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Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes

International Journal of Obesity volume 37, pages 765–770 (2013)Cite this article

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Abstract

Humans have an innate requirement for sleep that is intrinsically governed by circadian and endocrine systems. More recently, reduced sleep duration has gained significant attention for its possible contribution to metabolic dysfunction. Significant evidence suggests that reduced sleep duration may elevate the risk for impaired glucose functioning, insulin resistance and type 2 diabetes. However, to date, few studies have determined the implications of reduced sleep duration with regard to glucose control during pregnancy. With the high prevalence of overweight and obesity in women of reproductive age, the occurrence of gestational diabetes mellitus (GDM) is increasing. GDM results in elevated risk of maternal and fetal complications, as well as increased risk of type 2 diabetes postpartum. Infants born to women with GDM also carry a life-long risk of obesity and type 2 diabetes. The impact of reduced sleep on glucose management during pregnancy has not yet been fully assessed and a paucity of literature currently exits. Herein, we review the association between reduced sleep and impaired carbohydrate metabolism and propose how reduced sleep during pregnancy may result in further dysfunction of the carbohydrate axis. A particular focus will be given to sleep-disordered breathing, as well as GDM-complicated pregnancies. Putative mechanisms of action by which reduced sleep may adversely affect maternal and infant outcomes are also discussed. Finally, we will outline important research questions that need to be addressed.

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References

  1. A.D.A. Gestational diabetes mellitus. Diabetes Care 2004; 27 (Suppl 1): S88–S90.

    Google Scholar 

  2. Caughey AB, Cheng YW, Stotland NE, Washington AE, Escobar GJ . Maternal and paternal race/ethnicity are both associated with gestational diabetes. Am J Obstet Gynecol 2010; 202: 616.e1–616.e5.

    Article  Google Scholar 

  3. Hunsberger M, Rosenberg KD, Donatelle RJ . Racial/ethnic disparities in gestational diabetes mellitus: findings from a population-based survey. Womens Health Issues 2010; 20: 323–328.

    Article  PubMed  Google Scholar 

  4. Dabelea D, Snell-Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS . Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care 2005; 28: 579–584.

    Article  PubMed  Google Scholar 

  5. Flegal KM, Carroll MD, Kit BK, Ogden CL . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA 2012; 307: 491–497.

    Article  PubMed  Google Scholar 

  6. Ostlund I, Haglund B, Hanson U . Gestational diabetes and preeclampsia. Eur J Obstet Gynecol Reprod Biol 2004; 113: 12–16.

    Article  PubMed  Google Scholar 

  7. Donma MM . Macrosomia, top of the iceberg: the charm of underlying factors. Pediatr Int 2011; 53: 78–84.

    Article  PubMed  Google Scholar 

  8. Kim C . Gestational diabetes: risks, management, and treatment options. Int J Womens Health 2010; 2: 339–351.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Boney CM, Verma A, Tucker R, Vohr BR . Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005; 115: e290–e296.

    Article  PubMed  Google Scholar 

  10. National Sleep Foundation. 2010 Sleep in America Poll. National Sleep Foundation, 2010.

  11. Vgontzas AN, Mastorakos G, Bixler EO, Kales A, Gold PW, Chrousos GP . Sleep deprivation effects on the activity of the hypothalamic-pituitary-adrenal and growth axes: potential clinical implications. Clin Endocrinol (Oxf) 1999; 51: 205–215.

    Article  CAS  Google Scholar 

  12. Spiegel K, Leproult R, Van Cauter E . Impact of sleep debt on metabolic and endocrine function. Lancet 1999; 354: 1435–1439.

    Article  CAS  PubMed  Google Scholar 

  13. Banks S, Dinges DF . Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007; 3: 519–528.

    PubMed  PubMed Central  Google Scholar 

  14. Heslop P, Smith GD, Metcalfe C, Macleod J, Hart C . Sleep duration and mortality: The effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women. Sleep Med 2002; 3: 305–314.

