Sleepiness and sleep-disordered breathing during pregnancy

Sleep Breath. 2016 Dec;20(4):1231-1237. doi: 10.1007/s11325-016-1345-9. Epub 2016 Apr 16.

Abstract

Purpose: This study aimed to examine if there is a difference in the prevalence of obstructive sleep apnea (OSA) and sleepiness between pregnant and non-pregnant women. It also aimed to evaluate if obstetric outcomes were associated to sleep-disordered breathing among the pregnant women.

Methods: One hundred pregnant women (gestational weeks 24-34) and 80 age- and body mass index-matched non-pregnant women underwent whole-night respiratory recordings (airflow, snoring, respiratory movements, body position, pulse oximetry). The women also answered a questionnaire including the Epworth sleepiness scale.

Results: Eighty-nine percent of the pregnant women had normal body mass index (BMI). Objectively, recorded snoring was more common among the pregnant women (median 9 % of total estimated sleep time) than among the controls (4 % of total sleep time, p = 0.005). Three of the pregnant women had OSA (apnea/hypopnea index (AHI) >5), but in two cases, this was mainly due to central hypopneas. None had AHI >10. Two controls were diagnosed as OSA. Respiratory parameters including snoring showed no impact on obstetric outcomes. Total Epworth sleepiness scale (ESS) score was higher among pregnant women than among controls (median 9 vs 7, p < 0.001). There was no difference concerning the separate items. There were no significant associations between either subjectively reported or objectively recorded snoring and ESS scores.

Conclusion: There was no increased prevalence of obstructive sleep apnea among pregnant women. One reason for this could be that the majority of the women in this study were non-obese. Neither OSA nor snoring was likely an explanation for the increased daytime sleepiness seen in the pregnant women.

Keywords: Epworth sleepiness scale; Obstructive sleep apnea; Pregnancy; Sleep recordings; Sleep-disordered breathing; Snoring.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Disorders of Excessive Somnolence / diagnosis*
  • Disorders of Excessive Somnolence / epidemiology*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome
  • Psychometrics
  • Reference Values
  • Self Report
  • Sleep Apnea, Central / diagnosis
  • Sleep Apnea, Central / epidemiology
  • Sleep Apnea, Obstructive / diagnosis*
  • Sleep Apnea, Obstructive / epidemiology*
  • Snoring / diagnosis
  • Snoring / epidemiology
  • Surveys and Questionnaires