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Severity of sleep-disordered breathing improves following parturition.

AbstractSTUDY 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.
AuthorsNatalie Edwards, Diane M Blyton, Annemarie Hennessy, Colin E Sullivan
JournalSleep (Sleep) Vol. 28 Issue 6 Pg. 737-41 (Jun 2005) ISSN: 0161-8105 [Print] United States
PMID16477961 (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)

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