A longitudinal study of sleep duration in pregnancy and subsequent risk of gestational diabetes: findings from a prospective, multiracial cohort
Open accessAbstract
BACKGROUND: Both short and prolonged sleep duration have been linked to impaired glucose metabolism. Sleep patterns change during pregnancy, but prospective data are limited on their relation to gestational diabetes. OBJECTIVE: We sought to prospectively examine the trimester‐specific (first and second trimester) association between typical sleep duration in pregnancy and subsequent risk of gestational diabetes, as well as the influence of compensatory daytime napping on this association. STUDY DESIGN: In the prospective, multiracial Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies‐Singleton Cohort, 2581 pregnant women reported their typical sleep duration and napping frequency in the first and second trimesters. Diagnosis of gestational diabetes (n = 107; 4.1%) was based on medical records review. Adjusted relative risks with 95% confidence intervals for gestational diabetes were estimated with Poisson regression, adjusting for demographics, prepregnancy body mass index, and other risk factors. RESULTS: From the first and second trimester, sleep duration and napping frequency declined. Sleeping duration in the second but not first trimester was significantly related to risk of gestational diabetes. The association between second‐trimester sleep and gestational diabetes differed by prepregnancy obesity status (P for interaction = .04). Among nonobese but not obese women, both sleeping >8‐9 hours or <8‐9 hours were significantly related to risk of gestational diabetes: 5‐6 hours (adjusted relative risk, 2.52; 95% confidence interval, 1.27–4.99); 7 hours (adjusted relative risk, 2.01; 95% confidence interval, 1.09–3.68); or ≥10 hours (adjusted relative risk, 2.17; 95% confidence interval, 1.01–4.67). Significant effect modification by napping frequency was also observed in the second trimester (P for interaction = .03). Significant and positive association between reduced sleep (5‐7 hours) and gestational diabetes was observed among women napping rarely/never (adjusted relative risk, 2.48; 95% confidence interval, 1.20–5.13), whereas no comparable associations were observed among women napping most/sometimes. CONCLUSION: Our data suggest a U‐shaped association between sleep duration and gestational diabetes, and that napping and prepregnancy obesity status may modify this association.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
1 retracted
- Retracted
Impact of sleep debt on metabolic and endocrine function
Spiegel, K., Leproult, R., & Van Cauter, E. (1999) · The Lancet · doi:10.1016/s0140-6736(99)01376-8 · Cited by 3,668 · see citing works
How Many Imputations are Really Needed? Some Practical Clarifications of Multiple Imputation Theory
Graham, J. W., Olchowski, A. E., & Gilreath, T. D. (2007) · Prevention Science · doi:10.1007/s11121-007-0070-9 · Cited by 2,795 · see citing works
Self-Reported and Measured Sleep Duration: How Similar Are They?
Lauderdale, D. S., Knutson, K. L., Yan, L. L., Liu, K., & Rathouz, P. J. (2008) · Epidemiology · doi:10.1097/ede.0b013e318187a7b0 · Cited by 1,565 · see citing works
Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective
Zhu, Y., & Zhang, C. (2016) · Current Diabetes Reports · doi:10.1007/s11892-015-0699-x · Cited by 1,260 · see citing works
Self-citationAdverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines
Vgontzas, A. N., Zoumakis, E., Bixler, E. O., Lin, H.-M., Follett, H., Kales, A., & Chrousos, G. P. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031562 · Cited by 1,050 · see citing works
Sleep Deprivation and Activation of Morning Levels of Cellular and Genomic Markers of Inflammation
Irwin, M. R. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.16.1756 · Cited by 850 · see citing works
Sleep Restriction for 1 Week Reduces Insulin Sensitivity in Healthy Men
Buxton, O. M., Pavlova, M., Reid, E. W., Wang, W., Simonson, D. C., & Adler, G. K. (2010) · Diabetes · doi:10.2337/db09-0699 · Cited by 604 · see citing works
Intensity and Amount of Physical Activity in Relation to Insulin Sensitivity
Mayer-Davis, E. J. (1998) · JAMA · doi:10.1001/jama.279.9.669 · Cited by 598 · see citing works
DeSisto, C. L., Kim, S. Y., & Sharma, A. J. (2014) · Preventing Chronic Disease · doi:10.5888/pcd11.130415 · Cited by 577 · see citing works
Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies
Buck Louis, G. M., Grewal, J., Albert, P. S., Sciscione, A., Wing, D. A., Grobman, W. A., Newman, R. B., Wapner, R., D’Alton, M. E., Skupski, D., et al. (2015) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2015.08.032 · Cited by 532 · see citing works
Self-citationParity and Sleep Patterns During and After Pregnancy
Lee, K., ZAFFKE, M. E., & MCENANY, G. (2000) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(99)00486-x · Cited by 445 · see citing works
Applying Quantitative Bias Analysis to Epidemiologic Data
Fink, A. K., Fox, M. P., & Lash, T. L. (2009) · Statistics in the health sciences · doi:10.1007/b97920 · Cited by 354 · see citing works
Reutrakul, S., & Van Cauter, E. (2014) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.12355 · Cited by 321 · see citing works
Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism
Facco, F., Grobman, W. A., Kramer, J., Ho, K. H., & Zee, P. C. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.03.041 · Cited by 319 · see citing works