    Article  PubMed  Google Scholar 

  15. Young T, Finn L, Peppard PE, Szklo-Coxe M, Austin D, Nieto FJ et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31: 1071–1078.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Hublin C, Partinen M, Koskenvuo M, Kaprio J . Sleep and mortality: a population-based 22-year follow-up study. Sleep 2007; 30: 1245–1253.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ip MS, Lam B, Ng MM, Lam WK, Tsang KW, Lam KS . Obstructive sleep apnea is independently associated with insulin resistance. Am J Respir Crit Care Med 2002; 165: 670–676.

    Article  PubMed  Google Scholar 

  18. Cappuccio FP, D'Elia L, Strazzullo P, Miller MA . Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 33: 414–420.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Aronsohn RS, Whitmore H, Van Cauter E, Tasali E . Impact of untreated obstructive sleep apnea on glucose control in type 2 diabetes. Am J Respir Crit Care Med 2009; 181: 507–513.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lee KA . Alterations in sleep during pregnancy and postpartum: a review of 30 years of research. Sleep Med Rev 1998; 2: 231–242.

    Article  CAS  PubMed  Google Scholar 

  21. Kimura M, Zhang SQ, Inoue S . Pregnancy-associated sleep changes in the rat. Am J Physiol 1996; 271 (Pt 2): R1063–R1069.

    CAS  PubMed  Google Scholar 

  22. Lee KA, Zaffke ME, McEnany G . Parity and sleep patterns during and after pregnancy. Obstet Gynecol 2000; 95: 14–18.

    CAS  PubMed  Google Scholar 

  23. Feinsilver SH, Hertz G . Respiration during sleep in pregnancy. Clin Chest Med 1992; 13: 637–644.

    CAS  PubMed  Google Scholar 

  24. Brunner DP, Munch M, Biedermann K, Huch R, Huch A, Borbely AA . Changes in sleep and sleep electroencephalogram during pregnancy. Sleep 1994; 17: 576–582.

    Article  CAS  PubMed  Google Scholar 

  25. Soderpalm AH, Lindsey S, Purdy RH, Hauger R, Wit de H . Administration of progesterone produces mild sedative-like effects in men and women. Psychoneuroendocrinology 2004; 29: 339–354.

    Article  CAS  PubMed  Google Scholar 

  26. Santiago JR, Nolledo MS, Kinzler W, Santiago TV . Sleep and sleep disorders in pregnancy. Ann Intern Med 2001; 134: 396–408.

    Article  CAS  PubMed  Google Scholar 

  27. Suzuki S, Dennerstein L, Greenwood KM, Armstrong SM, Satohisa E . Sleeping patterns during pregnancy in Japanese women. J Psychosom Obstet Gynaecol 1994; 15: 19–26.

    Article  CAS  PubMed  Google Scholar 

  28. Hanif S . Frequency and pattern of urinary complaints among pregnant women. J Coll Physicians Surg Pak 2006; 16: 514–517.

    PubMed  Google Scholar 

  29. Okun ML, Coussons-Read ME . Sleep disruption during pregnancy: how does it influence serum cytokines? J Reprod Immunol 2007; 73: 158–165.

    Article  CAS  PubMed  Google Scholar 

  30. Popovic RM, White DP . Upper airway muscle activity in normal women: influence of hormonal status. J Appl Physiol 1998; 84: 1055–1062.

    Article  CAS  PubMed  Google Scholar 

  31. Gottlieb DJ, Punjabi NM, Newman AB, Resnick HE, Redline S, Baldwin CM et al. Association of sleep time with diabetes mellitus and impaired glucose tolerance. Arch Intern Med 2005; 165: 863–867.

    Article  PubMed  Google Scholar 

  32. Knutson KL, Ryden AM, Mander BA, Van Cauter E . Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med 2006; 166: 1768–1774.

