Sleep-disordered Breathing in Pregnancy

Pulmonary and Critical Care Medicine, Department of Medicine, Women and Infants Hospital of Rhode Island, The Warren Alpert Medical School of Brown University, 100 Dudley Street, Suite 1100, Providence, RI 02905, USA.
Clinics in chest medicine (Impact Factor: 2.07). 03/2011; 32(1):175-89, x. DOI: 10.1016/j.ccm.2010.11.003
Source: PubMed


Symptoms of sleep-disordered breathing are more common in pregnant women compared with nonpregnant women. It is likely that physiology of pregnancy predisposes to the development or worsening of sleep-disordered breathing, but some physiologic changes may also be protective against the development of this disease. Clinical presentation may be less predictive of sleep disordered breathing in pregnancy than in the non-pregnant population; nonetheless, snoring is associated with adverse pregnancy outcomes. Treatment strategies are similar to the nonpregnant population, however, pregnancy-specific scenarios may arise and these subtleties are addressed in this review.

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Available from: Vahid Mohsenin, May 03, 2014
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    • "Other mechanisms by which SDB could potentially have adverse effects on pregnancy (possibly mediated via obesity) include increased risk of preeclampsia, gestational diabetes, and effects on the hypothalamic pituitary axis. The influence of SDB on these disorders has been the subject of several recent reviews [18] [33], including an elegant summary of possible mechanisms by Iczi and colleagues [42]. A recent study by Louis and colleagues [28] demonstrated significant adverse pregnancy outcomes in 57 women with OSA, when compared with either normal-weight or obese controls. "
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    ABSTRACT: Sleep-disordered breathing (SDB) is a common disorder that has numerous medical consequences including cardiovascular morbidity. The clinical presentation in women is frequently vague, leading to its under-recognition in this population. Sleep is known to influence several female hormonal cycles including estrogen, progesterone, prolactin, luteinizing hormone (LH), and follicle stimulating hormone (FSH); consequently, sleep disruption may have adverse effects on female health including pregnancy. Miscarriage, defined as the loss of a pregnancy in the first trimester, occurs in one in four pregnancies; in up to half of cases, the cause may be unknown. Risk factors for miscarriage include increased age, increased weight, and a history of polycystic ovarian syndrome, all of which are also risk factors for SDB. Since SDB is frequently accompanied by sleep fragmentation and intermittent hypoxemia, we speculate that these factors may contribute to miscarriage risk. If this is the case, then treatment of SDB may be a possible intervention for subsequent pregnancies.
    Full-text · Article · Feb 2014 · Medical Hypotheses
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    • "Cardiopulmonary physiology and sleep related physiologic changes have been reviewed in recently published manuscripts [9] [10]. Briefly, pregnancy is associated with changes in upper airway size [11] [12] as well as mucosal edema and friability [13] [14] [15] [16] which result in a decrease in airway patency and higher Mallampati grades [17]. "

    Preview · Article · Apr 2013 · The Open Sleep Journal
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    • "The data suggest, however, that sleep apnea may develop in pregnant women who have a pre-existing tendency toward sleepdisordered breathing and may worsen in those women who already have sleep apnea [62]. Nasal continuous positive airway pressure (CPAP) has been used effectively in a number of pregnant women and was found to reduce nocturnal blood pressure increments in women with pre-eclampsia [62]. Future research should assess for UAR by using more sophisticated breathing equipment and should investigate the possible relationship of sleep-disordered breathing with maternal and fetal complications. "
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    ABSTRACT: Studies of sleep across the life cycle in women have utilized both survey and polysomnographic techniques, but have tended to be of small sample size with diverse methodology. As a result, definitive conclusions about the impact of the menstrual cycle and use of oral contraceptives on sleep parameters cannot yet be made. Sleep disruption during pregnancy and postpartum is nearly universal, but effective and practical countermeasures are still needed. Longitudinal studies of sleep in the postpartum period are also lacking. Menopause is associated with insomnia due to several factors including hot flashes, mood disorders and increased sleep-disordered breathing. The use of hormone replacement therapy to treat sleep and other variables is an active area of investigation. In summary, much research is required to fully elucidate the impact of the life cycle on sleep parameters in women.
    Full-text · Article · May 2003 · Sleep Medicine Reviews
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