Sleep-Related Disordered Breathing During Pregnancy in Obese Women

Maasilta, Paula; Bachour, Adel; Teramo, Kari; Polo, Olli; Laitinen, Lauri A.

doi:10.1378/chest.120.5.1448

Cited by 187 publications

(93 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The finding that the UA is narrowed in the third trimester of pregnancy is also consistent with weight gain [2,[6][7][8] and abdominal mass loading, resulting in decreased lung volume and trachea shortening [7,9,26]. FRANKLIN et al [2] and MAASILTA et al [6], as well as the present study, found that habitual snorers were significantly heavier than nonsnorers before and during pregnancy. This outcome suggests that both pre-pregnancy BMI and gestational weight gain have an important role in the development of SDB in pregnancy.…”

Section: Discussionsupporting

confidence: 86%

“…However, the nonpregnant group tended to have a higher BMI (p,0.059) than the pregnant group reported prior to pregnancy. An increased BMI in the nonpregnant group would bias against the findings of the current study by predisposing to UA narrowing, snoring and apnoeas [6,7,22,27] in the nonpregnant group, so this cannot be a factor in the current findings of the reverse. Indeed, the trend to a difference in BMI could well result from an overoptimistic estimation of pre-pregnancy BMI by the pregnant females.…”

Section: Discussioncontrasting

confidence: 55%

“…A cross-sectional study cannot prove potential reasons and consequences, but only proposes reasons when other confounding factors are controlled. In the current study, the factors that may alter UA dimension were controlled, including sex [22,27,30], age [22], obesity [6][7][8]22], familial factors [31] and sleep state [32]. However, the nonpregnant group tended to have a higher BMI (p,0.059) than the pregnant group reported prior to pregnancy.…”

Section: Discussionmentioning

confidence: 98%

“…BRADLEY et al [5] reported that snorers with or without obstructive sleep apnoea have narrower upper airways (UAs) than nonsnorers even when awake. In pregnancy, the physiological changes potentially predisposing to increased resistance [2] and reduced cross-sectional area of the UAs [4] include the following: weight gain [2,[6][7][8][9]; a decreased functional residual capacity (FRC) due to mass displacement of the diaphragm [9][10][11]; pharyngeal oedema of pregnancy [2][3][4]12]; and, possibly, the effect of sleep deprivation or fragmentation on pharyngeal dilator muscle activity [13] and UA collapsibility [14].…”

mentioning

confidence: 99%

See 3 more Smart Citations

Sleep-disordered breathing and upper airway size in pregnancy and post-partum

et al. 2006

View full text Add to dashboard Cite

Sleep-disordered breathing and snoring are common in pregnancy. The aim of this study was to determine whether pregnancy was associated with upper airway narrowing.One-hundred females in the third trimester of pregnancy were recruited and 50 agreed to be restudied 3 months after delivery. One-hundred nonpregnant females were also recruited. Upper airway dimensions were measured using acoustic reflection.Snoring was less common in nonpregnant (17%) than pregnant females (41%; odds ratio (OR) 3.34; 95% confidence interval (CI) 1.65-6.74) and returned to nonpregnant levels after delivery (18%; OR 0.15; 95% CI 0.06-0.40). Pregnant females had significantly smaller upper airways than nonpregnant females at the oropharyngeal junction when seated (mean difference 0.12; 95% CI 0.008-0.25), and smaller mean pharyngeal areas in the seated (mean difference 0.14; 95% CI 0.001-0.28), supine (mean difference 0.11; 95% CI 0.01-0.22) and lateral postures (mean difference 0.13; 95% CI 0.02-0.24) compared with the nonpregnant females. Pregnant females had smaller mean pharyngeal areas compared with post-partum in the seated (mean difference 0.18; 95% CI 0.02-0.32), supine (mean difference 0.20; 95% CI 0.06-0.35) and lateral postures (mean difference 0.26; 95% CI 0.12-0.39).In conclusion, this study confirmed increased snoring and showed narrower upper airways during the third trimester of pregnancy.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 99%

