Review ArticleClinical Review

Sleep-Disordered Breathing During Pregnancy

Chakradhar Venkata and Saiprakash B. Venkateshiah
The Journal of the American Board of Family Medicine March 2009, 22 (2) 158-168; DOI: https://doi.org/10.3122/jabfm.2009.02.080057

References

  1. ↵
    Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993; 328: 1230–5.
    OpenUrlCrossRefPubMedWeb of Science
  2. ↵
    Iber C A-IS, Chesson A, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications, 1st edition. Westchester (IL): American Academy of Sleep Medicine; 2007.
  3. ↵
    Elkus R, Popovich J Jr. Respiratory physiology in pregnancy. Clin Chest Med 1992; 13: 555–65.
    OpenUrlPubMedWeb of Science
  4. ↵
    Mabry RL. Rhinitis of pregnancy. South Med J 1986; 79: 965–71.
    OpenUrlCrossRefPubMedWeb of Science
  5. ↵
    Young T, Finn L, Palta M. Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med 2001; 161: 1514–9.
    OpenUrlCrossRefPubMedWeb of Science
  6. ↵
    Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997; 99: S757–62.
    OpenUrlCrossRefPubMedWeb of Science
  7. ↵
    Izci B, Vennelle M, Liston WA, Dundas KC, Calder AA, Douglas NJ. Sleep-disordered breathing and upper airway size in pregnancy and post-partum. Eur Respir J 2006; 27: 321–7.
    OpenUrlAbstract/FREE Full Text
  8. ↵
    Pilkington S, Carli F, Dakin MJ, et al. Increase in Mallampati score during pregnancy. Br J Anaesth 1995; 74: 638–42.
    OpenUrlAbstract/FREE Full Text
  9. ↵
    Contreras G, Gutierrez M, Beroiza T, et al. Ventilatory drive and respiratory muscle function in pregnancy. Am Rev Respir Dis 1991; 144: 837–41.
    OpenUrlPubMedWeb of Science
  10. ↵
    Bradley TD, McNicholas WT, Rutherford R, Popkin J, Zamel N, Phillipson EA. Clinical and physiologic heterogeneity of the central sleep apnea syndrome. Am Rev Respir Dis 1986; 134: 217–21.
    OpenUrlPubMedWeb of Science
  11. ↵
    Hertz G, Fast A, Feinsilver SH, Albertario CL, Schulman H, Fein AM. Sleep in normal late pregnancy. Sleep 1992; 15: 246–51.
    OpenUrlPubMedWeb of Science
  12. ↵
    Kapsimalis F, Kryger M. Obstructive sleep apnea in pregnancy. Sleep Med Clin 2007; 2: 603–13.
    OpenUrl
  13. ↵
    Edwards N, Middleton PG, Blyton DM, Sullivan CE. Sleep disordered breathing and pregnancy. Thorax 2002; 57: 555–8.
    OpenUrlAbstract/FREE Full Text
  14. ↵
    Remmers JE, deGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 1978; 44: 931–8.
    OpenUrlFREE Full Text
  15. ↵
    Weinberger SE, Weiss ST, Cohen WR, Weiss JW, Johnson TS. Pregnancy and the lung. Am Rev Respir Dis 1980; 121: 559–81.
    OpenUrlPubMedWeb of Science
  16. ↵
    Awe RJ, Nicotra MB, Newsom TD, Viles R. Arterial oxygenation and alveolar-arterial gradients in term pregnancy. Obstet Gynecol 1979; 53: 182–6.
    OpenUrlPubMedWeb of Science
  17. ↵
    White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med 2005; 172: 1363–70.
    OpenUrlCrossRefPubMedWeb of Science
  18. ↵
    Bevan DR, Holdcroft A, Loh L, MacGregor WG, O'Sullivan JC, Sykes MK. Closing volume and pregnancy. Br Med J 1974; 1: 13–5.
    OpenUrlAbstract/FREE Full Text
  19. ↵
    Brunner DP, Munch M, Biedermann K, Huch R, Huch A, Borbely AA. Changes in sleep and sleep electroencephalogram during pregnancy. Sleep 1994; 17: 576–82.
