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https://www.readbyqxmd.com/read/29747728/management-of-obstructive-sleep-apnea-in-pregnancy
#1
REVIEW
Jennifer E Dominguez, Linda Street, Judette Louis
The spectrum of sleep-disordered breathing (SDB) ranges from mild snoring to obstructive sleep apnea, the most severe form of SDB. Current recommendations are to treat these women with continuous positive airway pressure despite limited data. SDB in early and mid-pregnancy is associated with preeclampsia and gestational diabetes. Pregnant women with a diagnosis of obstructive sleep apnea at delivery were at significantly increased risk of having cardiomyopathy, congestive heart failure, pulmonary embolism, and in-hospital death...
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29649034/obstructive-sleep-apnea-in-pregnant-women-a-review-of-pregnancy-outcomes-and-an-approach-to-management
#2
Jennifer E Dominguez, Andrew D Krystal, Ashraf S Habib
Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors for sleep-disordered breathing in pregnancy, but certain physiologic changes of pregnancy may also increase a woman's risk of developing or worsening OSA. While it has been shown that untreated OSA in postmenopausal women is associated with a range of cardiovascular, pulmonary, and metabolic comorbidities, a body of literature is emerging that suggests OSA may also have serious implications for the health of mothers and fetuses during and after pregnancy...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29458699/continuous-positive-airway-pressure-therapy-in-gestational-diabetes-with-obstructive-sleep-apnea-a-randomized-controlled-trial
#3
Naricha Chirakalwasan, Somvang Amnakkittikul, Ekasitt Wanitcharoenkul, Suranut Charoensri, Sunee Saetung, Suwannee Chanprasertyothin, La-Or Chailurkit, Panyu Panburana, Sommart Bumrungphuet, Ammarin Thakkinstian, Sirimon Reutrakul
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with gestational diabetes mellitus (GDM). This study assessed the effects of continuous positive airway pressure (CPAP) in obese pregnant females with GDM and OSA. METHODS: A randomized controlled trial was conducted (April 2014 - June 2016). Obese females at 24 to 34 weeks gestation and with diet-controlled GDM were screened for OSA. Those with OSA were randomly assigned to receive 2 weeks nightly CPAP or be part of a waitlist control group...
March 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29363362/sleep-disordered-breathing-in-pregnant-women-maternal-and-fetal-risk-treatment-considerations-and-future-perspectives
#4
Kimberly Truong, Christian Guilleminault
Numerous physiologic and anatomic changes during pregnancy exacerbate or unmask obstructive sleep apnea in women. Left untreated, upper airway flow limitation during pregnancy may lead to dire maternal and fetal health consequences. Areas covered: This review outlines the relationship between sleep disordered breathing (SDB) and gestational hypertension, preeclampsia, and gestational diabetes. It also discusses the implications of SDB on fetal and maternal health and concludes with a review of the emerging literature of treatment options for SDB in pregnancy and its benefit...
March 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29357521/intermittent-hypoxia-in-utero-damages-postnatal-growth-and-cardiovascular-function-in-rats
#5
Ling Chen, Zahra Heidari Zadi, Jin Zhang, Steven M Scharf, Eung-Kwon Pae
Obstructive sleep apnea (OSA) is common in pregnancy and may compromise fetal and even postnatal development. We developed an animal model to determine if maternal OSA could have lasting effects in offspring. Pregnant Sprague-Dawley rats were exposed to reduced ambient O2 from 21 to 4-5%, approximately once per minute [chronic intermittent hypoxia (CIH)] for 8 h/day during gestation days 3-19. Similarly handled animals exposed to ambient air served as controls (HC). Offspring were studied for body growth and cardiovascular function for 8 postnatal weeks...
April 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29198302/obstructive-sleep-apnea-in-gestational-diabetes-a-pilot-study-of-the-role-of-the-hypothalamic-pituitary-adrenal-axis
#6
Margaret H Bublitz, Joao Filipe Monteiro, Andrew Caraganis, Susan Martin, Jeffrey Parker, Lucia Larson, Margaret A Miller, Ghada Bourjeily
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) in pregnancy is associated with gestational diabetes mellitus (GDM). This propensity toward heightened insulin resistance in OSA patients has not been well characterized and may be related to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. The aim of this study was to (1) assess the prevalence of OSA in pregnant women with GDM, (2) evaluate whether HPA axis dysregulation relates to OSA, and (3) investigate the relation between insulin resistance and OSA...
