Comparison of sleep disorders in pregnant women with gestational diabetes mellitus and healthy women

Document Type : Original Article

Authors

1 M.Sc. Student of Midwifery, Department of Midwifery and Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Instructor, Department of Midwifery, Behavioral Sciences Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Professor, Department of Psychiatry, Behavioral Sciences Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Assistant Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 M.Sc. Student of Genetic, Islamic Azad University of Tehran Unit, Tehran, Iran.

Abstract

Introduction: Sleep disorders are of common problems during pregnancy. The rate of gestational diabetes (GDM) is increasing in Iran. Is gestational diabetes may cause sleep disorders during pregnancy? This study was performed with aim to compare sleep disorders in pregnant women with and without GDM.
Methods: This comparative descriptive study was conducted on 240 pregnant women with gestational age of 22-32 weeks referring to health centers of Tehran ShahidBeheshti University of Medical Sciences in 2016. Case group consisted of 120 pregnant women with Fasting Blood Sugar>120 or Glucose Challenge Test>140 or abnormal Glucose Tolerance Test. Control group included 120 healthy pregnant women with normal blood sugar. Data collection tool were Pittsburgh Sleep Quality Index, Depression Anxiety Stress Scales- 21 and demographic characteristic questionnaires which were completed through interview. Data were analyzed using SPSS software (version 16), Mann-Whitney test and independent t test. P<0.05 was considered statistically significant.
Results: Mean total sleep score was 17.37±5.79 in healthy women and 13.42±9.32 in women with GDM. Statistical significant difference was observed between two groups in terms of age, number of pregnancy and number of abortion (P<0.05). Mean scores of depression, anxiety, and stress were higher in women with GDM. Statistical significant difference was observed between two groups in terms of subjective sleep quality (P=0.005), sleep duration (P<0.001), and total score of sleep quality (P<0.001).
Conclusion: Gestational diabetes can affect some dimensions of sleep. Sleep quality is lower in pregnant women with GDM than healthy pregnant women.

