Gestational Diabetes And Sleep

Introduction

Diabetes is a disease that happens when the blood sugar levels are constantly high in the bloodstream. There are different types of diabetes, the commonest ones being type 1 and type 2 diabetes. However, gestational diabetes is an important condition that can have severe consequences for the mother and baby and is increasing in society.¹

Here in this article, we are going to explain how sleep can affect sugar levels, especially during pregnancy and how sleep is related to gestational diabetes.

What is gestational diabetes?

Gestational diabetes is a type of diabetes diagnosed in pregnant women, who did not have a diagnosis of diabetes previously and it usually disappears after giving birth.

It can appear at any stage of pregnancy, but it generally appears in the second or third trimester.²

Like in the other types of diabetes the sugar levels in the bloodstream are high, affected by the way the cells are able to process it or not and this can cause concerns for the mother’s and baby’s health. Fortunately, gestational diabetes is generally controlled by lifestyle changes with a healthy diet and exercise.³

Symptoms

Gestational diabetes generally doesn’t present symptoms and the diagnosis is done through routine pregnancy tests. However, some women might present general diabetes symptoms like:

 · Feeling thirsty even when drinking a great amount of water.

· Passing out a lot of urine, especially overnight.

· Feeling hungry all the time.

· Losing weight even without trying and eating a lot.

· Feeling tired.

· Frequent infections, especially thrush.

· Blurred vision.⁴

Poor sleep increases the risk of developing gestational diabetes

Insulin is a hormone produced in an organ in the digestive system called the pancreas. After eating, our body breaks the food and converts carbohydrates to glucose. Glucose is a type of sugar responsible to provide energy to our cells and therefore our body.

Insulin acts to facilitate the entrance of glucose into the cells. It is a very important hormone, without it we cannot live.⁵

Poor sleep can affect blood sugar and researchers are now finding the mechanism behind this. By now, it is clear that some physiological factors are involved in this as the ones below:

· Poor sleep patterns and sleep deprivation increase cortisol levels, which can lead to higher sugar levels.

· Lack of sleep also increases insulin resistance affecting the glucose levels in the bloodstream.

· During pregnancy, the growth hormone produced by the placenta is related to higher levels of glucose during sleep.

· A poor sleep pattern also induces inflammation and oxidative stress affecting sugar levels.

· A protein called C-reactive protein is also increased in sleep deprivation and impacts sugar levels.

·        Inflammatory markers like IL-611 and TNF-alpha are higher in situations of lack of sleep and poor sleep pattern and can cause insulin resistance, affecting the way the cells interact which glucose.⁶

Physical and hormonal changes affect sleep patterns

During pregnancy, women can experience some changes in their sleep and feel more restless. This is due to different causes, physical and hormonal that occur during this period.

The sleep might be disturbed by:

· Sickness and vomiting

· Increased urinary frequency

· Breathlessness

· Heartburn

· Feeling generally uncomfortable

· Body aches, like back pain or leg pain

· The foetal movements can make you wake up

· Snoring                  

· Uterine contractions

· Anxiety

The high levels of hormones, like progesterone, and also the fact that the woman’s metabolism works at high levels during the pregnancy, can make them feel tired and sleepy during the day, which might affect the overnight sleep.⁷

Lack of sleep promotes insulin resistance

Insulin, like many other hormones in our bodies, is regulated by the daily cycle, known as the circadian clock. Scientists think that the circadian clock controls the time of production and release of insulin from the pancreas. It also seems like there are also sometimes when the cells are more or less sensitive to insulin.

Sleeping problems can cause disruptions in the circadian clock reducing the effectiveness of insulin, and leading to insulin resistance and, therefore, increasing blood sugar levels.

During pregnancy, the pancreas continues to produce insulin normally, but the resistance to this hormone is caused by many factors, such as lack of sleep and also hormone changes, which will lead to this imbalance that causes gestational diabetes.⁸

Pregnancy hormones sometimes promote insulin resistance

Gestational diabetes, differently from type 1 diabetes, is not caused by the lack of insulin but is more related to type 2 diabetes and insulin resistance. Although it is not clear the mechanism that causes it, it is known that during pregnancy the placenta, along with providing nutrients for the baby, is also responsible for producing different hormones that will help to maintain an ideal environment for the pregnancy to continue.

Some of these hormones (oestrogen, cortisol, and human placental lactogen) can make the body and cells more resistant to insulin. The amount of these hormones is higher from the 20th week of pregnancy and that is why gestational diabetes is more common after this period and the more the placenta grows, the more hormone it produces.

Like in type 2 diabetes, the pancreas tries to compensate for the insulin resistance by producing more insulin, when this mechanism fails, the result is gestational diabetes.⁹

How to improve sleep quality during pregnancy?

There are a couple of things that can be done to improve the sleep pattern during pregnancy like:

· Keep a dark, relaxing, and cool bedroom

· Don’t distract yourself with electronics like TV, smartphones, tablets, etc before sleeping

· Exercise during the day

· Place pillows to get a better position in bed and avoid pain

· Avoid caffeine

· Have a bedtime routine, helping yourself to prepare to sleep

· Avoid large meals at night to avoid heartburn

· Avoid sleeping on your back and favour the sides

These tips might help you to go fall asleep and also to keep a better sleep quality overnight, avoiding the consequences of sleep deprivation.¹⁰

Summary

Gestational diabetes is a type of diabetes that appears during pregnancy and usually goes away when the woman gives birth. Generally, it is asymptomatic, but it can present itself with general diabetes symptoms like feeling thirsty, passing out a lot of urine, feeling tired, and losing weight. It is mainly caused by insulin resistance and recent studies are showing that sleep deprivation affects the way cells respond to insulin directly. Therefore, it is very important to take care of the quality of your sleep when trying to avoid gestational diabetes.