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This study aims to investigate the associations of sleep quality with nocturnal glycemic control among GDM participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This study included 1186 GDM participants with available data from the WeBirth cohort in Hangzhou, China. Sleep quality and blood glucose levels were assessed simultaneously over 14\u00a0days using accelerometers and continuous glucose monitoring (CGM) devices. Multivariate linear mixed-effects models were applied to examine the associations of the sleep regularity index (SRI) and sleep efficiency (SE) with CGM-derived nocturnal metrics, adjusting for potential confounders (e.g. maternal age, pre-pregnancy BMI, and gestational weeks).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Per 1-SD increment in SRI was associated with lower nocturnal glycemic metrics, including coefficient of variation (CV) (\u03b2\u2009=\u2009-0.11 SD; 95% CI, -0.13 to -0.08) and time-above-range (TAR) (\u03b2\u2009=\u2009-0.08 SD; 95% CI, -0.10 to -0.05). SE demonstrated comparable associations with these metrics (CV: \u03b2\u2009=\u2009-0.13 SD; 95% CI, -0.16 to -0.11; TAR: \u03b2\u2009=\u2009-0.10 SD; 95% CI, -0.12 to -0.08). Further joint analyses indicated that SE exerts an independent, additive effect beyond sleep regularity. Specifically, individuals characterized by both irregular and inefficient sleep exhibited substantially higher mean blood glucose levels compared to those with regular and efficient sleep (\u03b2\u2009=\u20090.34 SD; 95% CI, 0.21 to 0.47).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlights that regular and efficient sleep patterns are independently and jointly associated with more favorable nocturnal glycemic outcomes in pregnant women with GDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trials<\/jats:title>\n                    <jats:p>The study received ethical approval from the Ethics Committee of Westlake University (20190701ZJS0007), and all participants provided written informed consent. The study is registered at ClinicalTrials.gov (NCT04060056; https:\/\/clinicaltrials.gov\/study\/NCT04060056), Westlake Precision Birth Cohort (WeBirth).<\/jats:p>\n                    <jats:p>Statement of Significance GDM poses significant risks to both mothers and offspring, yet modifiable lifestyle factors influencing nocturnal glycemic control remain incompletely understood. This large cohort study demonstrates that sleep regularity and efficiency are independently and jointly associated with improved overnight glycemic outcomes in pregnant women with gestational diabetes, suggesting that sleep quality represents an underappreciated but actionable target for glycemic management during pregnancy. These findings extend beyond pharmacological and dietary interventions by highlighting the therapeutic potential of behavioral sleep interventions in this vulnerable population. Future research should examine whether structured sleep management can reduce adverse maternal and neonatal outcomes and explore the biological mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/sleep\/zsag256","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:01:40Z","timestamp":1790164900000},"source":"Crossref","is-referenced-by-count":0,"title":["Sleep regularity and efficiency are associated with nocturnal glycemic control in pregnant women with gestational diabetes"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8375-4427","authenticated-orcid":false,"given":"Rui-Qi","family":"Shi","sequence":"first","affiliation":[{"name":"Affiliated Hangzhou First People\u2019s Hospital, School of Medicine, Westlake University , Hangzhou ,","place":["China"]},{"name":"Zhejiang Key Laboratory of Multi-Omics in Infection and Immunity, School of Medicine, Westlake University , Hangzhou 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