To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multi-ethnic Asian population.


686 women (376 Chinese, 186 Malay and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes (GUSTO) mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score >5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, BMI, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score).


296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers. 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted OR = 1.75, 95% CI 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66).


During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM.

Author notes

Corresponding author: Joshua J Gooley, PhD 8 College Road Singapore 169857 Phone: +65 6516 7430 Fax: +65 6221 8625 Email: joshua.gooley@duke-nus.edu.sg