Persistent Short Sleep During Peripartum Period Increases Metabolic Syndrome Risk

Metabolic syndrome risk is significantly higher among women who experience persistent short sleep from pregnancy to 2 to 7 years after delivery, according to study results published in JAMA Network Open.

Investigators from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (NuMoM2b) group hypothesized that persistent short sleep from pregnancy to years after delivery would be associated with elevated hypertension and metabolic syndrome risk.

Data for this analysis were sourced from NuMoM2b and NuMoM2b-Heart Health Study (HHS), which recruited 10,038 nulliparous women between 2010 and 2013 at 8 sites in the United States. The women (n=3922) who attended follow-up visits between 2014 and 2017 were evaluated for metabolic outcomes on the basis of self-reported persistent short sleep of less than 7 hours a night.

Of the 3922 women included in the analysis, 64.8% were White and they had a mean (SD) age of 27.3 (5.4) years at baseline and a body mass index (BMI) of 26.5 (6.4) kg/m².

The women reported a median (interquartile range [IQR]) sleep duration of 8.0 (7.3-8.6) hours in early pregnancy, 8.0 (7.0-8.4) hours in midpregnancy, and 7.0 (6.5-8.0) hours at 2 to 7 years after delivery. When stratified by sleep pattern, 50.4% of women never had short sleep, 14.4% had persistent short sleep, 11.4% had resolved short sleep, and 23.8% had new-onset short sleep.

At a mean follow-up of 3.1 years after delivery, 21.4% of women had prevalent hypertension, 18.0% had incident hypertension, 16.3% had prevalent metabolic syndrome, and 13.3% had incident metabolic syndrome.

Persistent short sleep was significantly more common among women who were separated, divorced, or widowed (adjusted odds ratio [aOR], 5.71; 95% CI, 2.56-12.72) or never married (aOR, 1.68; 95% CI, 1.29-2.19) compared with being married and among Black women (aOR, 2.17; 95% CI, 1.59-2.97) relative to White women. However, persistent short sleep was less common among women with government insurance compared with commercial or military insurance (aOR, 0.55; 95% CI, 0.41-0.73).

New-onset short sleep was more prevalent among Black (aOR, 1.73; 95% CI, 1.31-2.30) and Hispanic (aOR, 1.33; 95% CI, 1.05-1.68) women compared with White women and among women with an Associate or technical degree compared with women who have less than a high school education (aOR, 1.62; 95% CI, 1.01-2.58).

The odds of having metabolic syndrome were significantly higher among women with persistent short sleep (aOR, 1.60; 95% CI, 1.21-2.11) relative to those who never had short sleep. No other trends were observed for the relationship between short sleep and metabolic syndrome or hypertension risk at follow-up.

Among a subset of women (n=1368) who underwent home sleep apnea testing, no interactions between sleep patterns and race or ethnicity or marital status were observed for the outcomes of hypertension and metabolic syndrome.

“[P]ersistent short sleep duration from pregnancy to 2 to 7 years after delivery was associated with an increased risk of developing metabolic syndrome,” the investigators concluded. “This underscores the peripartum period as a critical life stage during which inadequate sleep may contribute to metabolic dysregulation and long-term cardiovascular risk.”

The major study limitation is the reliance on self-reported sleep duration.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Sleep Wake Advisor