Sleep Apnea in Pregnancy Associated with Risk of Metabolic Syndrome and Hypertension

As published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine, sleep disordered breathing during pregnancy has been associated with a 2 to 3-times increased risk for preeclampsia and/or gestational diabetes. Preeclampsia, gestational diabetes, and other adverse pregnancy outcomes are risk factors for later development of hypertension and metabolic disease in the mother.

Study participants (n=1,964) who were experiencing their first pregnancies and experienced 5 or more breathing pauses or drops in oxygen during their estimated sleep period were considered to have sleep apnea. The sleep apnea tests measure the number of times a person experiences breathing pauses and associated drops in oxygen levels.  All study participants were tested during pregnancy, and 62% were also tested 2 to 7 years later. 

“While epidemiologic data from cohorts of middle-aged and older adults indicate that sleep disordered breathing is associated with adverse cardiometabolic outcomes, less is known about how sleep-disordered breathing in pregnancy and in the post-delivery period impacts maternal health,” stated Francesca L. Facco, MD, assistant professor, Department of Obstetrics, Gynecology & Reproductive Science, Division of Maternal Fetal Medicine, UPMC Magee-Womens Hospital, Pittsburgh, and colleagues conducted sleep apnea tests.
 
“We found that the presence of sleep apnea measured both during pregnancy and two to seven years after delivery was associated with the development of hypertension and metabolic syndrome,” said Dr. Facco.

Compared with participants who never had an abnormal sleep study, the follow up participants (n=1,222) were at more than threefold increased risk for incident hypertension and a more than twofold increased risk for metabolic syndrome. Incident hypertension is defined as the first occurrence at any follow-up visit of systolic blood pressure 140 mm Hg or higher or diastolic blood pressure 90 mm Hg or higher.

“Our data also demonstrated a higher risk of developing metabolic syndrome and hypertension using a simple measurement of oxygen dips per hour of sleep,” said study coauthor Susan Redline, MD, MPH, who directs the Sleep Medicine Epidemiology program at Brigham and Women’s Hospital and Harvard Medical School, Boston. “These results suggest that use of simple oxygen monitoring devices may be useful for identifying women in pregnancy and in the post-delivery period at risk for adverse health outcomes and identifying women who may potentially benefit from treating sleep apnea.”