Postpartum Recommendations for Women with Pregnancy-Associated Sleep Apnea51
| Initial Postpartum Management | If Symptoms Recur with Withdrawal of Therapy or Weight Gain Persists | |
|---|---|---|
| Mild to moderate pregnancy-associated sleep apnea | Postpartum withdrawal of therapy with close follow-up for symptom recurrence; if asymptomatic, monitor for recurrence in future pregnancies | Obtain overnight PSG to determine baseline AHI; assess need for treatment and therapeutic options based on findings |
| Severe pregnancy-associated sleep apnea | Continue therapy and obtain overnight PSG when weight within 10% to 15% of baseline to rule out persistent OSA | Obtain repeat overnight PSG to establish baseline AHI (consider split-night study with CPAP titration) and the need for continued therapy |
| Preexisting sleep apnea | Consider return to prepregnancy therapy when weight within 10% to 15% of baseline, with close follow-up for symptom recurrence | Repeat overnight PSG (with split-night study if using CPAP at baseline) to determine new baseline AHI; modify prepregnancy therapy based on findings |
PSG, polysomnography; AHI, apnea-hypopnea index; OSA, obstructive sleep apnea; CPAP, continuous positive airway pressure.
Reproduced with permission from Pien GW, Schwab RJ. Sleep disorders during pregnancy. Sleep 2004;27:1405–17.