Effects of pregnancy on mothers' sleep
Hedman, C., Pohjasvaara, T., Tolonen, U., Suhonen-Malm, A. S., & Myllylä, V. V. (2002) · Sleep Medicine · doi:10.1016/s1389-9457(01)00130-7 · Cited by 306 · see citing works
Fisher, S. C., Kim, S. Y., Sharma, A. J., Rochat, R. W., & Morrow, B. (2013) · Preventive Medicine · doi:10.1016/j.ypmed.2013.02.015 · Cited by 258 · see citing works
Sleep disturbances during pregnancy
Mindell, J. A., & Jacobson, B. J. (2000) · Journal of Obstetric, Gynecologic & Neonatal Nursing · doi:10.1111/j.1552-6909.2000.tb02072.x · Cited by 239 · see citing works
Daytime Sleepiness in Obesity: Mechanisms Beyond Obstructive Sleep Apnea—A Review
Panossian, L. A., & Veasey, S. C. (2012) · SLEEP · doi:10.5665/sleep.1812 · Cited by 174 · see citing works
Qiu, C., Enquobahrie, D. A., Frederick, I. O., Abetew, D. F., & Williams, M. A. (2010) · BMC Women s Health · doi:10.1186/1472-6874-10-17 · Cited by 172 · see citing works
Sleep Disturbances and Their Relationship to Glucose Tolerance in Pregnancy
Reutrakul, S., Zaidi, N., Wroblewski, K., Kay, H. H., Ismail, M., Ehrmann, D. A., & Van Cauter, E. (2011) · Diabetes Care · doi:10.2337/dc11-0780 · Cited by 161 · see citing works
Sleep duration and quality, and risk of gestational diabetes mellitus in pregnant Chinese women
Wang, H., Leng, J., Li, W., Wang, L., Zhang, C., Li, W., Liu, H., Zhang, S., Chan, J., Hu, G., et al. (2017) · Diabetic Medicine · doi:10.1111/dme.13155 · Cited by 75 · see citing works
Self-citationO'Keeffe, M. M., & St‐Onge, M. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.142 · Cited by 71 · see citing works
Assah, F. K., Brage, S., Ekelund, U., & Wareham, N. J. (2008) · Diabetologia · doi:10.1007/s00125-008-1033-9 · Cited by 68 · see citing works
Is Sleep Disturbed in Pregnancy?
Naud, K., Ouellet, A., Brown, C., Pasquier, J., & Moutquin, J. (2010) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)34400-0 · Cited by 66 · see citing works
Objectively measured sleep duration and hyperglycemia in pregnancy
Herring, S. J., Nelson, D. B., Pien, G. W., Homko, C., Goetzl, L. M., Davey, A., & Foster, G. D. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.07.018 · Cited by 64 · see citing works
Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia
Izci‐Balserak, B., JACKSON, N. J., Ratcliffe, S. J., Pack, A. I., & Pien, G. W. (2013) · Sleep And Breathing · doi:10.1007/s11325-013-0809-4 · Cited by 60 · see citing works
Mild Sleep Restriction Acutely Reduces Plasma Glucagon Levels in Healthy Men
Schmid, S. M., Jauch-Chara, K., Hallschmid, M., & Schultes, B. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0969 · Cited by 55 · see citing works
Izci-Balserak, B., & Pien, G. W. (2014) · Current Diabetes Reports · doi:10.1007/s11892-013-0459-8 · Cited by 52 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Lu, Q., Zhang, X., Wang, Y., Li, J., Xu, Y., Song, X., Su, S., Zhu, X., Vitiello, M. V., Shi, J., et al. (2021) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2021.101436 · Cited by 311 · see citing works
Zhang, X., Zhang, R., Cheng, L., Wang, Y., Ding, X., Fu, J., Dang, J., Moore, J., & Li, R. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.05.014 · Cited by 50 · see citing works
Kantrowitz-Gordon, I., McCurry, S. M., Landis, C. A., Lee, R., & Wi, D. (2020) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00675-1 · Cited by 11 · see citing works
“as gestational diabetes [2], preterm birth [3], and cesarean delivery [4].”
BackgroundChen, H., He, Y., Zeng, X., Chen, Q., Zhou, N., Yang, H., Zhou, W., Zhang, L., Yang, R., Huang, Q., et al. (2022) · Nature and Science of Sleep · doi:10.2147/nss.s353742 · Cited by 10 · see citing works
Lai, Y., Wang, C., Ouyang, J., Wu, L., Wang, Y., Wu, P., Ye, Y.-X., Yang, X., Gao, Y., Wang, Y.-X., et al. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.04.003 · Cited by 5 · see citing works
- Authors
- Rawal, S., Hinkle, S. N., Zhu, Y., Albert, P. S., & Zhang, C.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Zhang, Cuilin
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 216
- Issue
- 4
- Pages
- 399.e1-399.e8
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC6331053
- OpenAlex
- W2560535794
- Semantic Scholar
- c033d0985a9caedf8952103f291285dcce939f78
- Cited by
- 69
- References
- 29
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 12 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 9 · 2019: 9 · 2018: 5 · 2017: 6
- FWCI
- 8.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of California, Irvine
- Columbia University
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HHSN27500006, HHSN275200800014C, HHSN275201000009C)
- Medical University of South Carolina
- Northwestern University
- University of Alabama at Birmingham
- Tufts University
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- sleep duration, gestational diabetes mellitus, pregnancy, daytime napping, pre-pregnancy obesity, impaired glucose metabolism, U-shaped relationship, second trimester, effect modification, maternal risk factors, pre-pregnancy body mass index, impaired fasting glucose, impaired glucose tolerance, prediabetes, gestational weight gain, gestational hypertension
- MeSH terms
- Adult, Female, Humans, Obesity, Pregnancy, Pregnancy Trimester, First, Pregnancy Trimester, Second, Prospective Studies, Risk, Sleep, Time Factors, United States, Diabetes, Gestational, Racial Groups
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
