The effect of sleep impairment on gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies

Zhang, Xinge; Zhang, Rui; Cheng, Lei; Wang, Yueqiao; Ding, Xiaoting; Fu, Jialin; Dang, Jiajia; Moore, Justin B.; Li, Rui

doi:10.1016/j.sleep.2020.05.014

“…However, relevant research conclusions are inconsistent. Some systematic reviews have indicated that short sleep or long sleep are risk factors for T2DM in adult [7][8][9][10] and risk factors for gestational diabetes mellitus in pregnant women [11][12][13]. However, studies for adults have not been updated in time.…”

Section: Introductionmentioning

confidence: 99%

A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus

Lu

¹

,

Yang

²

,

Fang

³

et al. 2021

Journal of Diabetes Research

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Objective. To study the association between sleep duration and the incidence of type 2 diabetes mellitus (T2DM) and to provide a theoretical basis for the prevention of T2DM through a meta-analysis. Methods. PubMed, Web of Science, Scopus, Embase, Cochrane Library, ProQuest, CNKI, Wanfang, VIP, and SINOMED were searched from their inception until May 2020. All cohort studies on the relationship between sleep duration and T2DM in adults were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Metaregression and publication bias were evaluated, and sensitivity and meta-analyses were conducted with RevMan 5.3. Results. A total of 17 studies were collected, involving 737002 adults. The incidence of T2DM was 4.73% in short sleep duration (SSD) ( t ≤ 6 h ), 4.39% in normal sleep duration (NSD) ( 6 h < t < 9 h ), and 4.99% in long sleep duration (LSD) ( t ≥ 9 h ). The meta-analysis demonstrated that SSD increased the risk of T2DM compared with NSD ( RR = 1.22 , 95% CI: 1.15-1.29, P < 0.001 ), LSD increased the risk of T2DM compared with NSD ( RR = 1.26 , 95% CI: 1.15-1.39, P < 0.001 ), and the risk of T2DM has no significant difference between SSD and LSD ( RR = 0.97 , 95% CI: 0.89-1.05, P = 0.41 ). The sensitivity of each study was robust and the publication bias was weak. Conclusion. SSD or LSD can increase the risk of T2DM.

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“…Sleep quality, which was found to have a significant influence on the self-efficacy of diabetes management in the pregnant women with GDM in this study, has not been addressed in previous research. However, considering the results of a systematic review showing that poor sleep quality increased the risk of GDM [10] and this study, which found that sleep quality was a factor that affects positive diabetes management self-efficacy for pregnant women with GDM, strategies to improve sleep quality should be developed.…”

Section: Discussionmentioning

confidence: 96%

“…The physical effects resulting from impaired sleep and poor sleep quality are experienced by people with negative emotions [9]. In a recent systematic review and meta-analysis, insufficient sleep duration and poor sleep quality were identified as significant risk factors for developing GDM [10]. Although the effect of poor sleep quality on diabetes has been proven by several previous epidemiological studies [11], there have been no studies on the direct impact of sleep quality on diabetes management self-efficacy among pregnant women with GDM.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, we hypothesized that diabetes management self-efficacy was crucial for pregnant women with GDM to successfully practice diabetes management, and that various psychological, emotional, and physical factors could influence that self-efficacy. However, the existing literature has been focused on the changing trends in the treatment of pregnant women with GDM [2,3], the influence of self-efficacy on improved treatment compliance in this population [4], and the level of improvement in self-management or blood sugar control after interventions [10]. To the authors' knowledge, no studies have yet investigated the influence of the factors introduced above on the level of diabetes management self-efficacy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Do depression, anxiety, emotional intelligence, and sleep quality affect diabetes management self-efficacy in Korean women with gestational diabetes in pregnancy?: a descriptive correlational study

