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睡眠障碍性呼吸和日间小睡与母体高血糖有关。

Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia.

机构信息

Centre for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, 3624 Market Street, Suite 205, Philadelphia, PA 19104, USA.

出版信息

Sleep Breath. 2013 Sep;17(3):1093-102. doi: 10.1007/s11325-013-0809-4. Epub 2013 Jan 25.

Abstract

OBJECTIVES

Sleep disturbances in pregnancy may impair glucose mechanism. This study aimed to examine associations of sleep-disordered breathing, sleep, and nap duration with 1-h glucose challenge test (GCT) levels in pregnant women after controlling for known risk factors for gestational diabetes.

METHODS

This is a case-control study of 104 pregnant women. All women underwent full polysomnography and a GCT and completed the multivariable apnea prediction and Pittsburgh Sleep Quality indexes. The primary outcome was maternal hyperglycemia measured by GCT. Bivariate and multivariable logistic regression analyses were performed.

RESULTS

Over 13 % subjects reported habitual snoring in the first trimester. Only 9.3 % women with normoglycemia (GCT < 135) were habitual snorers, whereas 45.5 % women with hyperglycemia (GCT ≥ 135) had habitual snoring (p < 0.001). Sleep-disordered breathing symptoms (loud snoring, snorting/gasping, and apneas) (odds ratio (OR) 2.85; 95 % confidence interval (CI) 1.50-5.41; p = 0.001) and total nap duration (OR 1.48; 95 % CI 0.96-2.28; p = 0.08) were associated with hyperglycemia. After adjusting for confounders, sleep-disordered breathing symptoms (OR 3.37; 95 % CI 1.44-8.32; p = 0.005) and nap duration (OR 1.64; 95 % CI 1.00-2.681.02; p = 0.05) continued to be associated with hyperglycemia. However, the primary exposure measure, the apnea/hypopnea index in the first trimester was not significantly associated with hyperglycemia (OR 1.03; 95 % CI 0.83-1.28; p = 0.77).

CONCLUSIONS

Sleep-disordered breathing symptoms and nap duration are associated with hyperglycemia. Sleep duration was not associated with hyperglycemia. Research is needed concerning whether women with sleep-disordered breathing and/or daytime napping are at risk for gestational diabetes.

摘要

目的

孕期睡眠障碍可能损害葡萄糖代谢。本研究旨在探讨睡眠呼吸障碍、睡眠和小睡时长与妊娠女性 1 小时葡萄糖挑战试验(GCT)水平之间的关系,这些关系在控制了妊娠糖尿病的已知危险因素后进行评估。

方法

这是一项纳入了 104 名孕妇的病例对照研究。所有女性均接受了全面的多导睡眠图和 GCT 检查,并完成了多变量睡眠呼吸暂停预测和匹兹堡睡眠质量指数的评估。主要结局是通过 GCT 测量的孕妇高血糖。进行了双变量和多变量逻辑回归分析。

结果

超过 13%的受试者在孕早期报告习惯性打鼾。仅 9.3%的血糖正常(GCT<135)女性是习惯性打鼾者,而 45.5%的高血糖(GCT≥135)女性有习惯性打鼾(p<0.001)。睡眠呼吸障碍症状(响亮的鼾声、鼻息声/喘息声和呼吸暂停)(比值比(OR)2.85;95%置信区间(CI)1.50-5.41;p=0.001)和总小睡时长(OR 1.48;95%CI 0.96-2.28;p=0.08)与高血糖相关。在校正混杂因素后,睡眠呼吸障碍症状(OR 3.37;95%CI 1.44-8.32;p=0.005)和小睡时长(OR 1.64;95%CI 1.00-2.681.02;p=0.05)仍与高血糖相关。然而,主要暴露测量指标(孕早期的呼吸暂停/低通气指数)与高血糖无显著相关性(OR 1.03;95%CI 0.83-1.28;p=0.77)。

结论

睡眠呼吸障碍症状和小睡时长与高血糖相关。睡眠时长与高血糖无关。需要进一步研究睡眠呼吸障碍和/或日间小睡的女性是否存在妊娠糖尿病风险。

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