• Raphieal Newbold, Andrea Benedetti, R John Kimoff, Sara Meltzer, Natasha Garfield, Kaberi Dasgupta, Robert Gagnon, Lorraine Lavigne, Allen Olha, Evelyne Rey, and Sushmita Pamidi.
• Centre for Outcomes Research and Evaluation (CORE) of the Research Institute, McGill University Health Centre, Montreal, QC, Canada.
• Chest. 2021 Jan 1; 159 (1): 356-365.

BackgroundWomen with hyperglycemia during pregnancy are at high risk for adverse perinatal outcomes. Maternal sleep-disordered breathing (SDB) during pregnancy is common and is a risk factor for gestational diabetes mellitus (GDM). However, the relationship between SDB severity and glucose control is unknown.Research QuestionIs there an association between SDB severity and glucose levels as assessed by continuous glucose monitoring in GDM?Study Design And MethodsWomen with GDM underwent sleep recordings and 72-hour continuous glucose monitoring. Linear mixed models were used to estimate the association of the apnea-hypopnea index (AHI), rapid eye movement (REM)-AHI, and non-REM-AHI with mean glucose levels during nighttime (two periods: 11 pm to 3 am and 3 am to 6 am), daytime (8 am to 9 pm), and 24-hours. Models were adjusted for BMI and antihyperglycemic medications.ResultsIn 65 participants who were 35 ± 5 (mean ± SD) years of age with BMI of 33 ± 7 kg/m2, 31% were undergoing insulin and/or metformin therapy. A ten-unit increase in AHI was associated with elevated nocturnal glucose levels (11 pm to 3 am: 0.20 mmol/L [95% CI, 0.04-0.40]) with persistent elevations into the morning (8 am: 0.26 mmol/L [95% CI, 0.08-0.4]) when adjusted for BMI and medications. REM-AHI was also associated with higher nocturnal and morning glucose levels, whereas non-REM was not. AHI was not associated with either mean daytime or 24-hour glucose levels.InterpretationGreater severity of SDB was associated with higher nocturnal and morning glucose levels in women with GDM.Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

20 keywords...

hide…