Interaction effect between long sleep duration in early pregnancy and prepregnancy overweight/obesity on gestational diabetes mellitus

Impact of snoring on the risk of stroke in patients with diabetes mellitus

BACKGROUND

The impact of snoring and diabetes on stroke risk is unclear. This study examined the association between snoring and stroke risk and how it varies with diabetes mellitus (DM) status.

METHODS

This research was conducted as a prospective cohort study. A total of 4,352 subjects were included in the analysis, with a mean follow-up time of 13.7 years. The study used snoring history obtained through interviews as the primary exposure variable and DM as the secondary exposure variable. The main outcome measured was the occurrence of stroke. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Additionally, a joint test was conducted to evaluate the combined effect of snoring and diabetes on the occurrence of stroke.

RESULTS

In our study of 4,352 subjects, 1,135 (26.1%) had a history of snoring, 233 (5.4%) had diabetes mellitus, and over the 18-year observation period, there were 168 cases of new-onset stroke. Snoring was not associated with an increased risk of stroke (HR: 0.95, 95% CI [0.68-1.33]), but DM significantly elevated the risk of stroke (3.02 [1.96-4.65]). In the interaction analysis of snoring and DM status on stroke risk, snoring was a significant risk factor for stroke only in the population with DM (2.89 [1.07-7.60]). Compared to non-snoring and non-DM, the multivariate HRs for stroke were 1.09 (0.76-1.57) for snoring and non-DM, 1.64 (0.83-2.82) for non-snoring and DM, and 2.95 (1.42-5.45) for snoring and DM.

CONCLUSION

Diabetes mellitus was associated with an increased risk of stroke, while a history of snoring was not. In a sub analysis, snoring appeared to be associated with an increased risk of stroke among subjects with diabetes mellitus.

Maternal sleep during pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis

AIM/INTRODUCTION

Sleep problem is an important public health concern worldwide. We conducted a meta-analysis to quantitatively evaluate whether sleep duration associated with pregnancy outcomes, and the associations were modified by important characteristics of studies.

MATERIALS AND METHODS

Basing on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) databases, we searched for the published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June, 2021. We conducted risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks (RR) or odds ratios (OR) with 95% confidence intervals (CI) were used to estimate the pooled effects.

RESULTS

5246 references were identified through databases searching, 41 studies were included in the study. Pregnant with short sleep duration had 1.81 times (95% CI 1.35-2.44, P < 0.001) risk of gestational diabetes mellitus (GDM). The association between short sleep duration and the risk of gestational hypertension (GH), cesarean section (CS), low birthweight (LBW), preterm birth (PTB) and small for gestational age (SGA) were not significant (P > 0.05). Furthermore, long sleep duration was significantly correlated with GDM (OR 1.24. 95% CI 1.12-1.36, P < 0.001) and CS (OR 1.13. 95% CI 1.04-1.22, P = 0.004), while long sleep duration was not linked with GH, LBW, PTB and SGA (P > 0.05).

CONCLUSIONS

Short / long sleep duration appeared to be associated with adverse pregnancy outcome, specifically with an increased risk of GDM. Sleep should be systematically screened in the obstetric population.