    Article  PubMed  Google Scholar 

  33. Gangwisch JE, Heymsfield SB, Boden-Albala B, Buijs RM, Kreier F, Pickering TG et al. Sleep duration as a risk factor for diabetes incidence in a large U.S. sample. Sleep 2007; 30: 1667–1673.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Ayas NT, White DP, Al-Delaimy WK, Manson JE, Stampfer MJ, Speizer FE et al. A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care 2003; 26: 380–384.

    Article  PubMed  Google Scholar 

  35. Knutson KL, Van Cauter E, Zee P, Liu K, Lauderdale DS . Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes: the Coronary Artery Risk Development in Young Adults (CARDIA) Sleep Study, 2011 Diabetes Care 34: 1171–1176.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Bjorkelund C, Bondyr-Carlsson D, Lapidus L, Lissner L, Mansson J, Skoog I et al. Sleep disturbances in midlife unrelated to 32-year diabetes incidence: the prospective population study of women in Gothenburg. Diabetes Care 2005; 28: 2739–2744.

    Article  PubMed  Google Scholar 

  37. Nedeltcheva AV, Kessler L, Imperial J, Penev PD . Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance. J Clin Endocrinol Metab 2009; 94: 3242–3250.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Bosy-Westphal A, Hinrichs S, Jauch-Chara K, Hitze B, Later W, Wilms B et al. Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women. Obes Facts 2008; 1: 266–273.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Buxton OM, Pavlova M, Reid EW, Wang W, Simonson DC, Adler GK . Sleep restriction for 1 week reduces insulin sensitivity in healthy men. Diabetes 2010; 59: 2126–2133.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Kilkus JM, Booth JN, Bromley LE, Darukhanavala AP, Imperial JG, Penev PD . Sleep and eating behavior in adults at risk for type 2 diabetes. Obesity (Silver Spring) 2011; 20: 112–117.

    Article  Google Scholar 

  41. Facco FL, Grobman WA, Kramer J, Ho KH, Zee PC . Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism. Am J Obstet Gynecol 2010; 203: 142 e1–142 e5.

    Article  CAS  Google Scholar 

  42. Qiu C, Enquobahrie D, Frederick IO, Abetew D, Williams MA . Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study. BMC Womens Health 2010; 10: 17.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  43. Reutrakul S, Zaidi N, Wroblewski K, Kay HH, Ismail M, Ehrmann DA et al. Sleep disturbances and their relationship to glucose tolerance in pregnancy. Diabetes Care 2011; 34: 2454–2457.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Spiegel K, Knutson K, Leproult R, Tasali E, Van Cauter E . Sleep loss: a novel risk factor for insulin resistance and type 2 diabetes. J Appl Physiol 2005; 99: 2008–2019.

    Article  CAS  PubMed  Google Scholar 

  45. Butte NF . Carbohydrate and lipid metabolism in pregnancy: normal compared with gestational diabetes mellitus. Am J Clin Nutr, 2000; 71 (Suppl): 1256 S–1261 S.

    Article  CAS  PubMed  Google Scholar 

  46. Davies MJ, Gray IP . Impaired glucose tolerance. BMJ 1996; 312: 264–265.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Tasali E, Leproult R, Ehrmann DA, Van Cauter E . Slow-wave sleep and the risk of type 2 diabetes in humans. Proc Natl Acad Sci USA. 2008; 105: 1044–1049.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Boyle PJ, Scott JC, Krentz AJ, Nagy RJ, Comstock E, Hoffman C . Diminished brain glucose metabolism is a significant determinant for falling rates of systemic glucose utilization during sleep in normal humans. J Clin Invest 1994; 93: 529–535.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Brandenberger G, Ehrhart J, Piquard F, Simon C . Inverse coupling between ultradian oscillations in delta wave activity and heart rate variability during sleep. Clin Neurophysiol 2001; 112: 992–996.

    Article  CAS  PubMed  Google Scholar 

  50. Born J, Fehm HL . Hypothalamus-pituitary-adrenal activity during human sleep: a coordinating role for the limbic hippocampal system. Exp Clin Endocrinol Diabet 1998; 106: 153–163.

