Severity of sleep-disordered breathing improves following parturition.

Abstract

STUDY OBJECTIVE:

Changes in sleep-disordered breathing associated with late pregnancy have not previously been systematically investigated; however, a number of case reports indicate exacerbation of obstructive sleep apnea in late pregnancy, often in association with maternal hypertension. We aimed to compare the severity of sleep-disordered breathing and associated maternal blood-pressure responses in late pregnancy with the nonpregnant state.

DESIGN:

Case-controlled, longitudinal study of sleep-disordered breathing during late pregnancy and postpartum.

STUDY PATIENTS:

Ten women referred for suspected sleep-disordered breathing during the third trimester of pregnancy.

INTERVENTIONS:

None.

MEASUREMENTS AND RESULTS:

Full overnight polysomnography and continuous systemic blood pressure were measured during the third trimester of pregnancy and 3 months following delivery. Parameters of sleep-disordered breathing, including apnea hypopnea index and minimum overnight arterial oxyhemoglobin saturation, were compared between antenatal and postnatal studies. An improvement in both apnea-hypopnea index and minimum arterial oxyhemoglobin saturation occurred consistently in all subjects postnatally. In non-rapid eye movement sleep, mean apnea-hypopnea index was reduced from 63 +/- 15 per hour antenatally to 18 +/- 4 per hour postnatally (P = .03), and in rapid eye movement sleep, from 64 +/- 11 per hour to 22 +/- 4 per hour (P = .002). Minimum arterial oxyhemoglobin saturation was increased from 86% +/- 2% antenatally to 91% +/- 1% postnatally (P = .01). Arterial blood-pressure responses to apnea peaked at 170 to 180 mm Hg antenatally, while they only peaked at 130 to 140 mm Hg postnatally.

CONCLUSION:

This study indicates that late pregnancy may be associated with increased severity of sleep-disordered breathing and associated blood-pressure responses.

• Authors: Natalie Edwards, Diane M Blyton, Annemarie Hennessy, Colin E Sullivan
• Journal: Sleep (Sleep) Vol. 28 Issue 6 Pg. 737-41 (Jun 2005) ISSN: 0161-8105 [Print] United States
• PMID: 16477961 (Publication Type: Journal Article)

Topics

• Adult
• Arousal (physiology)
• Blood Pressure (physiology)
• Case-Control Studies
• Continuous Positive Airway Pressure (methods)
• Female
• Follow-Up Studies
• Humans
• Polysomnography
• Postpartum Period (physiology)
• Pregnancy
• Pregnancy Outcome
• Pregnancy Trimester, Third (physiology)
• Severity of Illness Index
• Sleep Apnea Syndromes (diagnosis, epidemiology, therapy)
• Sleep Stages (physiology)