January 15, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29174411/gestational-intermittent-hypoxia-increases-susceptibility-to-neuroinflammation-and-alters-respiratory-motor-control-in-neonatal-rats
#7
REVIEW
Stephen M Johnson, Karanbir S Randhawa, Jenna J Epstein, Ellen Gustafson, Austin D Hocker, Adrianne G Huxtable, Tracy L Baker, Jyoti J Watters
Sleep disordered breathing (SDB) and obstructive sleep apnea (OSA) during pregnancy are growing health concerns because these conditions are associated with adverse outcomes for newborn infants. SDB/OSA during pregnancy exposes the mother and the fetus to intermittent hypoxia. Direct exposure of adults and neonates to IH causes neuroinflammation and neuronal apoptosis, and exposure to IH during gestation (GIH) causes long-term deficits in offspring respiratory function. However, the role of neuroinflammation in CNS respiratory control centers of GIH offspring has not been investigated...
November 22, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29172922/thiol-disulfide-homeostasis-in-pregnant-women-with-obstructive-sleep-apnea-syndrome
#8
Yasemin Üstündağ, Hakan Demirci, Rifat Balık, Ozcan Erel, Fahri Özaydın, Bilgen Kücük, Dilber Ertaş, Emin Ustunyurt
BACKGROUND: Repetitive episodes of hypoxia and reoxygenation during sleep in patients with obstructive sleep apnea syndrome (OSAS) resemble an ischemia-reperfusion injury. We aimed to test the hypothesis that oxidative stress occurs in pregnant women with OSAS. We also aimed to compare thiol/disulfide homeostasis with ischemia-modified albumin (IMA) and total antioxidant capacity (TAC) as markers of ischemia-reperfusion injury in pregnant women with and without OSAS and healthy control...
November 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29157580/obstructive-sleep-apnea-and-diet-controlled-gestational-diabetes
#9
Ekasitt Wanitcharoenkul, Naricha Chirakalwasan, Somvang Amnakkittikul, Suranut Charoensri, Sunee Saetung, Suwannee Chanprasertyothin, La-Or Chailurkit, Panyu Panburana, Sommart Bumrungphuet, Boonsong Ongphiphadhanakul, Sirimon Reutrakul
BACKGROUND: Obstructive sleep apnea (OSA) was shown to be associated with gestational diabetes mellitus (GDM). However, prevalence of OSA in GDM women, its relationship to metabolic control, and predictive factors have not been studied. MATERIAL AND METHODS: Eighty-two obese pregnant women with diet-controlled GDM between 24 and 34 weeks of gestation participated. The Berlin questionnaire was used to assess OSA symptoms. OSA was diagnosed using an overnight monitor...
November 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29031756/obstructive-sleep-apnea-in-pregnancy-is-associated-with-adverse-maternal-outcomes-a-national-cohort
#10
Ghada Bourjeily, Valery A Danilack, Margaret H Bublitz, Heather Lipkind, Janet Muri, Donna Caldwell, Iris Tong, Karen Rosene-Montella
OBJECTIVE: Pregnancy and the obesity epidemic impacting women of reproductive age appear to predispose women to obstructive sleep apnea (OSA) in pregnancy. The aim of this study is to examine the association between OSA and adverse maternal outcomes in a national cohort. METHODS: The National Perinatal Information Center in the US was used to identify women with a delivery discharge diagnosis of OSA from 2010 to 2014. We used the International Classification of Diseases, ninth Revision to classify OSA diagnosis and maternal outcomes...
October 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29017230/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#11
Martin Gerlach, Bernd Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
October 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28926639/risk-of-glucose-intolerance-and-gestational-diabetes-mellitus-in-relation-to-maternal-habitual-snoring-during-early-pregnancy
#12
Chunfang Qiu, Wayne Lawrence, Bizu Gelaye, Lee Stoner, Ihunnaya O Frederick, Daniel A Enquobahrie, Tanya K Sorensen, Michelle A Williams
BACKGROUND: Obstructive sleep apnea (OSA) or habitual snoring is known to be associated with impaired glucose tolerance and type 2 diabetes among both men and non-pregnant women. We examined the association of habitual snoring during early pregnancy with risk of impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM). METHODS: A cohort of 1,579 women was interviewed during early pregnancy. We collected information about snoring frequency during early pregnancy...
2017: PloS One
https://www.readbyqxmd.com/read/28828052/the-role-of-obstructive-sleep-apnea-in-developing-gestational-hypertension-and-preeclampsia
#13
Laura Lungeanu-Juravle, Natalia Patrascu, Oana Claudia Deleanu, Mircea Cinteza
Gestational hypertension and preeclampsia are the most frequent medical complications in pregnancy and major causes of maternal and fetal morbidity and mortality. It is also known that these conditions are associated with a long term increased cardiovascular global risk for these young women. Obstructive sleep apnea (OSA) seems to be not only a frequent pathology associated with pregnancy but also an independent factor for developing gestational hypertension. It is well known the relationship between gestational hypertension, preeclampsia and intrauterine growth restriction of the foetus so the outcomes of this pathologies are important for both mother and child...
