ANN ARBOR, Mich. — 1 in 2 hypertensive pregnant women who habitually snore may have unrecognized obstructive sleep apnea, a sleeping disorder that can reduce blood oxygen levels during the night and that has been linked to serious health conditions, new University of Michigan-led research shows.
One in four hypertensive pregnant women who don't snore also unknowingly suffer from the sleeping disorder, according to the study that appears in the British Journal of Obstetrics and Gynecology.
"We know that habitual snoring is linked with poor pregnancy outcomes for both mother and child, including increased risk of C-sections and smaller babies," says lead author Louise O'Brien, Ph.D., M.S., associate professor at U-M's Sleep Disorders Center in the Department of Neurology and adjunct associate professor in the Department of Obstetrics & Gynecology at the U-M Medical School.
"Our findings show that a substantial proportion of hypertensive pregnant women have obstructive sleep apnea and that habitual snoring may be one of the most telling signs to identify this risk early in order to improve health outcomes."
Habitual snoring – snoring three or more nights a week – is the hallmark symptom of obstructive sleep apnea, which has been shown to increase in frequency during pregnancy. and affects up to one-third of women by the third trimester.
O'Brien's previous studies have found that snoring during pregnancy may influence delivery and baby's health, with a higher risk for C-sections and delivering smaller babies. Women who begin snoring during pregnancy are also at a strong risk for high blood pressure and preeclampsia, O'Brien's research has shown.
"Hypertensive pregnant women who report snoring should be evaluated for obstructive sleep apnea since sleep apnea can be treated during pregnancy," says O'Brien, who is also a member of the Institute for Healthcare Policy and Innovation.
"Prompt recognition, evaluation, and management will not only improve health benefits for both moms and babies but may also help cut the high healthcare expenses of operative deliveries, taking care of babies who are admitted to the NICU and other associated health risks."
Alexandra S. Bullough, MBChB, FRCA, M.D., assistant professor, anesthesiology (formerly of U-M, now at Loyola University Health System in Chicago);
Mark C. Chames, M.D., assistant professor, obstetrics & gynecology, U-M;
Anita V. Shelgikar, M.D., assistant professor, neurology, U-M;
Roseanne Armitage, Ph.D., professor, psychiatry, U-M;
Christian Guilleminault, M.D., professor, psychiatry and behavioral Sciences, Stanford University;
Colin E. Sullivan, MBBS, PhS, FRACP, professor, University of Sydney, Sydney, Australia;
Timothy R. B. Johnson, M.D., professor, obstetrics & gynecology, U-M;
Ronald D. Chervin, M.D., MS, professor, neurology, U-M.
O'Brien received equipment support from Philips Respironics Inc. and is an advisory board member for the non-profit Star Legacy Foundation.
This project was supported by the Gene and Tubie Gilmore Fund for Sleep Research and the National Heart, Lung, and Blood Institute (NHLBI) K23 HL095739.
"Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study," BJOG, Doi: 10.1111/1471-0528.12885.
British Journal of Obstetrics and Gynaecology