Impact of Cognitive-Behavioral Therapy for Insomnia (CBT-I) and Glycemic Control in Women with Gestational Diabetes Mellitus: A ClinicalTrial Study

Background: Gestational Diabetes Mellitus (GDM) is a metabolic disorder that develops during pregnancy. Research indicates that sleep disturbances are a contributing factor to GDM. Objectives: This study investigates the effect of Cognitive-Behavioral Therapy for Insomnia (CBTI) on sleep quality and Glycemic Control in GDM. Methods: This clinical trial involved the selection of 80 women diagnosed with gestational diabetes mellitus (GDM) through convenience sampling from healthcare centers in Arak, Iran, after obtaining their written informed consent. The participants were divided into two groups: the intervention group (n=40) underwent six weekly sessions of cognitive behavioral therapy for insomnia (CBT-I), each session lasting between 30 and 45 minutes, while the control group (n=40) received standard prenatal care. Both groups were assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and their fasting blood sugar (FBS) and two-hour postprandial glucose levels were recorded at the start of the study and one month after the intervention. The data collected were analyzed using T-tests, chi-square tests, analysis of covariance (ANCOVA), and both independent and paired ttests. Results: The study revealed significantly improved sleep quality in the intervention group compared to the control group after the intervention (8.19 vs. 10.44; p=0.002). Additionally, mean fasting blood sugar was 93.68 ± 7.03 mg/dl in the intervention group versus 102.29 ± 7.32 mg/dl in the control group( p=0.001). The mean two-hour postprandial glucose level was 112.83 ± 2.02 mg/dl in the intervention group versus 118.32 ± 1.65 mg/dl in the control group ( p=0.001). Discussion: The study indicated that this intervention not only had positive effects on sleep quality, but also contributed to lowering blood glucose. Conclusion: This study suggests that the CBT-I can be used as a complementary method to enhance the quality of sleep and glycemic control in this population.