Sleep Apnea May Boost Pregnancy Complications
MONDAY, May 22, 2017 -- Mothers-to-be with sleep apnea may have a higher risk of pregnancy complications, longer hospital stays and admission to the ICU than those without the sleep disorder, a new study suggests.
The study of more than 1.5 million U.S. women found sleep apnea linked to significantly higher odds for problems such as heart failure, hysterectomy, preeclampsia and gestational diabetes.
The findings may come as a surprise even to physicians, said study lead author Dr. Ghada Bourjeily.
"When people think of obstructive sleep apnea, they usually think of older men," said Bourjeily, an associate professor of medicine at Brown University in Providence, R.I.
It's true that men are more likely to develop the condition, but the physiological changes of pregnancy may also trigger sleep apnea, the researchers said in background notes. However, it often goes undiagnosed.
People with the condition have disrupted breathing during sleep, sometimes hundreds of times a night, depriving the brain and other parts of the body of oxygen.
Risk for the condition rises with age and weight. About half the people with sleep apnea are overweight, according to the U.S. National Institutes of Health.
The study "opens the door to a way to potentially improve maternal and child health," said Dr. Jill Rabin, co-chief of ambulatory care of the women's health programs for Northwell Health in New Hyde Park, N.Y.
Rabin, who wasn't involved in the study, said the link makes sense.
"If the woman isn't getting enough oxygen," that could help explain health conditions such as heart disease, she said.
For the study, researchers analyzed 2010-2014 pregnancy records from a national database of more than 1.5 million women. Fewer than 1 percent had been diagnosed with sleep apnea, they said.
After taking into account obesity and other risk factors, the researchers found women with sleep apnea were almost three times more likely to be admitted to the ICU than those without it. And their hospital stays averaged five days versus three.
Women with sleep apnea were also more than five times more likely to have swelling in the lungs (pulmonary edema), and about 3.6 times more likely to have congestive heart failure. Moreover, these women were more than twice as likely to need a hysterectomy, the study found.
"We can't say the sleep apnea is causing these associations, so we have to be careful about interpreting this, but it's definitely associated with it," Bourjeily said.
No information was available on whether the condition was treated or not, and Bourjeily acknowledged that's a limitation of the study.
The researchers are now exploring what might explain the links between sleep apnea and pregnancy complications, and whether treatment can improve the outcomes.
The experts' advice? Try to get down to a healthy weight before becoming pregnant, Bourjeily said. That will potentially decrease their risks of complications.
"Obesity by itself is a risk factor for sleep apnea," she said.
Rabin said if you're pregnant and your partner tells you that you snore, mention it to your doctor. "It might be worth looking into," Rabin said. She said she would refer a patient with suspected sleep apnea to a sleep specialist or a lung specialist.
A breathing device called CPAP (continuous positive airway pressure) and other treatment approaches can help patients sleep better, Bourjeily said. When sleep gets better, quality of life improves, she said.
Bourjeily presented her findings Monday at the American Thoracic Society annual meeting, in Washington, D.C. Research presented at meetings is typically viewed as preliminary until it's published in a peer-reviewed journal.
To learn more about sleep apnea, visit the U.S. National Institutes of Health.
Posted: May 2017