(25-07-10) Snoring in Pregnancy Linked to Increased Gestational Diabetes

?Women who snore frequently during pregnancy are at elevated risk for
gestational diabetes mellitus, according to a case-control study.
Although the risk is particularly high in obese snorers, snoring remained an
independent risk factor for developing gestational diabetes even after
controlling for body mass index, Louise M. O?Brien, Ph.D., reported at the
annual meeting of the Associated Professional Sleep Societies.
?These findings have important implications for the prevention of an event ?
gestational diabetes mellitus ? and all its associated morbidities. I have to
believe there is a role for patient education and screening: asking pregnant
women about their sleep and especially about their snoring in order to improve
pregnancy outcomes,? said Dr. O?Brien of the department of neurology at the
University of Michigan, Ann Arbor.
She reported on 1,221 women in their third trimester who completed
questionnaires about habitual snoring, which was defined as snoring three or
more nights per week. Nearly 31% of the women were habitual snorers in their
last trimester. Their mean response to a screening 1-hour oral glucose
tolerance test was a blood glucose level of 124 mg/dL, significantly higher
than the 117 mg/dL in nonsnorers. Thirty percent of frequent snorers had a
response of 130 mg/dL or more, compared with 30% of nonsmokers.
A formal diagnosis of gestational diabetes mellitus was made in 24% of the
habitual snorers and 17% of nonsnorers, a significant difference.
Altogether, 37% of study participants were obese in their third trimester.
That struck some audience members as a high figure, but Dr. O?Brien said that
it reflects the advanced state of the obesity epidemic in Michigan.
Habitual snorers were more likely to be obese. Gestational diabetes was
diagnosed in 34.5% of obese habitual snorers and 13% of nonobese nonsnorers.
In a multivariate regression analysis adjusted for age, race, gestational age,
and parity, obese snorers were at 3.6-fold increased risk of developing
gestational diabetes, compared with nonobese nonsnorers. Upon controlling
further for body mass index, habitual snoring in pregnancy remained
independently associated with a significant 1.5-fold increased rate of
gestational diabetes.
Dr. O?Brien noted that this finding of an increased risk of gestational
diabetes associated with snoring was independently confirmed in two other
recent studies.
Physicians at Northwestern University in Chicago reported in a prospective
sleep survey study of 189 healthy nulliparas that 18.5% of them snored at least
3 nights per week. Their mean 1-hour oral glucose tolerance test values were
significantly higher than nonsnorers? by a margin of 118 to 108 mg/dL. Their
14.3% incidence of gestational diabetes was significantly higher than the 3.3%
rate in nonsnorers, as well.
The 48% of women who averaged less than 7 hours of sleep per night had a 10.2%
incidence of gestational diabetes, compared with 1.1% in those who slept at
least 7 hours (Am. J. Obstet. Gynecol. May 25, 2010; PMID:20510182).
In the other study, investigators at Seattle?s Swedish Medical Center
interviewed 1,290 women early in pregnancy regarding sleep duration and
snoring. The incidence of gestational diabetes among study participants was
5.3%.
Women who reported sleeping an average of 4 hours or less per night had a 5.6-
fold greater rate of gestational diabetes than those who slept 9 hours.
Overweight short sleepers had a 9.8-fold increased risk. Overweight women who
snored at least 3 nights per week had a 6.9-fold increased gestational diabetes
incidence compared with normal-weight nonsnorers (BMC Womens Health May 14,
2010; PMID:20470416).


Dr. O?Brien reported having no financial conflicts.


Fonte: univadis.it

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