The Surprising Link Between Your Sleep and Gestational Diabetes

Pregnancy is hard work—and it’s definitely not always comfortable. The hours are long, you may have heartburn and hemorrhoids and be sick to your stomach.

Meanwhile—surprise!—you’re getting bigger everywhere you look, sometimes even your feet.

Your body is flooded with hormones. Add that to your changing emotional landscape and it’s no wonder you’re having trouble sleeping.

Unfortunately, the results of a recent study suggest that pregnant women who sleep less than 6 hours and 15 minutes a night are almost three times more likely to have gestational diabetes as those who sleep more.

What is gestational diabetes?

Even if you’re a healthy mom-to-be doing everything right, you can still develop gestational diabetes during pregnancy. Like diabetes itself, gestational diabetes is elevated levels of blood sugar, specifically during pregnancy, says Vishesh Kapur, M.D., M.P.H., founder of the Sleep Medicine Center at Harborview.

When you’re pregnant, you are at the mercy of your hormones. Progesterone, a hormone produced by your placenta, helps make sure that baby gets all the nutrients needed to grow, says Katherine McLean, M.D., an obstetrician at Meridian Women’s Health at Ballard. But it also raises the possibility of elevated blood sugars in mom.

Why is gestational diabetes bad for baby?

If you have gestational diabetes, it may make your baby put on extra weight. Sometimes physicians recommend early delivery due to the baby’s large size.

A baby may also have trouble breathing after birth as a result of gestational diabetes, says McLean. That’s because when mom's blood sugar is high, the baby's pancreas starts to produce more insulin. This leads to a higher metabolism, which results in the need for more oxygen.

Why is gestational diabetes dangerous for moms?

Gestational diabetes also carries risks for you. High blood sugar can cause you to gain more weight in pregnancy than is healthy, says McLean. It also raises your risk of high blood pressure, which can be dangerous in pregnancy.

Having gestational diabetes means that you are more likely to develop diabetes outside of pregnancy, too. Sometimes diabetes is already a problem; it had just never been diagnosed before pregnancy. Other times, weight gained during pregnancy can tip you over the edge from a tendency toward diabetes before pregnancy to full-blown diabetes afterwards, says McLean.

Clearly there are risks associated with gestational diabetes—for both mother and baby. And according to the Centers for Disease Control and Prevention, 2 to 10 percent of pregnancies in the United States will be affected by gestational diabetes.

What’s sleep got to do with it?

It’s long been known that less than six hours of sleep a night is associated with weight gain and the development of diabetes. People who sleep less are more likely to be overweight than those who sleep well. And obesity is a risk factor for the development of diabetes.

But there is evidence that trouble sleeping contributes to the development of diabetes, independent of weight gain.

“It’s not too surprising that it’s doing something similar in pregnant women,” says Kapur.

What can you do? Sleeping tips for pregnant women.

It’s not that you haven’t been trying to sleep. It’s that you can’t.

“Sleep is often disrupted in pregnancy,” says Kapur. Like everything else in pregnancy, sleeping is going to be harder.

“Women may need to change position more frequently, they may be having more heartburn symptoms and other things reducing their sleep time,” says Kapur.

Along with healthy eating, exercise and not smoking, adequate sleep is a good idea for all pregnant women. McLean has some tips for expectant moms, especially those with gestational diabetes, to help them sleep better.

Eat, drink and be smart

Coffee can be a nice pick-me-up in the morning but not so nice when it continues to keep you up at 2 a.m. Try to consume 200 milligrams or less of caffeine per day (equivalent to 12 ounces of coffee). Avoid caffeine after noon. And remember that caffeine is found in food and beverages other than coffee, too.

“I also recommend not eating for at least two to three hours before bed,” says McLean. This helps reduce reflux and helps women to sleep more soundly.

Think pillows—and more pillows

Pillow placement is very important to prevent back pain and hip pain. Many of my patients use multiple pillows—one between their legs and one under the curve of their waist as they lie on their side, says McLean. Others like “all-in-one” options like the Snoogle, the pillow known as the mother of all pregnancy pillows, she says.

Exercise can only help

The primary benefit of exercise for women with gestational diabetes is that it can lower blood sugar levels. Some studies also suggest that exercise can help pregnant women to sleep (though the jury is still out).

Moderate aerobic and strength training are both safe as long as they have not been ruled out by your healthcare provider for medical reasons. The exercise recommendation for pregnant women is for 20 to 30 minutes per day on most days of the week.

Give yourself time

Keeping in mind that it may take you a bit longer to fall asleep, and that you may need to get up to go to the bathroom, give yourself a little more time to sleep than you would normally. The things you can control—like allowing yourself enough time to sleep—should be a priority, says Kapur.

Turn off before you tuck in.

Set your pregnancy app and computer aside at least an hour before bedtime. Studies show that using media devices before bedtime is associated with poor sleep quality and quantity.

Sometimes it also helps moms to know that they are not alone in their sleep struggles, says McLean.

“It’s not that you’re doing anything wrong. It just comes with the territory,” she says.