Obesity Is Associated With Insufficient Sleep in Pregnant Women at Risk for GDM

Obesity in pregnant women at risk for GDM was associated with insufficient sleep and snoring, though further research is needed to assess the relationship between diet and sleep disturbances across different stages of pregnancy.

Obesity in pregnant women at risk for gestational diabetes mellitus (GDM) is associated with insufficient sleep, according to study results published in Obesity Science and Practice.

Researchers conducted a cross-sectional study to evaluate sleep duration, insufficient sleep, and snoring risk among pregnant women at risk for GDM. Data were captured from women included in the Treatment of Booking Gestational Diabetes Mellitus study, a large multicenter randomized controlled trial. Eligible participants were adults at 4 to 19 weeks’ gestation carrying a singleton pregnancy.

Participants were divided into 5 groups based on World Health Organization (WHO) classification: overweight (BMI, 25.0-29.9 kg/m2; n=806), obesity class I (BMI, 30.0-34.9 kg/m2; n=537), obesity class II (BMI, 35.0-39.9 kg/m2; n=326), and obesity class III (BMI, ≥40.0 kg/m2; n=339). Participants self-reported sleep parameters using an abbreviated version of the Pittsburgh Sleep Quality Index questionnaire.

The primary study outcomes were decreased sleep duration (<8 hours daily), insufficient sleep (>5 days every month), and the occurrence of snoring. The association between WHO-defined obesity classes and sleep parameters was evaluated via multivariable logistic regression models. Models were adjusted for age, gestational age, parity, ethnicity, smoking status, alcohol consumption before pregnancy, family history of diabetes, marital/relationship status, and employment status.

A total of 2865 women, with a mean (SD) age of 31.3 (5.1) years and a mean BMI of 29.9 (7.6) kg/m2 at baseline,were included.  The majority of participants were of European descent (37.7%), followed by South Asian (26.9%) and Middle Eastern (7.9%) descent. Overall, participants reported sleeping a mean (SD) of 7.8 (1.4) hours daily and having 7.8 (8.9) days of insufficient sleep per month. The overall prevalence of snoring was 36.6%. 

Further researcher is required to support the findings, investigate changes across different stages of pregnancy and ascertain the role of diet in sleep disturbances.

The researchers found European vs non-European women with a BMI of less than 25.0 kg/m2 were more likely to report sleeping less than 8 hours daily and experience less than 5 days per month of insufficient sleep. For all obesity classes greater than 25.0 kg/m2, no differences in sleep duration and snoring occurrence were observed between women of European and non-European descent. However, insufficient sleep of more than 5 days per month was more commonly reported among European vs non-European across all WHO-defined overweight and obesity groups.

Further analysis showed significantly increased risk for insufficient sleep among participants with class II (adjusted odds ratio [aOR], 1.38; 95% CI, 1.03-1.85) and class III (aOR, 1.34; 95% CI, 1.01-1.80) obesity. In addition, the risk for snoring increased as BMI increased, including after adjustment for potential confounders.

This study is limited as sleep parameters were self-reported on an unvalidated sleep index questionnaire.

“Further researcher is required to support the findings, investigate changes across different stages of pregnancy and ascertain the role of diet in sleep disturbances,” the researchers concluded.


Reyes PA, Immanuel J, Hague WM, et al. The relationship between body mass index and sleep in women with risk factors for gestational diabetes mellitus.  Obes Sci Pract. Published online June 7, 2023. doi:10.1002/osp4.689