Sleep Disturbance and risk for adverse pregnancy outcomes

描述(申请人提供)：睡眠障碍在普通人群中很常见，女性是特别危险的人群。最近的研究表明，睡眠时间短与睡眠障碍之间存在联系，并伴随着不利的健康风险。来自生理学和流行病学研究的证据表明，睡眠时间短与肥胖、糖尿病、高血压和死亡风险增加之间存在关联。此外，特定的睡眠障碍，特别是睡眠呼吸障碍与心血管和代谢障碍有关。尽管越来越多的证据表明睡眠对健康的重要性，也有数据表明睡眠障碍在孕妇中很常见，但关于睡眠与母婴结局之间潜在的重要联系，特别是怀孕的代谢和心血管并发症之间潜在的重要联系的研究很少。具体地说，关于睡眠不足和睡眠障碍如何导致妊娠期糖尿病、妊娠期高血压和先兆子痫的数据有限。我们已经确定了一个独特和及时的机会，利用最近建立的由10,000名孕妇组成的无产研究网络的资源，解决睡眠异常(睡眠时间短、睡眠质量差和常见的睡眠障碍)与妊娠结局之间的关系。需要检验的总体假设是，睡眠障碍与怀孕期间心脏代谢紊乱的风险增加有关。具体地说，该应用程序建议评估一大批孕妇的自我报告和客观睡眠/觉醒特征，从怀孕前三个月到分娩，将从这些人群中测量详细的心血管和代谢性妊娠结局。其具体目标是：1)利用调查和活动记录法在一大群孕妇中系统地描述睡眠模式；2)确定异常睡眠模式(睡眠质量和睡眠障碍)与妊娠心血管和代谢紊乱(妊娠期高血压、先兆子痫、妊娠期糖尿病)之间的关系；3)确定孕妇群体中自我报告的睡眠测量与客观得出的睡眠测量(使用活动记录法)之间的一致性。这项应用将在怀孕人群中提供第一次大规模的纵向睡眠评估，并确定睡眠特征和疾病与妊娠结局之间的关系。这项研究的结果有可能为改善妊娠结局的临床护理提供信息和改变。 公共卫生相关性：睡眠障碍在孕妇中很常见，很少有研究评估怀孕期间的睡眠或检查有睡眠障碍的妇女的母婴结局。鉴于睡眠障碍与代谢和心血管并发症之间的联系，孕妇尤其容易患上这些并发症，因此非常有必要进行这样的研究。目前的应用程序将抓住独特的机会，利用最近建立的无产研究网络的资源来研究睡眠异常与妊娠结局之间的关系；具体地说，该应用程序建议评估一大批孕妇的自我报告和客观睡眠/觉醒特征，详细的心血管和代谢性妊娠结局将从这些队列中测量出来。这项研究将为未来的研究奠定基础，以确定孕期睡眠障碍的筛查和治疗是否是改善妊娠结局的有效策略。

DESCRIPTION (provided by applicant): Sleep disturbances are common in the general population, and women are a population at particular risk. Recent studies indicate a link between short sleep duration and sleep disturbances with adverse health risks. Evidence from physiological and epidemiological studies demonstrate an association between short sleep duration and an increased risk of obesity, diabetes, hypertension, and mortality. In addition, specific sleep disorders, in particular sleep disordered breathing have been linked with cardiovascular and metabolic disorders. Despite the emerging evidence of the importance of sleep for health and data that sleep disturbances are common among pregnant women, there is a paucity of research on the potentially important link between sleep and maternal/ fetal outcomes, particularly metabolic and cardiovascular complications of pregnancy. Specifically, there is limited data on how insufficient sleep and sleep disorders may contribute to the development of gestational diabetes, gestational hypertension, and preeclampsia. We have identified a unique and timely opportunity to leverage the resources of the recently established Nulliparous Research Network of 10,000 pregnant women to address the relationship between sleep abnormalities (short sleep duration, poor sleep quality and common sleep disorders) and pregnancy outcomes. The overall hypothesis to be tested is that sleep disturbances are associated with an increase risk for cardiometabolic disorders during pregnancy. Specifically this application proposes to evaluate self-reported and objective sleep/wake characteristics in a large cohort of pregnant women from whom detailed cardiovascular and metabolic pregnancy outcomes will be measured from the first trimester to delivery. The specific aims are: 1) To systematically characterize sleep patterns using survey and actigraphy in a large cohort of pregnant women; 2) To determine the relationships between abnormal sleep patterns (sleep quality and sleep disorders) and cardiovascular and metabolic disorders of pregnancy (gestational hypertension, preeclampsia, gestational diabetes); 3) To determine concordance between self-reported measures of sleep and objectively derived sleep measures (using actigraphy) in a pregnant population. This application will provide the first large scale longitudinal assessment of sleep in a pregnant population and determine the relationship between sleep characteristics and disorders with pregnancy outcomes. The results of this study have the potential to inform and change clinical care to improve pregnancy outcomes. PUBLIC HEALTH RELEVANCE: Disturbed sleep is common among pregnant women and few studies have evaluated sleep in pregnancy or examined maternal and fetal outcomes in women with sleep disturbances. Given the link between sleep disturbances and metabolic and cardiovascular complications, of which pregnant women are at particular risk, there is a great need for such a study. The current application will seize the unique opportunity to leverage the resources of the recently established Nulliparous Research Network to study the relationship between sleep abnormalities and pregnancy outcomes; specifically this application proposes to evaluate self-reported and objective sleep/wake characteristics in a large cohort of pregnant women from whom detailed cardiovascular and metabolic pregnancy outcomes will be measured. This study will form the basis for future studies to determine whether screening for and treatment of sleep disturbances during pregnancy is an effective strategy to improve pregnancy outcomes.