    OpenUrlPubMedWeb of Science
  20. ↵
    Kambam JR, Handte RE, Brown WU, Smith BE. Effect of normal and preeclamptic pregnancies on the oxyhemoglobin dissociation curve. Anesthesiology 1986; 65: 426–7.
    OpenUrlPubMed
  21. ↵
    Joel-Cohen SJ, Schoenfeld A. Fetal response to periodic sleep apnea: a new syndrome in obstetrics. Eur J Obstet Gynecol Reprod Biol 1978; 8: 77–81.
    OpenUrlCrossRefPubMedWeb of Science
  22. ↵
    Charbonneau M, Falcone T, Cosio MG, Levy RD. Obstructive sleep apnea during pregnancy. Therapy and implications for fetal health. Am Rev Respir Dis 1991; 144: 461–3.
    OpenUrlCrossRefPubMedWeb of Science
  23. ↵
    Sherer DM, Caverly CB, Abramowicz JS. Severe obstructive sleep apnea and associated snoring documented during external tocography. Am J Obstet Gynecol 1991; 165(5 Pt 1): 1300–1.
    OpenUrlPubMedWeb of Science
  24. ↵
    Franklin KA, Holmgren PA, Jonsson F, Poromaa N, Stenlund H, Svanborg E. Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest 2000; 117: 137–41.
    OpenUrlCrossRefPubMedWeb of Science
  25. ↵
    Pien GW, Fife D, Pack AI, Nkwuo JE, Schwab RJ. Changes in symptoms of sleep-disordered breathing during pregnancy. Sleep 2005; 28: 1299–305.
    OpenUrlPubMedWeb of Science
  26. ↵
    Crocker BD, Olson LG, Saunders NA, et al. Estimation of the probability of disturbed breathing during sleep before a sleep study. Am Rev Respir Dis 1990; 142: 14–8.
    OpenUrlPubMedWeb of Science
  27. ↵
    Kump K, Whalen C, Tishler PV, et al. Assessment of the validity and utility of a sleep-symptom questionnaire. Am J Respir Crit Care Med 1994; 150: 735–41.
    OpenUrlPubMedWeb of Science
  28. ↵
    Loube DI, Poceta JS, Morales MC, Peacock MD, Mitler MM. Self-reported snoring in pregnancy. Association with fetal outcome. Chest 1996; 109: 885–9.
    OpenUrl
  29. Nikkola E, Ekblad U, Ekholm E, Mikola H, Polo O. Sleep in multiple pregnancy: breathing patterns, oxygenation, and periodic leg movements. Am J Obstet Gynecol 1996; 174: 1622–5.
    OpenUrlCrossRefPubMedWeb of Science
  30. Maasilta P, Bachour A, Teramo K, Polo O, Laitinen LA. Sleep-related disordered breathing during pregnancy in obese women. Chest 2001; 120: 1448–54.
    OpenUrlCrossRefPubMedWeb of Science
  31. ↵
    Guilleminault C, Kreutzer M, Chang JL. Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. Sleep Med 2004; 5: 43–51.
    OpenUrlCrossRefPubMedWeb of Science
  32. ↵
    Edwards N, Blyton DM, Hennessy A, Sullivan CE. Severity of sleep-disordered breathing improves following parturition. Sleep 2005; 28: 737–41.
    OpenUrlPubMedWeb of Science
  33. Izci B, Martin SE, Dundas KC, Liston WA, Calder AA, Douglas NJ. Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Med 2005; 6: 163–9.
    OpenUrlCrossRefPubMedWeb of Science
  34. ↵
    Guilleminault C, Palombini L, Poyares D, Takaoka S, Huynh NT, El-Sayed Y. Pre-eclampsia and nasal CPAP: part 1. Early intervention with nasal CPAP in pregnant women with risk-factors for pre-eclampsia: preliminary findings. Sleep Med 2007; 9: 9–14.
    OpenUrl
  35. ↵
    Sahin FK, Koken G, Cosar E, et al. Obstructive sleep apnea in pregnancy and fetal outcome. Int J Gynaecol Obstet 2008; 100: 141–6.
    OpenUrlCrossRefPubMed
  36. ↵
    Edwards N, Blyton DM, Kirjavainen T, Kesby GJ, Sullivan CE. Nasal continuous positive airway pressure reduces sleep-induced blood pressure increments in preeclampsia. Am J Respir Crit Care Med 2000; 162: 252–7.