    Article  CAS  Google Scholar 

  51. Dodt C, Breckling U, Derad I, Fehm HL, Born J . Plasma epinephrine and norepinephrine concentrations of healthy humans associated with nighttime sleep and morning arousal. Hypertension 1997; 30 (Pt 1): 71–76.

    Article  CAS  PubMed  Google Scholar 

  52. Steiger A . Sleep and endocrinology. J Intern Med 2003; 254: 13–22.

    Article  CAS  PubMed  Google Scholar 

  53. Born J, Muth S, Fehm HL . The significance of sleep onset and slow wave sleep for nocturnal release of growth hormone (GH) and cortisol. Psychoneuroendocrinology 1988; 13: 233–243.

    Article  CAS  PubMed  Google Scholar 

  54. Martin SE, Wraith PK, Deary IJ, Douglas NJ . The effect of nonvisible sleep fragmentation on daytime function. Am J Respir Crit Care Med 1997; 155: 1596–1601.

    Article  CAS  PubMed  Google Scholar 

  55. Philip P, Stoohs R, Guilleminault C . Sleep fragmentation in normals: a model for sleepiness associated with upper airway resistance syndrome. Sleep 1994; 17: 242–247.

    CAS  PubMed  Google Scholar 

  56. Omisade A, Buxton OM, Rusak B . Impact of acute sleep restriction on cortisol and leptin levels in young women. Physiol Behav 2010; 99: 651–656.

    Article  CAS  PubMed  Google Scholar 

  57. Schmid SM, Hallschmid M, Jauch-Chara K, Wilms B, Lehnert H, Born J et al. Disturbed glucoregulatory response to food intake after moderate sleep restriction. Sleep 2011; 34: 371–377.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Gonzalez-Ortiz M, Martinez-Abundis E, Balcazar-Munoz BR, Pascoe-Gonzalez S . Effect of sleep deprivation on insulin sensitivity and cortisol concentration in healthy subjects. Diabetes Nutr Metab 2000; 13: 80–83.

    CAS  PubMed  Google Scholar 

  59. Schmid SM, Hallschmid M, Jauch-Chara K, Bandorf N, Born J, Schultes B . Sleep loss alters basal metabolic hormone secretion and modulates the dynamic counterregulatory response to hypoglycemia. J Clin Endocrinol Metab 2007; 92: 3044–3051.

    Article  CAS  PubMed  Google Scholar 

  60. Rizza RA, Mandarino LJ, Gerich JE . Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor detect of insulin action. J Clin Endocrinol Metab 1982; 54: 131–138.

    Article  CAS  PubMed  Google Scholar 

  61. Dinneen S, Alzaid A, Miles J, Rizza R . Metabolic effects of the nocturnal rise in cortisol on carbohydrate metabolism in normal humans. J Clin Invest 1993; 92: 2283–2290.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Henley DE, Russell GM, Douthwaite JA, Wood SA, Buchanan F, Gibson R et al. Hypothalamic-pituitary-adrenal axis activation in obstructive sleep apnea: the effect of continuous positive airway pressure therapy. J Clin Endocrinol Metab 2009; 94: 4234–4242.

    Article  CAS  PubMed  Google Scholar 

  63. Weinstein SP, Paquin T, Pritsker A, Haber RS . Glucocorticoid-induced insulin resistance: dexamethasone inhibits the activation of glucose transport in rat skeletal muscle by both insulin- and non-insulin-related stimuli. Diabetes 1995; 44: 441–445.

    Article  CAS  PubMed  Google Scholar 

  64. Delaunay F, Khan A, Cintra A, Davani B, Ling ZC, Andersson A et al. Pancreatic beta cells are important targets for the diabetogenic effects of glucocorticoids. J Clin Invest 1997; 100: 2094–2098.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Khani S, Tayek JA . Cortisol increases gluconeogenesis in humans: its role in the metabolic syndrome. Clin Sci (Lond) 2001; 101: 739–747.

