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VNA of Care New England

Pregnancy Linked to Sleep Apnea, Especially With GDM

Gestational diabetes linked to increased odds of obstructive sleep apnea, after adjustment for BMI
THURSDAY, Aug. 22 (HealthDay News) -- Pregnancy is associated with sleep disturbances and with obstructive sleep apnea (OSA), especially in the presence of gestational diabetes mellitus (GDM), according to a study published online Aug. 21 in the Journal of Clinical Endocrinology & Metabolism.
Sirimon Reutrakul, M.D., from the Rush University Medical Center in Chicago, and colleagues conducted an observational case control study using polysomnography to assess the correlation between pregnancy, OSA, and GDM. Participants included 15 non-pregnant women with normal glucose tolerance (NP-NGT), 15 pregnant women with normal glucose tolerance (P-NGT), and 15 pregnant women with GDM (P-GDM). The groups were matched for age and race/ethnicity.
The researchers found that P-NGT women had a significantly higher apnea hypopnea index (AHI) and more disrupted sleep as indicated by significantly higher wake time after sleep onset and microarousal index, compared with NP-NGT. Total sleep time was significantly lower and the AHI was higher for P-GDM compared with P-NGT women. The prevalence of OSA was significantly higher in P-GDM (73 percent) versus P-NGT women (27 percent). GDM diagnosis was associated with OSA diagnosis, after adjustment for pre-pregnancy body mass index (odds ratio, 6.60). After adjustment for pre-pregnancy body mass index, in pregnancy, there was a significant correlation between higher microarousal index with higher glycated hemoglobin and fasting glucose levels. Higher oxygen desaturation levels correlated with increased fasting glucose levels.
"In summary, we found that pregnancy is associated with significant disturbances in sleep quality in general, and an increased risk for OSA particularly in the presence of GDM," the authors write.
One author disclosed financial ties to the biopharmaceutical industry. A second author reported serving as an expert witness for a legal firm.
Abstract (http://jcem.endojournals.org/content/early/2013/08/20/jc.2013-2348.abstract )Full Text (subscription or payment may be required) (http://jcem.endojournals.org/content/early/2013/08/20/jc.2013-2348.full.pdf+html )
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