Sleep quality in women with diabetes in pregnancy: a single-center retrospective study
Authors: Wu Qizhen , Meng Zhaoyan , Liu Qing , Zhang Lili , Mao Baohong , Wang Cheng , Zhou Min , Zhang Zhi , Yang Dehua , Jin Ruirui , Yi Tongying 
Published: August 2023

Abstract
Purpose
Sleep quality is an important indicator of individual quality of life, which not only affects people’s mental health but is also closely related to the occurrence of many diseases. Sleep disorders associated with diabetes in pregnancy can greatly endanger the health of both mothers and babies, and their hazards are strongly associated with blood glucose levels. This study explored the quality of sleep and sleep disorders in pregnant women with diabetes.

Methods
From June 2020 to July 2021, a total of 693 patients diagnosed with diabetes during pregnancy in Gansu Provincial Maternal and Child Health Hospital were used as the experiment group, including 626 patients with gestational diabetes mellitus (GDM) and 67 patients with pregestational diabetes mellitus (PGDM). At the same time, 709 women not having diabetes were randomly selected as the control group. To obtain the general situation of the participants, the participants were surveyed using the Pittsburgh Sleep Quality Index (PSQI) and the STOP-BANG (S, Snoring; T, Tiredness; O, Observed apnea; P, high blood Pressure; B, Body mass index > 35 kg/ m2; A, Age > 50 years; N, Neck circumference > 40 cm; G, male Gender) questionnaire. The differences in sleep quality and obstructive sleep apnea-hypopnea syndrome (OSAHS) were analyzed between the experiment group and the control group by using chi-square and t-test, and the clinical features and related factors of sleep disorder were analyzed.

Results
Compared with the control group, the age, pre-pregnancy weight, body mass index (BMI), and neck circumference were larger in the experimental group (P < 0.05). The experimental group had higher PSQI scores for sleep quality, time to fall asleep score, sleep duration, sleep efficiency, sleep disorder, and daytime dysfunction than the control group (all P < 0.001). Specific analysis of the clinical features of sleep disorders indicated that the experimental group scored higher than the control group (P < 0.05). The analysis of the types of daytime dysfunction showed that the experiment group scored higher in terms of frequently feeling sleepy and lack of energy to do things than the control group (P < 0.05). Analysis of STOP-BANG scores indicated that the proportion of patients with GDM or PGDM having fatigue, hypertension, BMI > 35 kg/m2, and neck circumference > 40 cm was higher than that in the control group (P < 0.05). According to regression analysis, sleep quality of patients with GDM was significantly impacted by the increases in age (OR: 1.243, CI:1.197–1.290), neck circumference (OR: 1.350, CI: 1.234–1.476), PSQI score (OR: 2.124, CI:1.656–2.724), and sleep efficiency score (OR: 3.083, CI:1.534–6.195), whereas that of patients with PGDM was impacted by age (OR: 1.191, CI:1.086–1.305), neck circumference (OR: 1.981, CI: 1.469–2.673), and PSQI score (OR: 7.835, CI: 2.383–25.761).

Conclusions
Pregnant women with diabetes had poorer sleep quality and a higher risk of developing OSAHS than those without diabetes. There may be some link between sleep quality and the onset of diabetic.