Obstructive Sleep Apnea Is Associated with Newly Diagnosed Gestational Diabetes Mellitus
Open accessAbstract
Abstract Rationale Sleep-disordered breathing (SDB) is associated with increased risk of adverse pregnancy outcomes, including gestational diabetes mellitus (GDM). GDM is a significant cause of maternal and infant morbidities. Assessing these risk factors concurrently may facilitate both the identification of women at GDM risk and the initiation of GDM prevention strategies. Objectives To investigate whether SDB events, including SDB in rapid eye movement (REM) sleep and other sleep parameters, are associated with increased risk of GDM and to evaluate the performance of the models investigating associations between breathing and sleep parameters and GDM risk. Methods In this case–control study, 46 women with newly diagnosed GDM and 46 healthy control subjects, who were individually matched for age, gestational age, body mass index, race, and parity, completed overnight polysomnographic studies and sleep questionnaires after being screened for GDM during the late-second to mid-third trimesters. Conditional logistic regression analysis was used to identify models investigating associations between risk factors and GDM risk. The Bayesian information criterion (BIC) was employed to compare models; the model with the lowest BIC is preferred. Results Obstructive sleep apnea (OSA; defined as an apnea–hypopnea index [AHI] >5 events/h) was present in 22% of subjects with GDM and 9% of control subjects (P < 0.001). Women with OSA had a higher GDM risk (odds ratio [OR], 4.71; 95% confidence interval [CI], 1.05–21.04). In individual models, GDM risk was also significantly higher among women with higher overall AHI (events/h OR, 1.81; 95% CI, 1.01–3.27), higher AHI in REM (events/h OR, 2.09; 95% CI, 1.02–4.31), higher oxygen desaturation index greater than or equal to 4% (ODI4; events/h OR, 2.21; 95% CI, 1.03–4.73), and higher Sleep Apnea Symptom Score (OR, 2.72; 95% CI, 1.11–6.69). The percentage of non-REM sleep was significantly associated with decreased risk of GDM (percentage of non-REM sleep OR, 0.88; 95% CI, 0.78–0.99). The BIC supports the conclusion that there is a strong association between AHI in REM and GDM risk compared with the other significant models. Conclusions SDB events, including REM-related OSA, are linked to increased GDM risk. GDM risk is also influenced by intercorrelated sleep variables.
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The study by Izci Balserak et al reinforces the evidence that the risk of OSA is significantly related to metabolic alterations during pregnancy.
“The study by Izci Balserak et al. (24) reinforces the evidence that the risk of OSA is significantly related to metabolic alterations during pregnancy.”
From Diabetes gestacional y riesgo de apnea obstructiva del sueño en el tercer trimestre (2025) · cites this paper as [24]
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Self-citation
- Authors
- Izci Balserak, B., Pien, G. W., Prasad, B., Mastrogiannis, D., Park, C., Quinn, L. T., Herdegen, J., & Carley, D. W.
- Affiliations
- College of Nursing, and
- Johns Hopkins University (US)
- University of Illinois Chicago (US)
- SUNY Upstate Medical University (US)
- Rush University Medical Center (US)
- Venue
- Annals of the American Thoracic Society
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-06-01
- Volume
- 17
- Issue
- 6
- Pages
- 754-761
- ISSN
- 2325-6621 (ISSN-L)
- 2329-6933
- PMC
- PMC7258422
- OpenAlex
- W3006163254
- Cited by
- 31
- References
- 38
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 2
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of the American Thoracic Society (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007713)
- National Institute of Nursing Research (R00NR013187)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- obstructive sleep apnea, gestational diabetes mellitus, sleep-disordered breathing, REM sleep, oxygen desaturation index, apnea-hypopnea index, NREM sleep, GDM risk factors, polysomnography, pregnancy outcomes, GDM prevention, Bayesian model selection, risk prediction model, maternal health, infant health
- MeSH terms
- Adolescent, Adult, Bayes Theorem, Blood Glucose, Female, Humans, Pregnancy, Pregnancy Complications, Risk Factors, Sleep, REM, Body Mass Index, Logistic Models, Case-Control Studies, Diabetes, Gestational, Polysomnography, Sleep Apnea, Obstructive, Young Adult
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