See 2 more Smart Citations

Sleep-disordered breathing and upper airway size in pregnancy and post-partum

et al. 2006

View full text Add to dashboard Cite

show abstract

“…As previously noted, estimates in non-pregnant women range from 2% to 5%, whereas estimates in pregnancy range from ~10% in early pregnancy to upwards of 30% in late pregnancy. 67,[75][76][77][78] There is currently a paucity of objective data on the incidence of sleep related breathing disorders in pregnancy. Our current knowledge relies primarily on self-reported symptoms, including excessive daytime sleepiness, snoring, or breathing cessations, which suggest but do not confirm the presence of OSA.…”

Section: Sleep Related Breathing Disorders In Pregnancymentioning

confidence: 99%

Sleep and Pregnancy-Induced Hypertension: A Possible Target for Intervention?

Haney

Buysse²,

Okun³

2013

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Sleep disturbances in the general population are associated with elevated blood pressure. This may be due to several mechanisms, including sympathetic activation and hypothalamic-pituitary-adrenal (HPA) axis disturbance. Elevated blood pressure in pregnancy can have devastating effects on both maternal and fetal health and is associated with increased risk for preeclampsia and poor delivery outcomes. Preliminary evidence suggests that mechanisms linking sleep and blood pressure in the general population may also hold in the pregnant population. However, the effects of disturbed sleep on physiologic mechanisms that may directly infl uence blood pressure in pregnancy have not been well studied. The role that sleep disturbance plays in gestational blood pressure elevation and its subsequent consequences warrant further investigation. This review evaluates the current literature on sleep disturbance and elevated blood pressure in pregnancy and proposes possible treatment interventions. T he association between sleep disturbances and elevated blood pressure has been extensively studied in the general population. However, relatively few studies have investigated this relationship in the pregnant population. Pregnancy predisposes women to a variety of sleep disturbances.1,2 Similar to non-pregnant individuals, sleep disturbance in pregnancy may be a risk factor for elevated blood pressure, which can lead to maternal and fetal morbidity . 3,4Gestational hypertension, defi ned as a blood pressure higher than 140/90 diagnosed after 20 weeks of gestation, is associated with fetal growth restriction and abruptio placentae and can predispose to preeclampsia, as well as cardiovascular disease later in lif e. 1,[4][5][6] There are few studies evaluating the link between sleep and blood pressure during pregnancy. In this paper, we fi rst review the relationship between sleep and blood pressure in non-pregnant adults. We then outline factors that predispose pregnant women to poor sleep. We conclude with a review of the emerging literature on the associations between sleep and blood pressure in pregnancy. SLEEP AND BLOOD PRESSURE IN THE NON-PREGNANT POPULATIONIn the U.S. the average sleep duration has decreased by 1.5-2 h/night, with > 30% of Americans sleeping < 6 h/night. 7This phenomenon and the concurrent increase in hypertension intimated a possible link between sleep duration and blood pressure. Recently, a series of epidemiological papers have noted an association between sleep duration (both short and long) and elevated blood press ure [8][9][10][11] ; for example, the Sleep Heart Health Study reported that participants who slept < 5 or ≥ 9 h/night had a greater frequency of hypertension than individuals sleeping

show abstract

Stillbirth

Jones

2018

Dewhurst's Textbook of Obstetrics &Amp; Gynaecology

View full text Add to dashboard Cite

Sleep-Related Disordered Breathing During Pregnancy in Obese Women

Cited by 187 publications

References 23 publications

Sleep-disordered breathing and upper airway size in pregnancy and post-partum

Sleep-disordered breathing and upper airway size in pregnancy and post-partum

Sleep and Pregnancy-Induced Hypertension: A Possible Target for Intervention?

Stillbirth

Contact Info

Product

Resources

About