Links Between Gestational Diabetes and Obstructive Sleep Apnea

Links Between Gestational Diabetes and Obstructive Sleep ApneaGestational diabetes is the name for symptoms of abnormally high blood glucose (blood sugar) that appear for the first time during a woman’s pregnancy. The presence of the condition increases pregnancy-related risks for both mothers and newborns in several ways. According to the results of a study published in August 2013 in The Journal of Clinical Endocrinology & Metabolism, women with gestational diabetes have sharply increased chances of developing obstructive sleep apnea, a sleep disorder that can have significantly adverse effects on an individual’s mental and physical health.

Gestational Diabetes Basics

Pregnant women experience changes in their hormone levels that can potentially reduce the effectiveness of insulin, the naturally produced substance required to process glucose in the bloodstream and keep blood sugar levels within normal limits. In some cases, interference with insulin’s effects is severe enough to trigger the onset of gestational diabetes. Individuals with unusually high chances of developing diabetes while pregnant include women who were already overweight or obese, women with diabetes in their family bloodline, women who get pregnant after their mid-20s, women who previously gave birth to a child with a birth defect, women with high blood pressure and women who previously gave birth to an exceptionally large baby.

Gestational diabetes affects roughly 4 percent to 8 percent of pregnant women in the U.S. Typically, the condition appears during the second half of the pregnancy. Most women effectively use diet and exercise to correct gestational diabetes. However, if not controlled properly, it can result in problems such as increased chances of delivering by Cesarean section, increased risks for traumatic injury to a child during birth, increased risks for maternal high blood pressure during pregnancy, minor increases in the risks for infant death and heightened chances that a woman will develop type 2 diabetes at some point after childbirth.

Obstructive Sleep Apnea Basics

Obstructive sleep apnea (OSA) is a condition that produces abnormal pauses in breathing (i.e., apnea) by periodically narrowing the amount of space available in the throat during sleep. This narrowing comes from an unusual relaxation of the muscles that line the throat. Depending on the individual, the breathing pauses associated with OSA can occur as infrequently as five times or less per hour or as often as 30-plus times per hour. The potential mental health implications of these pauses include daytime sleepiness, unusual mood swings, short spurts of high-energy activity that superficially resemble a manic state and an increase in general irritability. If these symptoms grow severe enough to significantly interfere with a person’s ability to function,  a doctor may officially diagnose obstructive sleep apnea as a mental disorder according to guidelines established by the American Psychiatric Association.

Current Findings

In the study published in The Journal of Clinical Endocrinology & Metabolism, researchers from the University of Chicago and Rush University Medical Center looked for the presence of obstructive sleep apnea in 45 women of childbearing age. Fifteen of these women were pregnant and had a diagnosis for gestational diabetes. Another 15 of the women were pregnant but did not have gestational diabetes. The remaining 15 women did not have gestational diabetes and also were not expecting a child.

After reviewing their findings, the authors of the study concluded that the presence of gestational diabetes increases a woman’s risks for developing obstructive sleep apnea by almost 600 percent above the OSA risks found in pregnant women unaffected by gestational diabetes. Compared to the women diagnosed with gestational diabetes, the pregnant women free from the disorder slept an average of one hour more per night and also experienced a lower overall number of nightly sleep disturbances.

Considerations

The authors of the study in The Journal of Clinical Endocrinology & Metabolism note that most of the participating women with gestational diabetes were substantially overweight or obese. They also cite the previous work of other researchers, which shows that the connection between diabetes and obstructive sleep apnea runs both ways: even in men and non-pregnant women, the presence of OSA significantly increases the chances that diabetes will occur. Finally, the study’s authors believe that doctors should consider checking all women with gestational diabetes for the presence of obstructive sleep apnea, especially if these women already have other prominent risks for the onset of OSA, such as obesity or high blood pressure. Since obstructive sleep apnea can trigger diabetes, the authors also recommend that doctors screen their OSA-affected pregnant patients for gestational diabetes.

Posted on November 9th, 2013

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