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A recent study by Kuopio University Hospital and the University of Eastern Finland shows that sleep disturbances during pregnancy may be a significant risk factor for gestational diabetes mellitus (GDM).
GDM is a rapidly increasing public health problem, and it is already diagnosed in almost one in five pregnant women in Finland. GDM increases the risk of complications for both the mother and the child during pregnancy and, in the long term, the risk of obesity and diabetes. Sleep disturbances are also very common during pregnancy. They have been suspected to have an adverse effect on glucose metabolism, but there is only limited data based on research on the subject.
According to the new results of the Kuopio Birth Cohort study (KuBiCo), sleep disturbances experienced in the second trimester are associated with an increased risk of GDM - regardless of the mother's age, body mass index (BMI) or other known risk factors.
More than 5,000 pregnant women in Finland participated in the study. During the third trimester of their pregnancy, they responded to a sleep survey regarding the second trimester. Monitoring continued until delivery, and 23 per cent of the participants were diagnosed with GDM.
The study found that especially difficulty falling asleep, nighttime or early morning awakenings and daytime sleepiness were associated with a higher risk of GDM. "The more sleeping difficulties the pregnant mother had, the greater the risk of her developing gestational diabetes was," says Lic Med Joanna Laurila.
In addition, it was found that a higher BMI in early pregnancy was the strongest single factor predicting several sleep disturbances.
Sleep disturbances were more common among those who needed medication for GDM than among those for whom lifestyle changes were a sufficient treatment.
The results indicate that sleep is not just a side factor in wellbeing but an essential part of controlling metabolism during pregnancy. Detecting sleep disturbances can help identify women who have an increased risk of gestational diabetes."
Johanna Masar, Research Physician
According to the researchers, the screening for and management of sleep disturbances should be included in routine monitoring during pregnancy, such as monitoring by maternity clinics. Improving the quality of sleep may support healthy lifestyles and promote better glucose balance during pregnancy. "In the future, sleep issues will also be examined in more detail in the Nirvana study, which is part of the KuBiCo study. The Nirvana study focuses more on sleep apnoea and the identification of sleep disturbances," says Chief Physician, Professor Leea Keski-Nisula.
