sleep duration; Prospective study; Sleep quality.