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. 2014 Dec;121(13):1685-93.
doi: 10.1111/1471-0528.12885. Epub 2014 May 30.

Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study

L M O'Brien  1 , A S Bullough, M C Chames, A V Shelgikar, R Armitage, C Guilleminualt, C E Sullivan, T R B Johnson, R D Chervin
Affiliations

Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study

L M O'Brien et al. BJOG. 2014 Dec.

Abstract

Objective: To assess the frequency of obstructive sleep apnoea among women with and without hypertensive disorders of pregnancy.

Design: Cohort study.

Setting: Obstetric clinics at an academic medical centre.

Population: Pregnant women with hypertensive disorders (chronic hypertension, gestational hypertension, or pre-eclampsia) and women who were normotensive.

Methods: Women completed a questionnaire about habitual snoring and underwent overnight ambulatory polysomnography.

Main outcome measures: The presence and severity of obstructive sleep apnoea.

Results: Obstructive sleep apnoea was found among 21 of 51 women with hypertensive disorders (41%), but in only three of 16 women who were normotensive (19%, chi-square test, P=0.005). [Author correction added on 16 June 2014, after first online publication: Results mentioned in the abstract were amended.] Non-snoring women with hypertensive disorders typically had mild obstructive sleep apnoea, but >25% of snoring women with hypertensive disorders had moderate to severe obstructive sleep apnoea. Among women with hypertensive disorders, the mean apnoea/hypopnoea index was substantially higher in snorers than in non-snorers (19.9±34.1 versus 3.4±3.1, P=0.013), and the oxyhaemoglobin saturation nadir was significantly lower (86.4±6.6 versus 90.2±3.5, P=0.021). Among women with hypertensive disorders, after stratification by obesity, the pooled relative risk for obstructive sleep apnoea in snoring women with hypertension compared with non-snoring women with hypertension was 2.0 (95% CI 1.4-2.8).

Conclusions: Pregnant women with hypertension are at high risk for unrecognised obstructive sleep apnoea. Although longitudinal and intervention studies are urgently needed, given the known relationship between obstructive sleep apnoea and hypertension in the general population, it would seem pertinent that hypertensive pregnant women who snore should be tested for obstructive sleep apnoea, a condition believed to cause or promote hypertension.

Keywords: Hypertension; obstructive sleep apnoea; pregnancy; snoring.

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Conflict of interest statement

The other authors have indicated no financial conflicts of interest.

Figures

Figure 1
Figure 1
Figure 1a: Proportion of women with each threshold of AHI by hypertensive status. AHI=Apnea/hypopnea index; HTN=hypertension; GHTN=gestational hypertension Figure 1b: Proportion of women falling at or below thresholds of minimum nocturnal oxygen saturation by hypertensive status SpO2=oxygen saturation; HTN=hypertension; GHTN=gestational hypertension
See this image and copyright information in PMC

Comment in

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