Sleep Duration in Women With Previous Gestational Diabetes

Not Applicable

Completed

Brief Summary: Women with a history of gestational diabetes (GDM) are at high risk of developing diabetes in the future. Sleep disturbances are emerging as risk factors for incident diabetes. The purpose of this study is to test the effects of 6-week sleep extension in women with a history of GDM and short sleep on glucose metabolism by randomized controlled study.

Detailed Description: The primary aim of this study is to evaluate the effects of a sleep extension intervention in non-diabetic women with a prior history of GDM and habitual short sleep duration on the outcomes of glucose metabolism. The participants will be randomized to a 6-week sleep extension intervention group, using technology-assisted sleep intervention, or a healthy living information control group. Glucose metabolism parameters will be assessed by an oral glucose tolerant test.

Recruitment & Eligibility

Inclusion Criteria

Premenopausal women, age 18-45, with a history of GDM who currently do not have diabetes
At least one year post-partum
Reported habitual sleep duration <7h/night during work- or weekdays with a desire to sleep longer
Reported time spent in bed =<8 hours
Own a smartphone compatible with Fitbit.
No need to provide care at night for her child(ren), defined as >3 times a week and >30 minutes at a time
No history of obstructive sleep apnea, insomnia, or restless leg syndrome

Exclusion Criteria

A1C ≥6.5%
Currently pregnant or planning pregnancy or breast feeding
Insomnia symptoms defined as severe as assessed by the Insomnia Severity Index (score ≥15)
Rotating shift or night shift work
High risk for obstructive sleep apnea screened by STOP BANG questionnaire.
Significant medical morbidities, such as congestive heart failure, cirrhosis, chronic obstructive pulmonary disease requiring oxygen, active treatment for cancer or psychiatric problem, history of stroke with neurological deficits, cognitive impairment, kidney failure requiring dialysis, illicit drug use.

Arm && Interventions

Group	Intervention	Description
Sleep intervention	Sleep extension	Sleep extension
Healthy living	Healthy living	Health education

Primary Outcome Measures

Name	Time	Method
Changes in Fasting Glucose	6 weeks	Changes in fasting glucose between baseline and 6 weeks
Sleep Duration Change	baseline and 6 weeks	Changes in sleep duration from baseline to 6 weeks

Secondary Outcome Measures

Name	Time	Method
HOMA-IR Change	baseline and 6 weeks	HOMA-IR change at week 0 to week 6. This is an index of fasting insulin resistance, and the higher reflects greater insulin resistance. Generally, a value greater than 2 is suggestive of insulin resistance
Change in Subjective Sleep Quality	Baseline and week 6	Pittsburgh sleep quality index (range 0 to 21 with higher score reflecting worse sleep quality)