Keywords

References

  1. Nguyen BT, Cheng YW, Snowden JM, Esakoff TF, Frias AE, Caughey AB. The effect on race/ethnicity on adverse perinatal outcomes among patients with gestational diabetes mellitus. Am J Obstet Gynecol 2012; 207(4):322-6.
  2. Ferrara A. Increasing prevalence of gestational diabetes mellitus a public health perspective. Diabetes Care 2007; 30(Suppl 2):S141-6.
  3. Cunningham FG, Leveno K J, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams’s obstetrics. 24th ed. New York: McGraw-Hill; 2014. P. 1104-26.
  4. Bener A, Saleh NM, Al-Hamaq A. Prevalence of  gestational diabetes and associated maternal and neonatal complications in a fast-developing community: global comparisons. Int J Women Health 2011; 3:367-73.
  5. Pu J, Zhao B, Wang EJ, Nimbal V, Osmundson S, Kunz L, et al. Racial/ethnic differences in gestational diabetes prevalence and contribution of common risk factors. Paediatr Perinat Epidemiol 2015; 29(5):436-43.
  6. Khoshniat Niku M, Abbaszadeh S, Larijani B. Investigation of studies of prevalence of pregnancy diabetes in different areas of Iran. J Sugar Lipid Iran 2008; 8(1):1-10. (Persian).
  7. Sayehmiri F, Bakhtyari S, Darvishi P, Sayehmiri K. Prevalence of gestational diabetes mellitus in Iran: a systematic review and meta-analysis study. Iran J Obstet Gynecol Infertil 2013; 15(40):16-23. (Persian).
  8. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Geneva: World Health Organization; 2013.
  9. Halperin IJ, Feig DS. The role of lifestyle interventions in the prevention of gestational diabetes. Curr Diab Rep 2014; 14(1):452.
  10. Neau JP, Texier B, Ingrand P. Sleep and vigilance disorders in pregnancy. Eur Neurol 2009; 62(1):23-9.
  11. Lopes EA, Carvalho LB, Seguro PB, Mattar R, Silva AB, Prado LBF, et al. Sleep disorders in pregnancy. Arq Neuropsiquiatr 2006; 62(2A):217-21.
  12. Najar S, Sharafi F, Afshari P, Haghighizadeh MH. The relationship between sleep disorders during pregnancy and premature labor and low birth weight. Iran J Obstet Gyneocol Infertil 2017; 20(7):44-9. (Persian).
  13. Jahdi F, Rezaei E, Behboodi MZ, Hagani H. Prevalence of sleep disorders in the pregnant women. Payesh 2013; 12(6):629-35. (Persian).
  14. Hedman C, Pohjasvaara T, Tolonen U, Suhonen-Malm AS, Myllylä V. Effects of pregnancy on mother’s. Sleep Med 2002; 3(1):37-42.
  15. Lee AK, Gay LC. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gyneocol 2004; 191(6):2041-6.
  16. Lee kA, Mcenany G, Zaffke ME. REM sleep and Mood state in child bearing women: sleepy or weepy? Sleep 2001; 23(7):877-85.
  17. Moline M, Broch H, Zak R. Sleep problems across the line cycle in women. Curr Treatment Options Neurol 2004; 6(4):319-30.
  18. Chasens ER, Umlauf MG, Weaver TE. Sleepiness, physical activity, and functional outcomes in veterans with type 2 diabetes. Appl Nurs Res 2009; 22(3):176-82.
  19. Cuellar NG, Ratcliffe SJ. A comparison of glycemic control, sleep, fatigue, and depression in type 2 diabetes with and without restless legs syndrome. J Clin Sleep Med 2008; 4(1):50-6.
  20. Reutrakul S, Zaidi N, Wrobleweski K, Kay H, Ismail M, Ehrumann D, et al. Sleep disturbances and their relationship to glucose tolerance in pregnancy. Diabetes Care 2011; 34(11):2454-7.
  21. Qiu C, Enquobahrie D, Fredrick IO, Abetew D, William MA. Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study. BMC Women Health 2010; 10:17.
  22. Izci Balserak B, Jackson N, Ratcliffe SA, Pack AI, Pien GW. Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia. Sleep Breath 2013; 17(3):1093-102.
  23. Chang JJ, Pien GW, Duntley SP, Macones GA. Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev 2010; 14(2):107-14.
  24. Buysse DJ, Reynolds CF 3rd, Monk TH, Bermaner SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28(2):193-213.
  25. Heydari A, Ehteshamzadeh P, Marashi M. The relationship between insomnia severity, sleep quality, sleepless and impaired mental health and academic performance of girls. J Woman Culture 2010; 1(4):65-76. (Persian).
  26. Sahebi A, Asghari MJ, Salari RS. Validation of depression, anxiety and stress (DASS-21) scales for the Iranian population. Iran Psychol 2005; 4(1):299-313. (Persian).
  27. Bobik YY, Lemish NY, Roy PK. Risk factors of gestational diabetes in women of Trans Carpathian region of Ukraine. Int J Surg Surg Sci 2014; 2(3):59-63.
  28. Albai A, Timar R, Timar B, Hogea C, Vlad A, Sdic O, et al. Obstetric and perinatal outcomes in women with type 1 diabetes mellitus. Roman J Diabetes Nutr Metab Dis 2013; 20(1):37-43.
  29. Schwartz N, Nachum Z, Green MS. The prevalence of gestational diabetes mellitus recurrence--effect of ethnicity and parity: a meta-analysis. Am J Obstet Gynecol 2015; 213(3):310-7.
  30. Abolfazl M, Hamidreza TS, Narges M, Maryam Y. Gestational diabetes and its association with unpleasant outcomes of pregnancy. Pak J Med Sci 2008; 24(4):566-70.
  31. Lin E, Von Korff M Alonso J, Angermeyer MC, Anthony J, Bromet E, et al. Mental disorders among persons with diabetes--results from the world mental health surveys. J Psychosom Res 2008; 65(6):571-80.
  32. Ducat L, Philipsonb LH, Anderson BJ. The mental health comorbidities of diabetes. JAMA 2014; 312(7):691-2.
  33. Izadi TA, Naderi FM, Naderi FA, Nikbakht R. Depression in patients with diabetes: a review article. J Diabetes Nurs 2014; 2(2):77-83. (Persian).
  34. Karami J, Momeni K, Alimoradi F. Prediction of sleep quality based on stress, depression and anxiety with role of mediator cognitive emotion regulation strategies in pregnant women. Iran J Obstet Gyneocol Infertil 2016; 19(9):1-10. (Persian).
  35. Jahanpak N, Razmjou N, Rezaei Ardani A, Mazloum SR, Bonakdaran S. The relationship between sleep duration and glucose challenge test results in pregnant women without risk factors of diabetes. Iran J Obstet Gyneocol Infertil 2013; 16(60):9-17. (Persian).
  36. Tasali E, Leproult R, Spiegel K. Reduced sleep duration or quality: relationships with insulin resistance and type 2 diabetes. Prog Cardiovasc Dis 2009; 51(5):381-91.
  37. Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC, et al. Sleep characteristics, mental health, and diabetes risk: a prospective study of US military service members in the Millennium Cohort Study. Diabetes Care 2013; 36(10):3154-61.
  38. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG, et al. Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep 2007; 30:1667-73.
  39. Hedayati A, Pouresmail A, Gholampour Y, Dehghan A. The relation between sleep disorders and hemoglobin A1c levels in patients with type II diabetes mellitus. Med J Mashhad Univ Med Sci 2016; 59(3):179-87. (Persian).
  40. Jennings JR, Muldoon MF, Hall M, Buysse DJ, Manuck SB. Self-reported sleep quality is associated with the metabolic syndrome. Sleep 2007; 30(2):219-23.
  41. Knutson KL, Ryden AM, Mander BA, Van Cauter E. Role of sleep duration and severity of type 2 diabetes mellitus. Arch Inter Med 2006; 166(16):1768-74.
  42. Knutson KL. Impact of sleep and sleep loss on glucose homeostasis and appetite regulation. Sleep Med Clin 2007; 2(2):187-97.
  43. Levy P, Bonsignore MR, Eckel J. Sleep, sleep-disordered breathing and metabolic consequences. Eur Respir J 2009; 34(1):243-60.
  44. Schmid SM, Jauch-Chara K, Hallschmid M, Schultes B. Mild sleep restriction acutely reduces plasma glucagon levels in healthy men. J Clin Endocrinol Metab 2009, 94(12):5169-73.
  45. Kumari M, Badrick E, Ferrie J, Perski A, Marmot M, Chandola T. Self-reported sleep duration and sleep disturbance are independently associated with cortisol secretion in the Whitehall II study. J Clin Endocrinol Metab 2009; 94(12):4801-9.
  46. Guastella AJ, Moulds ML. The impact of rumination on sleep quality following a stressful life event. Personal Individual Dif 2007; 42(6):1151-62.
  47. Nia N, Sadat A, Dolatian M, Hasan Pour Azghadi B, Ebadi A, Akbarzadeh Baghban A. Domestic violence and its association with domains of reproductive health in women: a systematic review. J Mazandaran Univ Med Sci 2018; 27(158):205-17. (Persian).
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 21, Issue 12
March 2019
Pages 49-56

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