Sleep Disturbance and risk for adverse pregnancy outcomes

描述（由申请人提供）：睡眠障碍在一般人群中很常见，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，并具有不利的健康风险。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、高血压和死亡率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。尽管有新的证据表明睡眠对健康的重要性，并且有数据表明睡眠障碍在孕妇中很常见，但关于睡眠与母亲/胎儿结局之间潜在的重要联系的研究很少，特别是妊娠的代谢和心血管并发症。具体来说，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发生的数据有限。 我们发现了一个独特而及时的机会，利用最近成立的由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。有待检验的总体假设是，睡眠障碍与妊娠期间心脏代谢紊乱风险增加有关。具体而言，本申请提出评估一大群孕妇的自我报告和客观睡眠/觉醒特征，将从孕早期到分娩测量这些孕妇的详细心血管和代谢妊娠结局。具体目标是：1）使用调查和体动记录仪系统地描述大队列孕妇的睡眠模式; 2）确定异常睡眠模式之间的关系（睡眠质量和睡眠障碍）和妊娠期心血管和代谢紊乱（妊娠期高血压、先兆子痫、妊娠期糖尿病）; 3）确定怀孕人群自我报告的睡眠测量值与客观得出的睡眠测量值（使用体动记录仪）之间的一致性。该应用程序将首次对怀孕人群的睡眠进行大规模纵向评估，并确定睡眠特征和睡眠障碍与妊娠结局之间的关系。这项研究的结果有可能为临床护理提供信息和改变，以改善妊娠结局。

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.