ATS 2019—Sleep-disordered breathing in pregnancy linked to elevated glucose levels


  • Tara Haelle
  • Conference Reports
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Takeaway

  • Maternal sleep-disordered breathing (SDB) is associated with increased nighttime glucose levels and may complicate glucose control in pregnancy.

Why this matters

  • Maternal SDB increases with pregnancy progression and is associated with gestational diabetes mellitus (GDM) risk, so data on association between SDB and glucose levels can inform glucose control strategies.

Study design

  • Cross-sectional study of 65 pregnant women with GDM who underwent polysomnography and 72-hour continuous glucose monitoring.
    • Mean age 35 years, mean BMI 32 kg/m2, mean 29 weeks gestation, 33% took insulin/metformin. 
  • Funding: NIH.

Key results

  • Mean apnea-hypopnea index (AHI) 16.1.
  • Mean oxygen desaturation index 3.0. 
  • AHI was positively correlated with mean 24-hour glucose (r=0.28, P=.04) before adjustment for age, BMI, and insulin/metformin use but not after (P=.1).
  • Increasing AHI showed positive association with increased glucose levels during early sleep (11 p.m.-3 a.m.; Β=0.02, P=.04) and late sleep (3-6 a.m.; Β=0.02; P=.02) after adjustment. 
  • No association between AHI and daytime glucose (8 a.m.-8 p.m.).
  • Adjusted prediction model: 30-year-old unmedicated pregnant woman with AHI ≥30 and BMI 30 “expected to have ~12% increase in mean nocturnal glucose levels” compared with no SDB.