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Sleep disordered breathing pregnancy

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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/29523262/predictors-of-sleep-disordered-breathing-in-pregnancy
#3
Judette M Louis, Matthew A Koch, Uma M Reddy, Robert M Silver, Corette B Parker, Francesca L Facco, Susan Redline, Chia-Ling Nhan-Chang, Judith H Chung, Grace W Pien, Robert C Basner, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Benjamin Carper, George R Saade, Frank P Schubert, Phyllis C Zee
BACKGROUND: Sleep-disordered breathing (SDB) is common in pregnancy, but there are limited data on predictors. OBJECTIVES: The objective of this study was to develop predictive models of sleep-disordered breathing during pregnancy. STUDY DESIGN: Nulliparous women completed validated questionnaires to assess for symptoms related to snoring, fatigue, excessive daytime sleepiness, insomnia, and restless leg syndrome. The questionnaires included questions regarding the timing of sleep and sleep duration, work schedules (eg, shift work, night work), sleep positions, and previously diagnosed sleep disorders...
May 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29454869/the-intrapartum-and-perinatal-risks-of-sleep-disordered-breathing-in-pregnancy-a-systematic-review-and-metaanalysis
#4
REVIEW
Nicole T Brown, Jessica M Turner, Sailesh Kumar
OBJECTIVE DATA: Sleep-disordered breathing is an increasingly common condition in nonobstetric populations and is associated with significant morbidity. The incidence of sleep-disordered breathing in pregnancy is unknown, and it is likely that many cases go undiagnosed. STUDY: A systematic review and metaanalysis was undertaken to determine whether pregnant women who receive a diagnosis of sleep-disordered breathing are more likely to have adverse intrapartum and perinatal outcomes compared with control subjects...
February 15, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29368415/sleep-disordered-breathing-in-hypertensive-disorders-of-pregnancy-a-bmi-matched-study
#5
Danielle L Wilson, Susan P Walker, Alison M Fung, Gabrielle Pell, Fergal J O'Donoghue, Maree Barnes, Mark E Howard
Sleep-disordered breathing is more common in hypertensive disorders during pregnancy; however, most studies have not adequately accounted for the potential confounding impact of obesity. This study evaluated the frequency of sleep-disordered breathing in women with gestational hypertension and pre-eclampsia compared with body mass index- and gestation-matched normotensive pregnant women. Women diagnosed with gestational hypertension or pre-eclampsia underwent polysomnography shortly after diagnosis. Normotensive controls body mass index-matched within ±4 kg m-2 underwent polysomnography within ±4 weeks of gestational age of their matched case...
January 25, 2018: Journal of Sleep Research
https://www.readbyqxmd.com/read/29363362/sleep-disordered-breathing-in-pregnant-women-maternal-and-fetal-risk-treatment-considerations-and-future-perspectives
#6
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/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/29066388/maternal-sleep-disordered-breathing
#8
REVIEW
Sushmita Pamidi, R John Kimoff
Emerging literature suggests that sleep-disordered breathing (SDB) worsens over the course of pregnancy and is associated with adverse maternal and fetal outcomes. Earlier studies, using mainly snoring as a surrogate marker for SDB, have shown an increase in the prevalence of SDB during pregnancy compared with that in the pregravid state. More recently, prospective observational studies in which the investigators ascertained SDB by using complete polysomnography have shown a prevalence ranging from approximately 17% to 45% in the third trimester...
October 21, 2017: Chest
https://www.readbyqxmd.com/read/28735925/upper-airway-flow-limitation-and-transcutaneous-carbon-dioxide-during-sleep-in-normal-pregnancy
#9
Ville Rimpilä, Riina Jernman, Katariina Lassila, Jukka Uotila, Heini Huhtala, Johanna Mäenpää, Olli Polo
OBJECTIVE: Sleep during pregnancy involves a physiological challenge to provide sufficient gas exchange to the fetus. Enhanced ventilatory responses to hypercapnia and hypoxia may protect from deficient gas exchange, but sleep-disordered breathing (SDB) may predispose to adverse events. The aim of this study was to analyze sleep and breathing in healthy pregnant women compared to non-pregnant controls, with a focus on CO2 changes and upper-airway flow limitation. METHODS: Healthy women in the third trimester and healthy non-pregnant women with normal body mass index (BMI) were recruited for polysomnography...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28236270/oxidative-and-carbonyl-stress-in-pregnant-women-with-obstructive-sleep-apnea
#10
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/28103130/serum-progesterone-levels-in-pregnant-women-with-obstructive-sleep-apnea-a-case-control-study
#11
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
https://www.readbyqxmd.com/read/27926645/association-between-sleep-disordered-breathing-and-hypertensive-disorders-of-pregnancy-and-gestational-diabetes-mellitus
#12
MULTICENTER STUDY
Francesca L Facco, Corette B Parker, Uma M Reddy, Robert M Silver, Matthew A Koch, Judette M Louis, Robert C Basner, Judith H Chung, Chia-Ling Nhan-Chang, Grace W Pien, Susan Redline, William A Grobman, Deborah A Wing, Hyagriv N Simhan, David M Haas, Brian M Mercer, Samuel Parry, Daniel Mobley, Shannon Hunter, George R Saade, Frank P Schubert, Phyllis C Zee
OBJECTIVE: To estimate whether sleep-disordered breathing during pregnancy is a risk factor for the development of hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM). METHODS: In this prospective cohort study, nulliparous women underwent in-home sleep-disordered breathing assessments in early (6-15 weeks of gestation) and midpregnancy (22-31 weeks of gestation). Participants and health care providers were blinded to the sleep test results...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27924661/sleep-disordered-breathing-in-pregnancy-the-maternal-and-fetal-implications
#13
REVIEW
Shanthi Carnelio, Adam Morton, H David McIntyre
Sleep disordered breathing (SDB) which includes obstructive sleep apnoea (OSA) and upper airway resistance syndrome (UARS), has emerged as a risk factor for adverse maternal-foetal outcomes in pregnancy. Physiological changes of pregnancy predispose a woman 'at risk' towards developing SDB. The increasing incidence of OSA in pregnancy closely correlates with the population trends of obesity. Common screening tools validated in non-pregnant subjects including Epworth Sleepiness Scale (ESS) and Berlin Questionnaire (BQ) are poor predictors of SDB in pregnancy...
