We have known for some time that sleep apnea can cause problems during pregnancy. Several studies have shown an increased risk of hypertension and diabetes in pregnant women with sleep apnea. However, a study in this month’s issue of the journal Sleep, bring to light some truly startling revelations about how sleep apnea affects a woman’s health during pregnancy.
The researchers drew upon a nationally representative sample of 55 million maternal-related hospital discharges. They reviewed the records of women who were pregnant or gave birth from 1998 to 2009. The findings were stunning.
They found that the incidence of sleep apnea increased by an average of 24 percent per year. In 1998, the rate of sleep apnea was .7 per 10,000. By 2009, it had climbed to 7.3. Even more shocking was how much having sleep apnea increased the pregnant women’s chances of developing associated medical problems. The researchers found that the chances of developing preeclampsia and eclampsia, two conditions involving hypertension associated with pregnancy, increased by a factor of 2.5 and 5.4 respectively. The chance of developing cardiomyopathy, a significant and dangerous weakness of the heart muscle, was nine times more likely in pregnant women with sleep apnea. Finally, pregnant women with sleep apnea were five times as likely to die while hospitalized for their pregnancy. In all cases, obesity made matters worse, and may have contributed to the rise in sleep apnea.
We know that untreated sleep apnea is associated with many undesirable metabolic and mechanical changes. There is an increased production of inflammatory mediators that damage organs and the lining of blood vessels. At the same time, sleep apnea results in insulin resistance, arterial vasoconstriction, and cardiac dysfunction. Is it any wonder that when coupled with the increased demands of pregnancy, bad things are more likely to happen?
I believe that this study is a wake-up call for all of us in the medical profession, especially for those physicians and healthcare professionals involved in maternal care. We all need to be more mindful of the increased risk of sleep apnea in our pregnant patients. We need to be more proactive about inquiring as to snoring and be suspicious of sleep apnea in any of our pregnant patients who are excessively overweight during their pregnancy.
The good news is that sleep apnea is treatable. I myself have had numerous patients who were successfully treated for sleep apnea during their pregnancies. I believe that now there is no reason for pregnant women to suffer these dreadful complications.
