Impact of Obstructive Sleep Apnea on Gestational Diabetes Mellitus

Introduction: Obstructive sleep apnea (OSA) increases the risk of type 2 diabetes, and hyperinsulinemia. Pregnancy increases the risk of OSA; however, the relationship between OSA and gestational diabetes mellitus (GDM) is unclear. We aimed (1) to evaluate OSA prevalence in GDM patients; (2) to assess the association between OSA and GDM; and (3) to determine the relationships between sleep parameters with insulin resistance (IR). Methods: A total of 177 consecutive women (89 with GDM, 88 controls) in the third trimester of pregnancy underwent a hospital polysomnography. OSA was defined when the apnea-hypopnea index (AHI) was >= 5 h(-1). Results: Patients with GDM had higher pregestational body mass index (BMI) and neck circumference than controls, but no differences in snoring or OSA-symptoms, or AHI (3.2 +/- 6.0 vs. 1.9 +/- 2.7 h(-1), p= .069). OSA prevalence was not significantly different in both groups. We did not identify OSA as a GDM risk factor in the crude analysis 1.65 (95%CI: 0.73-3.77; p= .232). Multiple regression showed that total sleep time (TST), TST spent with oxygen saturation< 90% (T90), and maximum duration of respiratory events as independent factors related with homeostasis model assessment of IR, while T90 was the only independent determinant of quantitative insulin sensitivity check index. Conclusion: OSA prevalence during the third trimester of pregnancy was not significantly different in patients with GDM than without GDM, and no associations between OSA and GDM determinants were found. We identified T90 and obstructive respiratory events length positive-related to IR, while TST showed an inverse relationship with IR in pregnant women. (C) 2021 Published by Elsevier Espana, S.L.U. on behalf of SEPAR.

Automated summary

This study aimed to evaluate the prevalence of obstructive sleep apnea (OSA) in pregnant women and its association with gestational diabetes mellitus (GDM), as well as the relationship between sleep parameters and insulin resistance (IR). The results showed no significant difference in OSA prevalence during the third trimester of pregnancy between GDM patients and non-GDM controls, and no associations between OSA and GDM determinants were found. Multiple regression analysis revealed that total sleep time, time spent with oxygen saturation< 90%, and maximum duration of respiratory events were independently associated with IR.