Abstract
Introduction
Experimental and epidemiological data have linked insufficient sleep to increased diabetes risk. Women with a history of gestational diabetes (GDM) have a 7-fold greater risk of developing type 2 diabetes. This pilot study explored the feasibility of a sleep extension intervention in women with a history of GDM and short sleep, and the effects on glucose metabolism.
Methods
Women age 18–45 years with a history of GDM (at least 1 year postpartum) and actigraphy confirmed short sleep duration (<7h/night) on weekdays were randomized at a ratio of 1 control (healthy living information) to 2 cases (6 weeks of “Sleep Extend” intervention: use of a Fitbit, weekly digital content, interactive tools, and coach delivered feedback in order to increase sleep duration). An oral glucose tolerance test (OGTT), 7-day actigraphy recording and questionnaires were obtained at baseline and 6 weeks (at the end of the intervention).
Results
Twelve women (mean (SD) age 40.3 (4.5) years) participated (n=8 Sleep Extend, n=4 control). Compared to baseline, nightly sleep duration increased in Sleep Extend group (+30.6 (48.8) minutes) but decreased in the control group (-6.8 (22.9) minutes). Both fasting and 2-h glucose levels from OGTT increased in both groups but were greater in the control group (Sleep extend vs. healthy living: fasting glucose +2.1 (9.8) vs. +12.8 (7.3) mg/dL; 2-h glucose +8.2 (21.9) vs. +20.0 (19.4) mg/dL). Self-reported sleep quality improved in both groups. When compared controls, Sleep Extend participants reported improved fatigue symptoms (Promis fatigue score change -5.1 (9.3) vs. 7.0 (1.0), p=0.008), and self-reported physical activity tended to increase (+1614 (3659) vs. -2900 (3922) MET-minutes/week). Combining all participants, an increase in sleep duration correlated with a decrease in fatigue (r= -.62, p=0.04) and anxiety symptoms (r= -.69, p=0.02).
Conclusion
Sleep extension through coaching and use of remote monitoring is feasible in women with a history of GDM. It appears to decrease fatigue and may improve glucose metabolism and physical activity.
Support (if any)
NIDDK P30 DK092949
Science, Technology, Engineering, and Mathematics learning models to establish the clean and healthy living behaviors
