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Title: Sleep-disordered breathing in hypertensive disorders of pregnancy: a BMI-matched study.
Austin Authors: Wilson, Danielle L ;Walker, Susan P;Fung, Alison M;Pell, Gabrielle;O'Donoghue, Fergal J ;Barnes, Maree ;Howard, Mark E 
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Victoria, Australia
Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
Issue Date: 2018 2018-01-25
Publication information: Journal of sleep research 2018; 27(5): e12656
Abstract: Sleep-disordered breathing is more common in hypertensive disorders during pregnancy; however, most studies have not adequately accounted for the potential confounding impact of obesity. This study evaluated the frequency of sleep-disordered breathing in women with gestational hypertension and pre-eclampsia compared with body mass index- and gestation-matched normotensive pregnant women. Women diagnosed with gestational hypertension or pre-eclampsia underwent polysomnography shortly after diagnosis. Normotensive controls body mass index-matched within ±4 kg m-2underwent polysomnography within ±4 weeks of gestational age of their matched case. The mean body mass index and gestational age at polysomnography were successfully matched for 40 women with gestational hypertension/pre-eclampsia and 40 controls. The frequency of sleep-disordered breathing in the cases was 52.5% compared with 37.5% in the control group (P = 0.18), and the respiratory disturbance index overall did not differ (P = 0.20). However, more severe sleep-disordered breathing was more than twice as common in women with gestational hypertension or pre-eclampsia (35% versus 15%, P = 0.039). While more than half of women with a hypertensive disorder of pregnancy meet the clinical criteria for sleep-disordered breathing, it is also very common in normotensive women of similar body mass index. This underscores the importance of adjusting for obesity when exploring the relationship between sleep-disordered breathing and hypertension in pregnancy. More severe degrees of sleep-disordered breathing are significantly associated with gestational hypertension and pre-eclampsia, and sleep-disordered breathing may plausibly play a role in the pathophysiology of pregnancy hypertension in these women. This suggests that more severe sleep-disordered breathing is a potential therapeutic target for reducing the prevalence or severity of hypertensive disorders in pregnancy.
DOI: 10.1111/jsr.12656
ORCID: 0000-0001-6754-7359
PubMed URL: 29368415
Type: Journal Article
Subjects: obese
obstructive sleep apnea
sleep study
Appears in Collections:Journal articles

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