Poor Sleep Tied to Higher Type 2 Diabetes Risk in Women With Gestational Diabetes

Women with a history of gestational diabetes (GD) who experience short sleep duration or frequent snoring face a significantly higher risk of developing type 2 diabetes (T2D), according to new research.1 The cohort study is published in JAMA Network Open.

Study links short sleep and snoring to increased type 2 diabetes risk in women with prior gestational diabetes. | Image credit: fizkes - stock.adobe.com

“To our knowledge, this is the first study to examine the association of sleep characteristics with both T2D risk and glucose metabolism biomarkers among women with a history of GD,” wrote the researchers of the study. “The strengths of this study include its prospective cohort design, large sample size of women with GD, long-term follow-up period, and detailed information gathered on potential confounding factors.”

Prioritizing sleep is essential for overall health, as inadequate rest can elevate stress hormones, increase inflammation, and raise the risk of cardiovascular disease.2 Maintaining good sleep hygiene and addressing sleep disorders like obstructive sleep apnea can help protect heart health and reduce the risk of related conditions such as hypertension and diabetes.

In this study, the researchers aimed to understand the associations of sleep duration and quality with T2D risk and levels of glucose metabolism biomarkers in women with a history of GD.

The researchers utilized data from the Nurses’ Health Study II, a large, ongoing longitudinal study that began in 1989, tracking the health and lifestyle factors of female nurse. The study included a subset of participants with a history of GD who were followed through June 2021. Sleep characteristics, including snoring frequency, sleep duration, and daytime sleepiness, were assessed in the 2001 questionnaire, which served as the baseline for follow-up. The primary outcome of a T2D diagnosis was self-reported biennially.

During 42,155 person-years of follow-up among 2891 women with a history of gestational GD, 563 participants (19.5%) developed T2D. Women who reported occasional or regular snoring had a significantly higher risk of T2D (HR, 1.54; 95% CI, 1.18-2.02) compared with those who rarely snored (HR, 1.6; 95% CI, 1.21-2.13), respectively. Similarly, those who slept 6 or fewer hours per night faced a 32% higher risk of developing T2D (HR, 1.32; 95% CI, 1.06-1.64) compared with those sleeping 7 to 8 hours. The highest risk was observed in women who both snored regularly and slept 6 or fewer hours (HR, 2.06; 95% CI, 1.38-3.07).

Additionally, increased snoring frequency was linked to elevated levels of glycated hemoglobin (HbA1c), C-peptide, and insulin, indicating a potential mechanistic pathway between poor sleep quality and metabolic dysfunction.

However, the researchers noted some limitations. Sleep characteristics were self-reported, though previous research supports the validity of self-reported snoring. Additionally, snoring and daytime sleepiness were assessed only once at baseline, which may have limited the accuracy of habitual sleep pattern representation. The study population primarily consisted of White women in the US, which may have affected the generalizability of the findings to other racial and ethnic groups. Furthermore, the lack of detailed data on snoring severity and sleep behavior patterns, such as social jetlag or sleep irregularity, limited a more comprehensive analysis of their impact on T2D risk.

Despite these limitations, the researchers believe the findings highlight the potential role of sleep health in reducing diabetes risk for this high-risk group.

“Prevention strategies for progression from GD to T2D should incorporate sleep health, emphasizing the monitoring of sleep duration and snoring,” wrote the researchers.

References

1. Yin X, Bao W, Ley SH, et al. Sleep characteristics and long-term risk of type 2 diabetes among women with gestational diabetes. JAMA Netw Open. 2025;8(3):e250142. doi:10.1001/jamanetworkopen.2025.0142

2. Santoro C. 5 things that impact heart health. AJMC®. February 14, 2025. Accessed March 10, 2025. https://www.ajmc.com/view/5-things-that-impact-heart-health