    OpenUrlCrossRefPubMedWeb of Science
  37. Guilleminault C, Querra-Salva M, Chowdhuri S, Poyares D. Normal pregnancy, daytime sleeping, snoring and blood pressure. Sleep Med 2000; 1: 289–97.
    OpenUrlCrossRefPubMed
  38. ↵
    Connolly G, Razak AR, Hayanga A, Russell A, McKenna P, McNicholas WT. Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women. Eur Respir J 2001; 18: 672–6.
    OpenUrlAbstract/FREE Full Text
  39. ↵
    Edwards N, Blyton DM, Kirjavainen TT, Sullivan CE. Hemodynamic responses to obstructive respiratory events during sleep are augmented in women with preeclampsia. Am J Hypertens 2001; 14(11 Pt 1): 1090–5.
    OpenUrlCrossRefPubMedWeb of Science
  40. ↵
    Yinon D, Lowenstein L, Suraya S, et al. Preeclampsia is associated with sleep-disordered breathing and endothelial dysfunction. Eur Respir J 2006; 27: 328–33.
    OpenUrlAbstract/FREE Full Text
  41. ↵
    Poyares D, Guilleminault C, Hachul H, et al. Pre-eclampsia and nasal CPAP: part 2. Hypertension during pregnancy, chronic snoring, and early nasal CPAP intervention. Sleep Med 2007; 9: 15–21.
    OpenUrlCrossRefPubMedWeb of Science
  42. ↵
    Schoenfeld A, Ovadia Y, Neri A, Freedman S. Obstructive sleep apnea (OSA)-implications in maternal-fetal medicine. A hypothesis. Med Hypotheses 1989; 30: 51–4.
    OpenUrlCrossRefPubMedWeb of Science
  43. ↵
    Lefcourt LA, Rodis JF. Obstructive sleep apnea in pregnancy. Obstet Gynecol Surv 1996; 51: 503–6.
    OpenUrlCrossRefPubMed
  44. ↵
    Roush SF, Bell L. Obstructive sleep apnea in pregnancy. J Am Board Fam Pract 2004; 17: 292–4.
    OpenUrlPubMed
  45. ↵
    Brain KA, Thornton JG, Sarkar A, Johnson AO. Obstructive sleep apnoea and fetal death: successful treatment with continuous positive airway pressure. BJOG 2001; 108: 543–4.
    OpenUrlPubMed
  46. ↵
    Lewis DF, Chesson AL, Edwards MS, Weeks JW, Adair CD. Obstructive sleep apnea during pregnancy resulting in pulmonary hypertension. South Med J 1998; 91: 761–2.
    OpenUrlPubMed
  47. ↵
    Hastie SJ, Prowse K, Perks WH, Atkins J, Blunt VA. Obstructive sleep apnoea during pregnancy requiring tracheostomy. Aust N Z J Obstet Gynaecol 1989; 29(3 Pt 2): 365–7.
    OpenUrlPubMed
  48. ↵
    Conti M, Izzo V, Muggiasca ML, Tiengo M. Sleep apnoea syndrome in pregnancy: a case report. Eur J Anaesthesiol 1988; 5: 151–4.
    OpenUrlPubMedWeb of Science
  49. ↵
    Kowall J, Clark G, Nino-Murcia G, Powell N. Precipitation of obstructive sleep apnea during pregnancy. Obstet Gynecol 1989; 74(3 Pt 2): 453–5.
    OpenUrlPubMedWeb of Science
  50. ↵
    Youssef HF, Dombrovskiy VY, Santiago TV, Nolledo MS. Sleep apnea is associated with gestational diabetes mellitus and pregnancy-induced hypertension [abstract] Am J Respir Crit Care Med 2007; 175: A996.
    OpenUrl
  51. ↵
    Pien GW, Schwab RJ. Sleep disorders during pregnancy. Sleep 2004; 27: 1405–17.
    OpenUrlPubMedWeb of Science
  52. ↵
    Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol 1998; 179: 1359–75.
    OpenUrlCrossRefPubMedWeb of Science
  53. ↵
    Beilin LJ, Deacon J, Michael CA, et al. Diurnal rhythms of blood pressure, plasma renin activity, angiotensin II and catecholamines in normotensive and hypertensive pregnancies. Clin Exp Hypertens B 1983; 2: 271–93.
