Pregnant Women with Gestational Hypertension May Have a High Frequency of Sleep Disordered Breathing

Overview

Journal Sleep

Publisher Oxford University Press

Specialty Psychiatry

Date 2011 Aug 2

PMID 21804665

Citations 36

Authors

John Reid

Robert Skomro

David Cotton

Heather Ward

Femi Olatunbosun

John Gjevre

Christian Guilleminault

Affiliations

Soon will be listed here.

Abstract

Background: Gestational hypertension is a common complication of pregnancy. Recent evidence suggests that women with gestational hypertension have a high rate of sleep disordered breathing (SDB). Using laboratory-based polysomnography, we evaluated for the frequency of SDB in women with gestational hypertension compared to healthy women with uncomplicated pregnancies.

Methods: In this single-center cross-sectional study, women with the diagnosis of gestational hypertension were screened in the Fetal Assessment Unit and Antepartum ward. Healthy subjects were recruited by local advertising. Subjects completed a series of questionnaires addressing sleep quality and daytime sleepiness, followed by full night polysomnography. The primary outcome was frequency of SDB (defined as a respiratory disturbance index ≥ 5) in the gestational hypertension and healthy groups.

Results: A total of 34 women with gestational hypertension and singleton pregnancies and 26 healthy women with uncomplicated singleton pregnancies consented to participate in the study. The mean ages and gestational ages, but not the body mass indices, of the 2 groups were similar. The frequencies of SDB in the more obese gestational hypertension group and the healthy group were 53% and 12%, respectively (P < 0.001).

Interpretation: Women with gestational hypertension may have a significantly higher frequency of SDB than do healthy women with uncomplicated pregnancies of similar gestational age. The relative causal contributions, if any, of SDB and obesity remain to be determined.

Citing Articles

Association between sleep disturbances during pregnancy and adverse perinatal outcomes.

Chang Y, Sun Z, Ning F, Dang X, Zhang G, Tang J Am J Transl Res. 2024; 16(8):3886-3896.

PMID: 39262762 PMC: 11384389. DOI: 10.62347/YXBM9408.

Obstructive Sleep Apnoea: A Shrouded High-Risk Association for Development of Hypertensive Disorders of Pregnancy.

Sarbhai V, Paswan P, Sarbhai V J Obstet Gynaecol India. 2023; 73(5):391-396.

PMID: 37916058 PMC: 10615999. DOI: 10.1007/s13224-023-01835-y.

Common sleep disorders in pregnancy: a review.

Kember A, Elangainesan P, Ferraro Z, Jones C, Hobson S Front Med (Lausanne). 2023; 10:1235252.

PMID: 37671402 PMC: 10475609. DOI: 10.3389/fmed.2023.1235252.

Adherence and efficacy of mandibular advancement splint treatment of sleep-disordered breathing during pregnancy: a pilot study.

Huynh N, Drouin-Gagne L, Gilbert C, Arcache J, Rompre P, Morency A Sleep Breath. 2022; 27(3):869-877.

PMID: 35829947 DOI: 10.1007/s11325-022-02681-4.

Obstructive sleep apnea in pregnant women.

Dominguez J, Habib A Int Anesthesiol Clin. 2022; 60(2):59-65.

PMID: 35261345 PMC: 9045012. DOI: 10.1097/AIA.0000000000000360.

References

Khan N, Hemmelgarn B, Herman R, Rabkin S, McAlister F, Bell C . The 2008 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy. Can J Cardiol. 2008; 24(6):465-75. PMC: 2643190. DOI: 10.1016/s0828-282x(08)70620-2. View

Getahun D, Ananth C, Oyelese Y, Chavez M, Kirby R, Smulian J . Primary preeclampsia in the second pregnancy: effects of changes in prepregnancy body mass index between pregnancies. Obstet Gynecol. 2007; 110(6):1319-25. DOI: 10.1097/01.AOG.0000292090.40351.30. View