    Article  CAS  Google Scholar 

  66. Beck-Nielsen H, De Pirro R, Pedersen O . Prednisone increases the number of insulin receptors on monocytes from normal subjects. J Clin Endocrinol Metab 1980; 50: 1–4.

    Article  CAS  PubMed  Google Scholar 

  67. Fantus IG, Ryan J, Hizuka N, Gorden P . The effect of glucocorticoids on the insulin receptor: an in vivo and in vitro study. J Clin Endocrinol Metab 1981; 52: 953–960.

    Article  CAS  PubMed  Google Scholar 

  68. Pagano G, Cavallo-Perin P, Cassader M, Bruno A, Ozzello A, Masciola P et al. An in vivo and in vitro study of the mechanism of prednisone-induced insulin resistance in healthy subjects. J Clin Invest 1983; 72: 1814–1820.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. Nepomnaschy PA, Welch KB, McConnell DS, Low BS, Strassmann BI, England BG . Cortisol levels and very early pregnancy loss in humans. Proc Natl Acad Sci USA. 2006; 103: 3938–3942.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Huizink AC, Robles de Medina PG, Mulder EJ, Visser GH, Buitelaar JK . Stress during pregnancy is associated with developmental outcome in infancy. J Child Psychol Psychiatry 2003; 44: 810–818.

    Article  PubMed  Google Scholar 

  71. Mullington JM, Simpson NS, Meier-Ewert HK, Haack M . Sleep loss and inflammation. Best Pract Res Clin Endocrinol Metab 2010; 24: 775–784.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol 2004; 43: 678–683.

    Article  CAS  PubMed  Google Scholar 

  73. Haack M, Sanchez E, Mullington JM . Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep 2007; 30: 1145–1152.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Vgontzas AN, Zoumakis E, Bixler EO, Lin HM, Follett H, Kales A et al. Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab 2004; 89: 2119–2126.

    Article  CAS  PubMed  Google Scholar 

  75. Punjabi NM, Beamer BA . C-reactive protein is associated with sleep disordered breathing independent of adiposity. Sleep 2007; 30: 29–34.

    Article  PubMed  Google Scholar 

  76. Larkin EK, Rosen CL, Kirchner HL, Storfer-Isser A, Emancipator JL, Johnson NL et al. Variation of C-reactive protein levels in adolescents: association with sleep-disordered breathing and sleep duration. Circulation 2005; 111: 1978–1984.

    Article  CAS  PubMed  Google Scholar 

  77. Andrews RC, Walker BR . Glucocorticoids and insulin resistance: old hormones, new targets. Clin Sci (Lond) 1999; 96: 513–523.

    Article  CAS  Google Scholar 

  78. Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002; 106: 2067–2072.

    Article  CAS  PubMed  Google Scholar 

  79. Heikkinen J, Mottonen M, Pulkki K, Lassila O, Alanen A . Cytokine levels in midtrimester amniotic fluid in normal pregnancy and in the prediction of pre-eclampsia. Scand J Immunol 2001; 53: 310–314.

    Article  CAS  PubMed  Google Scholar 

  80. Bourjeily G, Raker CA, Chalhoub M, Miller MA . Pregnancy and fetal outcomes of symptoms of sleep-disordered breathing. Eur Respir J 2010; 36: 849–855.

    Article  CAS  PubMed  Google Scholar 

  81. Klebanoff MA, Shiono PH, Rhoads GG . Outcomes of pregnancy in a national sample of resident physicians. N Engl J Med 1990; 323: 1040–1045.

    Article  CAS  PubMed  Google Scholar 

  82. Saito S, Sakai M, Sasaki Y, Tanebe K, Tsuda H, Michimata T . Quantitative analysis of peripheral blood Th0, Th1, Th2 and the Th1:Th2 cell ratio during normal human pregnancy and preeclampsia. Clin Exp Immunol 1999; 117: 550–555.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Rademacher TW, Gumaa K, Scioscia M . Preeclampsia, insulin signalling and immunological dysfunction: a fetal, maternal or placental disorder? J Reprod Immunol 2007; 76: 78–84.

