Sleep Disturbances and Daytime Sleepiness in Pregnant Women with Diabetes

Sleep disturbances in pregnancy are associated with depression, preterm delivery, hypertension, hyperglycemic disorders, and higher rate of cesarean as well as adverse perinatal outcomes. Diabetes is other prevalent condition in pregnancy related to these adverse outcomes, and insulin resistance is a common disruptor. As such, it is important to evaluate the quality of sleep and daytime somnolence in diabetic pregnancy.

Aim: Evaluate sleep quality and excessive daytime sleepiness in pregnancy complicated by diabetes mellitus. This is a cross-sectional study involving 115 pregnant women with diabetes (PWD), gestational age from 10 to 39 weeks. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI-BR) and daytime sleepiness by the Epworth Sleepiness Scale (ESS). The study was approved by IPADE ethic board (1.801.860). Statistical analysis was performed using the software IBM SPSS.

Results: Poor sleep quality (PSQI>5) was observed in60,4% of PWD, which is higher them most reported rates for normal pregnancy (60,4% vs. 45% p: 0.01, CI99%. SEDOV, 2017) but similar to reported data on Brazilian overweight pregnant women (65,9%; RIBEIRO 2015). The mean PSQI score was 6.91. Short sleep duration was present in 35,8% (mean sleep duration: 7,2 hours/night). Sleep was disturbed by frequent urination in 66,1% of PWD. Daytime somnolence reported in 20.8% of PWD, and was not related with the quality of sleep. The higher number of parity was independently associated with poor sleep quality [p=0.03; 0R=1.74; CI=1.03-2.97]. The presence of obesity, hypertension, educational level, type of diabetes or treatment were non-influential to sleep quality or daytime sleepiness.

Conclusion: Poor sleep quality and excessive daytime sleepiness are frequent in PWD and a higher number of parity is independently associated with poor sleep quality. Given that sleep disturbances are related to adverse outcomes in PWD, we suggest that this group of patients should be the focus of therapeutic measures to improve sleep.