February 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27857964/women-with-postpartum-weight-retention-have-delayed-wake-times-and-decreased-sleep-efficiency-during-the-perinatal-period-a-brief-report
#14
K M Sharkey, G M Boni, J A Quattrucci, S Blatch, S N Carr
OBJECTIVE: This study assessed sleep and circadian rhythms across the perinatal period in new mothers with and without postpartum weight retention (PPWR). METHODS: Weight was measured at 2 and 16 weeks postpartum in 21 women with previous major depression or bipolar disorder (mean age 29.5±4.7 years) who self-reported pre-pregnancy weight during third trimester. Wrist actigraphy was acquired at 33 weeks gestation and postpartum weeks 2, 6, and 16. Circadian phase was measured at 33 weeks gestation and 6 weeks postpartum...
September 2016: Sleep Health
https://www.readbyqxmd.com/read/27829873/sleep-disordered-breathing-in-pregnancy-food-for-thought
#15
REVIEW
Martino F Pengo, Debasree Banerjee, Amanpreet Kaur, Ghada Bourjeily
The last few years have witnessed a number of publications linking sleep disordered breathing to adverse pregnancy and neonatal outcomes in various populations. Associations with preeclampsia, gestational diabetes and growth restriction have been consistent across many studies. Though the manuscripts reviewed here consist mostly of preliminary data and need further confirmation, the studies have highlighted new directions in the assessment of the impact of sleep disordered breathing and pregnancy, and paved the way for new fields of research in this area...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27648062/insomnia-during-pregnancy-diagnosis-and-rational-interventions
#16
REVIEW
Ali M Hashmi, Shashi K Bhatia, Subhash K Bhatia, Imran S Khawaja
UNLABELLED: Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions. The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy...
July 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27590949/sleep-disorders-in-pregnancy-glycaemic-implications
#17
K V S Hari Kumar
Sleep is one of the essential biorhythms of the body that helps in optimum restoration of many body functions. The sleep-wake cycle is determined by the circadian centre and is responsible for the anabolic functions in the body. Infants require about 14 to 18 hours of sleep per day, which reduces gradually to about 8 hours in adults. Urbanization and evolutionary changes have altered the sleep hygiene and shortened the sleep duration. This lead to various sleep disorders like sleep disordered breathing, insomnia and narcolepsy...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27582156/sleep-disorders-in-pregnancy-glycaemic-implications
#18
K V S Hari Kumar
Sleep is one of the essential biorhythms of the body that helps in optimum restoration of many body functions. The sleep-wake cycle is determined by the circadian centre and is responsible for the anabolic functions in the body. Infants require about 14 to 18 hours of sleep per day, which reduces gradually to about 8 hours in adults. Urbanization and evolutionary changes have altered the sleep hygiene and shortened the sleep duration. This lead to various sleep disorders like sleep disordered breathing, insomnia and narcolepsy...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27235923/sleep-disordered-breathing-and-adverse-pregnancy-outcomes
#19
REVIEW
Mary Ashley Cain, Judette M Louis
Sleep disordered breathing (SDB) occurs in 0.6% to 15% of reproductive-aged women. Because of an overlap in symptoms of SDB and normal pregnancy findings, the diagnosis of SDB in pregnancy is challenging. The repetitive arousals, sleep fragmentation, and hypoxias experienced by patients with SDB lead to an increase in oxidative stress and inflammation. In the nonpregnant population SDB is associated with an increased risk of diabetes mellitus, heart disease, and stroke. Increasing evidence identifies an association between SDB in pregnancy and gestational diabetes, preeclampsia, and fetal growth abnormalities...
June 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27085867/sleepiness-and-sleep-disordered-breathing-during-pregnancy
#20
Maria Sarberg, Marie Bladh, Ann Josefsson, Eva Svanborg
PURPOSE: This study aimed to examine if there is a difference in the prevalence of obstructive sleep apnea (OSA) and sleepiness between pregnant and non-pregnant women. It also aimed to evaluate if obstetric outcomes were associated to sleep-disordered breathing among the pregnant women. METHODS: One hundred pregnant women (gestational weeks 24-34) and 80 age- and body mass index-matched non-pregnant women underwent whole-night respiratory recordings (airflow, snoring, respiratory movements, body position, pulse oximetry)...
December 2016: Sleep & Breathing, Schlaf & Atmung
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