Prevalence of Symptoms and Risk of Obstructive Sleep Apnea in Saudi Pregnant Women

Overview

Journal Ann Thorac Med

Specialty Pulmonary Medicine

Date 2020 Aug 25

PMID 32831939

Citations 4

Authors

Aljohara S Almeneessier

Mohammed Alangari

Abdulmalik Aldubayan

Abdulrahman Alsharidah

Aamer Altaki

Awad H Olaish

Yasser S Sabr

Ahmed S BaHammam

Affiliations

Soon will be listed here.

Abstract

Background: This case-control study aimed to assess the prevalence of symptoms and risk of obstructive sleep apnea (OSA) among Saudi pregnant women.

Methods: The study included consecutive Saudi pregnant women attending the antenatal service between July 2015 and December 2016. Pregnant women were compared with an age-matched group of nonpregnant women. OSA symptoms and risk were assessed using a validated Arabic version of the Berlin questionnaire (BQ).

Results: The study included 742 pregnant women and 742 age-matched nonpregnant women. At the time of the survey, 8.2% were in the first trimester; 33.4% in the second trimester; and 58.4%in third trimester. Snoring was reported by 14% of pregnant women, and 5% reported breathing pauses during sleep. Based on the BQ stratification for risk of OSA, 19.3% of pregnant women and 16.6% of the control group were at high risk for OSA. A comparison between the high OSA-risk and low OSA-risk pregnant women revealed that the pregnant women in high risk group were older (30.9 ± 5.9 years vs. 29 ± 5.4 years, = 0.001), had a higher body mass index (BMI) (34.3 ± 5.2 kg/m vs. 28.7 ± 5.8 kg/m, < 0.001), and higher parity (1.9 ± 2 vs. 1.5 ± 1.7, = 0.020). A multivariate logistic regression analysis revealed the following independent variables, BMI (odds ratio [OR] 1.173 [95% confidence interval [CI] 1.129-1.219],P < 0.001), pregnancy-induced hypertension (OR 7.85 [95% CI 1.691-36.447], = 0.013), and the presence of restless legs syndrome (OR 2.209 [95% CI 1.332-3.279],P < 0.001).

Conclusions: OSA symptoms and risk were relatively common among Saudi pregnant women. Increasing the awareness among physicians about this association is essential to improve early detection of the disorder.

Citing Articles

Prevalence and factors associated with restless legs syndrome among pregnant women in middle-income countries: a systematic review and meta-analysis.

Mislu E, Assalfew B, Arage M, Chane F, Hailu T, Tenaw L Front Med (Lausanne). 2024; 10:1326337.

PMID: 38188334 PMC: 10771314. DOI: 10.3389/fmed.2023.1326337.

Longitudinal Sleep Study in Pregnancy: Cohort Profile and Prevalence and Risk Factors for Sleep Symptoms in the First Trimester.

Senaratna C, Priyadarshanie N, Fernando S, Goonewardena S, Piyumanthi P, Perret J Int J Environ Res Public Health. 2023; 20(3).

PMID: 36767435 PMC: 9915362. DOI: 10.3390/ijerph20032070.

Knowledge and Attitude towards Obstructive Sleep Apnea among Primary Care Physicians in Northern Regions of Saudi Arabia: A Multicenter Study.

Al-Rasheedi A, Thirunavukkarasu A, Almutairi A, Alruwaili S, Alotaibi H, Alzaid W Healthcare (Basel). 2022; 10(12).

PMID: 36553893 PMC: 9778346. DOI: 10.3390/healthcare10122369.

Sleep microstructure and clinical characteristics of patients with restless legs syndrome.

AmiriFard H, Jameie M, Akbarpour S, Sadeghniiat Haghighi K, Shojaei M, Heidari R J Clin Sleep Med. 2022; 18(11):2653-2661.

PMID: 35924664 PMC: 9622991. DOI: 10.5664/jcsm.10184.

References

Fernandez Alonso A, Chedraui P, Perez-Lopez F . Assessment of obstructive sleep apnea-hypopnea syndrome risk at the end of pregnancy using the Berlin Questionnaire. Gynecol Endocrinol. 2015; 31(9):715-9. DOI: 10.3109/09513590.2015.1034099. View

Balserak B . Sleep disordered breathing in pregnancy. Breathe (Sheff). 2016; 11(4):268-77. PMC: 4818216. DOI: 10.1183/20734735.009215. View

Antony K, Agrawal A, Arndt M, Murphy A, Alapat P, Guntupalli K . Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea. J Perinatol. 2014; 34(6):441-8. DOI: 10.1038/jp.2014.25. View

