Research Studies Investigating Sleep-Disordered Breathing and Gestational Hypertension/Preeclampsia
| Author | Year | Number of Patients | Study Design/Methods | Results/Conclusions |
|---|---|---|---|---|
| Edwards N, et al (36)* | 2000 | 11 women | Prospective nonrandomized study of CPAP therapy in patients with severe preeclampsia | Sleep-induced partial upper airflow limitation was noted in all patients on polysomnographic studies, which was eliminated with CPAP therapy along with blood pressure improvement. |
| Franklin KA, et al (24) | 2000 | 502 women | Retrospective, cross-sectional questionnaire survey done on the day of delivery | Habitual snoring increased significantly by late pregnancy (23% vs 4% before pregnancy). Incidence of gestational hypertension (14% vs 6%); preeclampsia (10% vs 4%); and fetal growth retardation (7.1% vs 2.6%) were significantly higher in pregnant women with habitual snoring compared with nonsnorers. |
| Guilleminault C, et al (37) | 2000 | 267 women in the first part of the study; 26 women in the second part of the study | Prospective and cross-sectional study evaluating pregnancy-associated snoring and blood pressure | 52% of patients reported snoring at 6 months’ gestation compared with 37% at 6 weeks. Mean AHI and BP at 6 months’ gestation were slightly higher in snorers, but this data was not clinically or statistically significant. However, the absence of the normal nocturnal dip in systolic blood pressure was noted in snorers. |
| Connolly G, et al (38) | 2001 | 75 women (15 women with preeclampsia, 15 from each trimester and 15 nonpregnant controls) | Case control prospective study comparing inspiratory flow limitation during sleep | Patients with preeclampsia spent more time during sleep with significant inspiratory flow limitation (31%) compared with normotensive third trimester patients (15.5%) and rest of the 3 groups (<5%). |
| Edwards N, et al (39) | 2001 | 20 (10 normotensive pregnant women with OSA, 10 women with preeclampsia and OSA) | Case-control study evaluating hemodynamic responses to obstructive respiratory events during sleep | The pressor responses to obstructive respiratory events during sleep were enhanced in preeclamptic patients compared with controls. |
| Yinon D, et al (40) | 2006 | 17 women with preeclampsia were compared with 25 matched subjects | Case-control study evaluating sleep disordered breathing and endothelial dysfunction | Women with preeclampsia had a significantly higher RDI (18.4 vs 8.3; P < .05) and lower endothelial function index (1.5 vs 1.8; P < .05) compared with controls. |
| Poyares D, et al (41)* | 2007 | 16 pregnant women with hypertension and snoring (9 women in control group and 7 in the treatment group) | Randomized control study comparing nasal CPAP treatment with standard prenatal care | CPAP therapy added to standard prenatal care during early pregnancy improved blood pressure control without the need for escalating antihypertensive medication doses. However, infant outcomes seemed to be similar in both groups. |
↵* Studies evaluating therapy of sleep-disordered breathing.
AHI, apnea-hypopnea index; BP, blood pressure; CPAP, continuous positive airway pressure; OSA, obstructive sleep apnea; PSG, polysomnogram; RDI, respiratory disturbance index.