Lee

¹

,

Jang

²

2021

Korean J Women Health Nurs

0

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Purpose: This study aimed to identify factors associated with diabetes management self-efficacy in pregnant women with gestational diabetes mellitus (GDM) in Korea.Methods: A total of 173 pregnant women with GDM in Korea were recruited by posting announcements at two Korean online communities focusing on pregnancy and GDM. Participants completed a structured online survey from July to September 2018. Thirteen inappropriate responses were excluded and a total of 160 questionnaires were used in the final analysis. Descriptive statistics were calculated and multiple regression with the enter method was done to identify the associations of depressive mood, anxiety, emotional intelligence, and sleep quality with diabetes management self-efficacy. The SPSS version 23.0 (IBM Corp.) was used for the analysis. Results: Respondents reported a moderately depressive mood (mean, 10.36), low to moderate anxiety (mean, 41.65), above-average emotional intelligence (mean, 78.04), moderate sleep quality (mean 42.01), and above-average diabetes management self-efficacy (mean, 52.29). The major factor associated with diabetes management self-efficacy of pregnant women with GDM was emotional intelligence (β=.51, p<.001). Other factors, in descending order of influence, were sleep quality (β=.22, p<.001) and exercise (β=.18, p=.004). Taken together, the aforementioned factors explained 34.6% (F=39.53, p<.001) of the total variance. Conclusion: The results of this study suggest that to improve the diabetes management self-efficacy of pregnant women with GDM, it is necessary to develop an education program that can also enhance emotional intelligence, sleep quality, and exercise.

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“…Prevalence of OSA during pregnancy increases due to some physiological changes, such as weight gain or modifications in the upper airway (6,7). OSA is associated with adverse pregnancy outcomes such as gestational diabetes mellitus (GDM) (8)(9)(10), pre-eclampsia (8), gestational hypertension (11), and with fetal related outcomes (12,13), preterm birth, and neonatal low weight (14). Normal pregnancy is associated with higher inflammation markers compared to non-pregnant women (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Influence of Obstructive Sleep Apnea on Systemic Inflammation in Pregnancy

Alonso-Fernández

¹

,

Quetglas

²

,

Mochales

³

et al. 2021

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Background: Obstructive sleep apnea (OSA) is prevalent in pregnancy and it is associated with adverse pregnancy-related outcomes such as gestational diabetes, pre-eclampsia, and low birth weight. Maternal systemic inflammation is proposed to be one of the main intermediate mechanisms. However, the effects of OSA on systemic inflammation are unknown in normal pregnancy.Methods: Women in the 3rd trimester underwent hospital polysomnography to evaluate whether OSA increases systemic inflammation in normal pregnancy and its potential association with adverse fetal outcomes. OSA was defined as an apnea–hypopnea index (AHI) of ≥ 5 h−1. Plasma cytokines levels (TNF-α, IL-1β, IL-6, IL-8, and IL-10) were determined by multiple immunoassays.Results: We included 11 patients with OSA and 22 women with AHI < 5 h−1, who were homogeneous in age, and body mass index (BMI). Women with OSA had significant higher levels of TNF-α, IL-1β, IL-8, and IL-10. We found significant correlations between AHI during REM and TNF-α (r = 0.40), IL-1β (r = 0.36), IL-6 (r = 0.52), IL-8 (r = 0.43), between obstructive apnea index and TNF-α (r = 0.46) and between AHI and IL-1β (r = 0.43). We also found that CT90% was related to IL-8 (r = 0.37). There were no significant differences in neonatal characteristics; however, we found inverse correlations between TNF-α and IL-8 with birth weight (both r = −0.48), while IL-8 showed a significant inverse relationship with neonatal gestational age (r = −0.48).Conclusions: OSA in our normal pregnancy population was associated with higher systemic inflammation, which was related to obstructive events, especially during REM sleep. Moreover, systemic inflammation was inversely correlated with neonatal birth weight and age.

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The effect of sleep impairment on gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies

Cited by 31 publications

References 75 publications

A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus

A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus

Do depression, anxiety, emotional intelligence, and sleep quality affect diabetes management self-efficacy in Korean women with gestational diabetes in pregnancy?: a descriptive correlational study

Influence of Obstructive Sleep Apnea on Systemic Inflammation in Pregnancy

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