Felder J, Baer R, Rand L, Jelliffe-Pawlowski L, Prather A . Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth. Obstet Gynecol. 2017; 130(3):573-581. DOI: 10.1097/AOG.0000000000002132. View

Brown N, Turner J, Kumar S . The intrapartum and perinatal risks of sleep-disordered breathing in pregnancy: a systematic review and metaanalysis. Am J Obstet Gynecol. 2018; 219(2):147-161.e1. DOI: 10.1016/j.ajog.2018.02.004. View

Dudley K, Patel S . Disparities and genetic risk factors in obstructive sleep apnea. Sleep Med. 2015; 18:96-102. PMC: 4602395. DOI: 10.1016/j.sleep.2015.01.015. View

Wilson D, Walker S, Fung A, ODonoghue F, Barnes M, Howard M . Can we predict sleep-disordered breathing in pregnancy? The clinical utility of symptoms. J Sleep Res. 2013; 22(6):670-8. DOI: 10.1111/jsr.12063. View

Almeneessie A, Alyousefi N, Alzahrani M, Alsafi A, Alotaibi R, Olaish A . Prevalence of restless legs syndrome among pregnant women: A case-control study. Ann Thorac Med. 2020; 15(1):9-14. PMC: 6967142. DOI: 10.4103/atm.ATM_206_19. View

Ding N, Lin W, Zhang X, Ding W, Gu B, Ni B . Overnight fluid shifts in subjects with and without obstructive sleep apnea. J Thorac Dis. 2015; 6(12):1736-41. PMC: 4283308. DOI: 10.3978/j.issn.2072-1439.2014.11.19. View

10.

Rice J, Larrabure-Torrealva G, Luque Fernandez M, Grande M, Motta V, Barrios Y . High risk for obstructive sleep apnea and other sleep disorders among overweight and obese pregnant women. BMC Pregnancy Childbirth. 2015; 15:198. PMC: 4557601. DOI: 10.1186/s12884-015-0633-x. View

11.

Spence D, Allen R, Lutgendorf M, Gary V, Richard J, Gonzalez S . Association of obstructive sleep apnea with adverse pregnancy-related outcomes in military hospitals. Eur J Obstet Gynecol Reprod Biol. 2017; 210:166-172. DOI: 10.1016/j.ejogrb.2016.12.013. View

12.

Higgins N, Leong E, Park C, Facco F, McCarthy R, Wong C . The Berlin Questionnaire for assessment of sleep disordered breathing risk in parturients and non-pregnant women. Int J Obstet Anesth. 2010; 20(1):22-5. DOI: 10.1016/j.ijoa.2010.09.010. View

13.

Wali S, Abalkhail B, Krayem A . Prevalence and risk factors of obstructive sleep apnea syndrome in a Saudi Arabian population. Ann Thorac Med. 2017; 12(2):88-94. PMC: 5399696. DOI: 10.4103/1817-1737.203746. View

14.

Tantrakul V, Sirijanchune P, Panburana P, Pengjam J, Suwansathit W, Boonsarngsuk V . Screening of obstructive sleep apnea during pregnancy: differences in predictive values of questionnaires across trimesters. J Clin Sleep Med. 2014; 11(2):157-63. PMC: 4298773. DOI: 10.5664/jcsm.4464. View

15.

Roux F . Restless legs syndrome: impact on sleep-related breathing disorders. Respirology. 2012; 18(2):238-45. DOI: 10.1111/j.1440-1843.2012.02249.x. View

16.

Gao X, Schwarzschild M, Wang H, Ascherio A . Obesity and restless legs syndrome in men and women. Neurology. 2009; 72(14):1255-61. PMC: 2677487. DOI: 10.1212/01.wnl.0000345673.35676.1c. View

17.

Karaduman M, Sari O, Aydogan U, Akpak Y, Semiz A, Cihangir Yilanlioglu N . Evaluation of obstructive sleep apnea symptoms in pregnant women with chronic disease. J Matern Fetal Neonatal Med. 2015; 29(20):3379-85. DOI: 10.3109/14767058.2015.1127346. View

18.

Pien G, Fife D, Pack A, Nkwuo J, Schwab R . Changes in symptoms of sleep-disordered breathing during pregnancy. Sleep. 2005; 28(10):1299-305. DOI: 10.1093/sleep/28.10.1299. View

19.

Louis J, Mogos M, Salemi J, Redline S, Salihu H . Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009. Sleep. 2014; 37(5):843-9. PMC: 3985102. DOI: 10.5665/sleep.3644. View

20.

Alotair H, BaHammam A . Gender differences in Saudi patients with obstructive sleep apnea. Sleep Breath. 2008; 12(4):323-9. DOI: 10.1007/s11325-008-0184-8. View