    Article  CAS  PubMed  Google Scholar 

  84. Prabhakar NR . Sleep apneas: an oxidative stress? Am J Respir Crit Care Med 2002; 165: 859–860.

    Article  PubMed  Google Scholar 

  85. Gozal D, Kheirandish-Gozal L . Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more. Am J Respir Crit Care Med 2008; 177: 369–375.

    Article  CAS  PubMed  Google Scholar 

  86. Tapanainen PJ, Bang P, Wilson K, Unterman TG, Vreman HJ, Rosenfeld RG . Maternal hypoxia as a model for intrauterine growth retardation: effects on insulin-like growth factors and their binding proteins. Pediatr Res 1994; 36: 152–158.

    Article  CAS  PubMed  Google Scholar 

  87. Vgontzas AN, Bixler EO, Chrousos GP . Sleep apnea is a manifestation of the metabolic syndrome. Sleep Med Rev 2005; 9: 211–224.

    Article  PubMed  Google Scholar 

  88. Sharma S, Franco R . Sleep and its disorders in pregnancy. WMJ 2004; 103: 48–52.

    PubMed  Google Scholar 

  89. Mindell JA, Jacobson BJ . Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs 2000; 29: 590–597.

    Article  CAS  PubMed  Google Scholar 

  90. Loube DI, Poceta JS, Morales MC, Peacock MD, Mitler MM . Self-reported snoring in pregnancy. Association with fetal outcome. Chest 1996; 109: 885–889.

    Article  CAS  PubMed  Google Scholar 

  91. Franklin KA, Holmgren PA, Jonsson F, Poromaa N, Stenlund H, Svanborg E . Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest 2000; 117: 137–141.

    Article  CAS  PubMed  Google Scholar 

  92. Drager LF, Jun JC, Polotsky VY . Metabolic consequences of intermittent hypoxia: Relevance to obstructive sleep apnea. Best Pract Res Clin Endocrinol Metab 2010; 24: 843–851.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Grunstein RR, Stenlof K, Hedner J, Sjostrom L . Impact of obstructive sleep apnea and sleepiness on metabolic and cardiovascular risk factors in the Swedish Obese Subjects (SOS) Study. Int J Obes Relat Metab Disord 1995; 19: 410–418.

    CAS  PubMed  Google Scholar 

  94. Chasens ER . Obstructive sleep apnea, daytime sleepiness, and type 2 diabetes. Diabetes Educ 2007; 33: 475–482.

    Article  PubMed  Google Scholar 

  95. Bianchi MT, Cash SS, Mietus J, Peng CK, Thomas R . Obstructive sleep apnea alters sleep stage transition dynamics. PLoS One 2004; 5: e11356.

    Article  CAS  Google Scholar 

  96. Punjabi NM, Shahar E, Redline S, Gottlieb DJ, Givelber R, Resnick HE . Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004; 160: 521–530.

    Article  PubMed  Google Scholar 

  97. Babu AR, Herdegen J, Fogelfeld L, Shott S, Mazzone T . Type 2 diabetes, glycemic control, and continuous positive airway pressure in obstructive sleep apnea. Arch Intern Med 2005; 165: 447–452.

    Article  PubMed  Google Scholar 

  98. Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB et al. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care 2009; 32: 1017–1019.

    Article  PubMed  PubMed Central  Google Scholar 

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  1. New York Obesity Nutrition Research Center, St Luke’s/Roosevelt Hospital, New York, NY, USA

    M O’Keeffe & M-P St-Onge

  2. Department of Medicine, Institute of Human Nutrition, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    M O’Keeffe & M-P St-Onge

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O’Keeffe, M., St-Onge, MP. Sleep duration and disorders in pregnancy: implications for glucose metabolism and pregnancy outcomes. Int J Obes 37, 765–770 (2013). https://doi.org/10.1038/ijo.2012.142

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