December 2016: Mædica
https://www.readbyqxmd.com/read/28692233/-sleep-apnea-in-pregnancy
#14
Wawrzyniec Rieder, Raphaël Heinzer, David Baud
Snoring, chronic rhinitis and fragmentation of sleep are common symptoms in pregnancy, especially in the third trimester. The prevalence of obstructive sleep apnea is also increased in pregnant women and can be associated with pregnancy induced hypertension, preeclampsia and diabetes mellitus. The fetus is as well exposed to a higher risk of prematurity and intra-uterine growth restriction. Given the lack of adequate screening tool, the diagnosis of obstructive sleep apnea is a challenge for the physician and a high degree of clinical suspicion is necessary in order to identify the patients at risk and propose an appropriate management...
October 26, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28632190/soluble-pro-renin-receptor-and-obstructive-sleep-apnea-syndrome-oxidative-stress-in-brain
#15
REVIEW
Kazuhiro Takahashi, Koji Ohba, Kazuki Tajima, Tsuguo Nishijima, Shigeru Sakurai
(Pro)renin receptor ((P)RR) is a multi-functional molecule that is related to both the renin-angiotensin system (RAS) and vacuolar H⁺-ATPase (v-ATPase), an ATP-dependent multi-subunit proton pump. Soluble (P)RR (s(P)RR), which consists of the extracellular domain of (P)RR, is present in blood and urine. Elevated plasma s(P)RR concentrations are reported in patients with chronic kidney disease and pregnant women with hypertension or diabetes mellitus. In addition, we have shown that plasma s(P)RR concentrations are elevated in patients with obstructive sleep apnea syndrome (OSAS)...
June 20, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28558398/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#16
M Gerlach, B Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
August 2017: Pneumologie
https://www.readbyqxmd.com/read/28557355/screening-methods-for-obstructive-sleep-apnoea-in-severely-obese-pregnant-women
#17
H Longworth, K McCallin, R P Narayanan, M A Turner, S Quenby, D Rycroft, M Charnley, J Abayomi, J Topping, A D Weeks, J P H Wilding
Obstructive sleep apnoea (OSA) is an often-overlooked diagnosis, more prevalent in the obese population. Screening method accuracy, uptake and hence diagnosis is variable. There is limited data available regarding the obese pregnant population; however, many studies highlight potential risks of apnoeic episodes to mother and foetus, including hypertension, diabetes and preeclampsia. A total of 162 women with a body mass index (BMI) ≥ 35 were recruited from a tertiary referral hospital in the northwest of England...
August 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28236270/oxidative-and-carbonyl-stress-in-pregnant-women-with-obstructive-sleep-apnea
#18
Nazia Khan, Geralyn Lambert-Messerlian, Joao Filipe Monteiro, Julius Hodosy, Ľubomíra Tóthová, Peter Celec, Elizabeth Eklund, Patrizia Curran, Ghada Bourjeily
PURPOSE: Pregnant women are particularly susceptible to sleep-disordered breathing. Obstructive sleep apnea (OSA) in pregnancy is associated with poor pregnancy and fetal outcomes. Oxidative stress caused by intermittent hypoxemia and reoxygenation may impact pregnancy health. We hypothesize that pregnant women with OSA have a pronounced oxidative stress profile. METHODS: A case-control study was performed to study oxidative stress markers in the serum of pregnant women with or without OSA...
March 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28121644/peripartum-management-of-obstructive-sleep-apnea
#19
Jessica M Booth, Ashley M Tonidandel
The prevalence of obstructive sleep apnea is unknown during pregnancy, but the syndrome is likely underdiagnosed and rising in frequency along with the obesity epidemic. Obstructive sleep apnea is associated with adverse outcomes, including hypertensive disorders of pregnancy, gestational diabetes, preterm, and cesarean delivery. Obese pregnant women should be screened and referred to a sleep medicine specialist for evaluation. Continuous positive airway pressure is the treatment of choice with demonstrated safety and compliance in pregnancy...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28103130/serum-progesterone-levels-in-pregnant-women-with-obstructive-sleep-apnea-a-case-control-study
#20
Jennifer Lee, Elizabeth E Eklund, Geralyn Lambert-Messerlian, Glenn E Palomaki, Kristen Butterfield, Patrizia Curran, Ghada Bourjeily
BACKGROUND: Pregnancy is a risk factor for sleep disordered breathing, including obstructive sleep apnea (OSA). Progesterone, one of the key hormones in pregnancy, a known respiratory drive stimulant, increases ventilation and may protect against OSA. We aimed to examine the relationship between circulating progesterone and OSA, after accounting for body weight and gestational age. METHODS: A case control study was conducted of pregnant women with OSA and those at low risk for the disorder...
March 2017: Journal of Women's Health
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