    OpenUrlPubMed
  54. ↵
    Redman CW, Beilin LJ, Bonnar J. Reversed diurnal blood pressure rhythm in hypertensive pregnancies. Clin Sci Mol Med Suppl 1976; 3: 687S–689S.
    OpenUrlPubMed
  55. ↵
    Loredo JS, Ancoli-Israel S, Dimsdale JE. Sleep quality and blood pressure dipping in obstructive sleep apnea. Am J Hypertens 2001; 14(9 Pt 1): 887–92.
    OpenUrlCrossRefPubMedWeb of Science
  56. Hoffstein V, Mateika J. Evening-to-morning blood pressure variations in snoring patients with and without obstructive sleep apnea. Chest 1992; 101: 379–84.
    OpenUrlCrossRefPubMedWeb of Science
  57. Suzuki M, Guilleminault C, Otsuka K, Shiomi T. Blood pressure “dipping” and “non-dipping” in obstructive sleep apnea syndrome patients. Sleep 1996; 19: 382–7.
    OpenUrlPubMedWeb of Science
  58. ↵
    Feinsilver SH, Hertz G. Respiration during sleep in pregnancy. Clin Chest Med 1992; 13: 637–44.
    OpenUrlPubMedWeb of Science
  59. ↵
    Gordon M, Niswander KR, Berendes H, Kantor AG. Fetal morbidity following potentially anoxigenic obstetric conditions. VII. Bronchial asthma. Am J Obstet Gynecol 1970; 106: 421–9.
    OpenUrlPubMedWeb of Science
  60. ↵
    Santiago JR, Nolledo MS, Kinzler W, Santiago TV. Sleep and sleep disorders in pregnancy. Ann Intern Med 2001; 134: 396–408.
    OpenUrlCrossRefPubMed
  61. ↵
    Gozal D, Gozal E, Reeves SR, Lipton AJ. Gasping and autoresuscitation in the developing rat: effect of antecedent intermittent hypoxia. J Appl Physiol 2002; 92: 1141–4.
    OpenUrlAbstract/FREE Full Text
  62. Schwartz JE, Kovach A, Meyer J, McConnell C, Iwamoto HS. Brief, intermittent hypoxia restricts fetal growth in Sprague-Dawley rats. Biol Neonate 1998; 73: 313–9.
    OpenUrlCrossRefPubMedWeb of Science
  63. Gozal D, Reeves SR, Row BW, Neville JJ, Guo SZ, Lipton AJ. Respiratory effects of gestational intermittent hypoxia in the developing rat. Am J Respir Crit Care Med 2003; 167: 1540–7.
    OpenUrlCrossRefPubMedWeb of Science
  64. ↵
    Kushida CA, Littner MR, Hirshkowitz M, et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep 2006; 29: 375–80.
    OpenUrlPubMedWeb of Science
  65. ↵
    Leech JA, Ascah KJ. Hemodynamic effects of nasal CPAP examined by Doppler echocardiography. Chest 1991; 99: 323–6.
    OpenUrlCrossRefPubMedWeb of Science
  66. ↵
    Blyton DM, Sullivan CE, Edwards N. Reduced nocturnal cardiac output associated with preeclampsia is minimized with the use of nocturnal nasal CPAP. Sleep 2004; 27: 79–84.
    OpenUrlPubMed
  67. ↵
    Janson C, Gislason T, Bengtsson H, et al. Long-term follow-up of patients with obstructive sleep apnea treated with uvulopalatopharyngoplasty. Arch Otolaryngol Head Neck Surg 1997; 123: 257–62.
    OpenUrlCrossRefPubMedWeb of Science
  68. ↵
    Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996; 19: 156–77.
    OpenUrlPubMedWeb of Science
  69. ↵
    Fletcher EC, Munafo DA. Role of nocturnal oxygen therapy in obstructive sleep apnea. When should it be used? Chest 1990; 98: 1497–504.
    OpenUrlCrossRefPubMedWeb of Science
  70. ↵
    Morgenthaler TI, Kapen S, Lee-Chiong T, et al. Practice parameters for the medical therapy of obstructive sleep apnea. Sleep 2006; 29: 1031–5.
    OpenUrlPubMedWeb of Science
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