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Evening preference in gestational diabetes is associated with poor sleep quality, depressive symptoms, insomnia and fatigue


Sleep problems are common in pregnancy and women with gestational diabetes (GD) are at increased risk of associated clinical complications and adverse maternal outcomes. Preliminary reports indicate that mother circadian preference may influence sleep problems in pregnancy and in early childhood. This study assessed circadian preference in women with GD.


To investigate circadian preferences in woman with gestational Diabetes and correlate with other sleep and mood disorder.


This cross-sectional study consecutively evaluated women with GD attending a public health care unity in the northwest of Brazil. DMG was defined according to WHO 2013 criteria. An in-person interview was performed to collect clinical and demographic data as well as assesses patient’s Sleep quality (Pittsburgh Sleep Quality Index-PSQI), daytime sleepiness (Epworth Sleepiness Scale-ESS), Depression symptoms (Edinburgh Postnatal Depression Scale – EPDS, used during pregnancy), insomnia (Insomnia Severity Index -ISI) and fatigue (Fatigue Severity Scale-FSS). Circadian preference was measured using the Horne-Östberg Morningness-Eveningness Questionnaire (MEQ); Everningness was defined by a MEC score ≤ 40. The study was approved by Federal University of Ceará ethic board, approval number 1.801.860


During the second half of pregnancy, 242 women with GD, with age from 19 to 46 (33.2), mean BMI of 32,3 and mean gestational age of 28 weeks were evaluated. Hypertension was diagnosed in 21,4% and overweight or obesity in 78%. Among all, 19 were identified with evening preference (8.1%), and among them, the prevalence of hypertension was similar to rest of the group. MEQ lower scores (eveningness trend) were associated with higher PSQI index (r=-.016 p=.01) and EDPS (r=.45 p<0.005). Moreover, lower MEQ scores were correlated with increased levels of fatigue (r= -.30 p<0.005) and insomnia (r=.53 p<0.005).


Women with GD and evening preference reported more frequent sleep and mood disturbances, including poor sleep quality, insomnia, depressive symptoms and fatigue. These results show that eveningness, in women with GD, is associated with more sleep complications. Given this evidence, and the known risk of poor pregnancy outcomes associated with GD, Sleep disorders and depression, studies evaluating the effects of light exposure in these patients are warranted


Gestational Diabetes, Circadian Rhythm, everningness, sleep disturbancies, pregnancy


Área Clínica


Centro universitário Unichristus - Ceara - Brasil


Cristina Figeiredo Sampaio Facanha, Victória Sudário Alencar, Mariana Salles Ballalai, Leila Nascimento da Rocha, Paula Soares Machado, Thainá Lima Facó, Pedro Felipe Carvalhedo Bruin, Pedro Luis Pereira Sales, Veralice Meireles Salles Bruin