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Respiration during sleep in pregnancy.

S H Feinsilver1, G Hertz

  • 1State University of New York, Stony Brook.

Clinics in Chest Medicine
|December 1, 1992
PubMed
Summary

Pregnancy can worsen sleep-disordered breathing and hypoxemia, even with progesterone. Women with severe snoring or daytime sleepiness need polysomnography for potential sleep apnea treatment.

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Area of Science:

  • Obstetrics and Gynecology
  • Sleep Medicine
  • Maternal-Fetal Medicine

Background:

  • Maternal physiological changes during pregnancy significantly impact sleep patterns.
  • Supine positioning during sleep can exacerbate hypoxemia in pregnant women.
  • Progesterone's respiratory drive increase may not fully prevent sleep-disordered breathing in all pregnancies.

Purpose of the Study:

  • To highlight the potential for sleep-disordered breathing and hypoxemia during pregnancy.
  • To identify clinical indicators warranting further sleep study evaluation.
  • To discuss potential management strategies for sleep-disordered breathing in pregnancy.

Main Methods:

  • Review of physiological changes affecting sleep in late pregnancy.
  • Discussion of clinical signs suggestive of sleep-disordered breathing.
  • Consideration of diagnostic tools like clinical polysomnography.
  • Evaluation of treatment options, including nasal CPAP.

Main Results:

  • Sleep-disordered breathing and hypoxemia can occur during pregnancy, potentially worsening in the supine position.
  • The exact incidence of sleep-disordered breathing in pregnancy is currently unknown.
  • Severe snoring, observed irregular breathing, and excessive daytime somnolence are key indicators for polysomnography.

Conclusions:

  • Pregnant women experiencing specific sleep disturbances should undergo clinical polysomnography.
  • Nasal CPAP is suggested as a primary treatment for sleep-disordered breathing in pregnancy.
  • Treating significant sleep-disordered breathing is crucial due to potential adverse fetal outcomes.

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