Young T, Shahar E, Nieto F, Redline S, Newman A, Gottlieb D . Predictors of sleep-disordered breathing in community-dwelling adults: the Sleep Heart Health Study. Arch Intern Med. 2002; 162(8):893-900. DOI: 10.1001/archinte.162.8.893. View

Calaora-Tournadre D, Ragot S, Meurice J, Pourrat O, DHalluin G, Magnin G . [Obstructive Sleep Apnea Syndrom during pregnancy: prevalence of main symptoms and relationship with Pregnancy Induced-Hypertension and Intra-Uterine Growth Retardation]. Rev Med Interne. 2006; 27(4):291-5. DOI: 10.1016/j.revmed.2006.01.015. View

Charbonneau M, Falcone T, Cosio M, Levy R . Obstructive sleep apnea during pregnancy. Therapy and implications for fetal health. Am Rev Respir Dis. 1991; 144(2):461-3. DOI: 10.1164/ajrccm/144.2.461. View

Johns M . A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14(6):540-5. DOI: 10.1093/sleep/14.6.540. View

Dempsey J, Skatrud J, Jacques A, Ewanowski S, Woodson B, Hanson P . Anatomic determinants of sleep-disordered breathing across the spectrum of clinical and nonclinical male subjects. Chest. 2002; 122(3):840-51. DOI: 10.1378/chest.122.3.840. View

Helewa M, Burrows R, Smith J, Williams K, Brain P, Rabkin S . Report of the Canadian Hypertension Society Consensus Conference: 1. Definitions, evaluation and classification of hypertensive disorders in pregnancy. CMAJ. 1997; 157(6):715-25. PMC: 1228113. View

Ursavas A, Karadag M, Nalci N, Ercan I, Gozu R . Self-reported snoring, maternal obesity and neck circumference as risk factors for pregnancy-induced hypertension and preeclampsia. Respiration. 2007; 76(1):33-9. DOI: 10.1159/000107735. View

10.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

11.

Acien P, Lloret G, LLoret M . Perinatal morbidity and mortality in pregnancy hypertensive disorders: prognostic value of the clinical and laboratory findings. Int J Gynaecol Obstet. 1990; 32(3):229-35. DOI: 10.1016/0020-7292(90)90350-t. View

12.

Franklin K, Holmgren P, Jonsson F, Poromaa N, Stenlund H, Svanborg E . Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest. 2000; 117(1):137-41. DOI: 10.1378/chest.117.1.137. View

13.

Guilleminault , Chowdhuri , Poyares . Normal pregnancy, daytime sleeping, snoring and blood pressure. Sleep Med. 2000; 1(4):289-297. DOI: 10.1016/s1389-9457(00)00046-0. View

14.

Kir Sahin F, Koken G, Cosar E, Saylan F, Fidan F, Yilmazer M . Obstructive sleep apnea in pregnancy and fetal outcome. Int J Gynaecol Obstet. 2007; 100(2):141-6. DOI: 10.1016/j.ijgo.2007.08.012. View

15.

. The 2008 Canadian Hypertension Education Program recommendations: the scientific summary -- an annual update. Can J Cardiol. 2008; 24(6):447-52. PMC: 2643188. DOI: 10.1016/s0828-282x(08)70618-4. View

16.

Edwards N, Blyton D, Hennessy A, Sullivan C . Severity of sleep-disordered breathing improves following parturition. Sleep. 2006; 28(6):737-41. DOI: 10.1093/sleep/28.6.737. View

17.

Connolly G, Razak A, Hayanga A, Russell A, McKenna P, McNicholas W . Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women. Eur Respir J. 2001; 18(4):672-6. DOI: 10.1183/09031936.01.00053501. View

18.

Barton J, OBrien J, Bergauer N, Jacques D, Sibai B . Mild gestational hypertension remote from term: progression and outcome. Am J Obstet Gynecol. 2001; 184(5):979-83. DOI: 10.1067/mob.2001.112905. View

19.

Sibai B . Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003; 102(1):181-92. DOI: 10.1016/s0029-7844(03)00475-7. View

20.

Lain K, Roberts J . Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA. 2002; 287(24):3183-6. DOI: 10.1001/jama.287.24.3183. View