168: Sleep intervention to improve glycemic control in women with gestational diabetes mellitus: A pilot RCT

Abstract

Prior studies of sleep duration and glycemic control in women with gestational diabetes mellitus (GDM) demonstrate correlation between short sleep duration and worsened glycemic control. However, studies on improving sleep knowledge and quality in pregnancy and whether such interventions improve pregnancy outcomes are limited. We developed a novel sleep education program specific to pregnancy and women with GDM and aimed to determine feasibility of implementing this intervention in a pilot randomized controlled trial. The sleep education program was developed via collaboration by specialists in Maternal-Fetal Medicine, Sleep Medicine, and Psychiatry. The program was presented to focus groups of pregnant women and health care providers to gauge acceptability of the program and to modify content. The sleep education program was then tested on a group of women with GDM. Women were enrolled and randomized immediately after attending a GDM education class. The control group received standard GDM care in pregnancy. The intervention group participated in the sleep education program. Baseline demographics, sleep knowledge, and sleep quality information were obtained from all women at enrollment and again at 35 weeks. Degree of glycemic control was compared between groups as well as change in sleep knowledge and sleep quality. Between December 2017 and July 2019, 74 women were enrolled in the study and randomized. More than 50% of eligible women approached agreed to participate and retention in the intervention group was high at 94%. There was no difference between groups in the proportion of women achieving glycemic control during pregnancy (53% intervention 54% control, p 0.92). There were no differences between groups in measures of sleep knowledge or quality. This pilot study demonstrates that implementation of a sleep education program specific to pregnancy for women with GDM is feasible in the context of typical prenatal care. However, our pilot study did not suggest that a clinic-based sleep intervention in women with GDM results in improved glycemic control.