A recent review summarizes what is known about these conditions and suggests future research directions and opportunities.
By Dr. Liji Thomas, MDAug 23 2023Reviewed by Sophia Coveney Multiple sleep disorders may complicate pregnancy, including insomnia, obstructive sleep apnea , and restless legs syndrome . A recent review in Frontiers in Medicine summarizes what is known about these conditions and suggests future research directions and opportunities.
Almost one in two pregnant women report sleeping less than usual. The increasing bulk of the uterus causes frequent micturition due to bladder pressure, leading to frequent awakenings. This is exacerbated by fetal movements and the difficulty in finding a comfortable position from mid-pregnancy onwards.
Circadian sleep disturbances, including narcolepsy or those related to shift work or jetlag or simply voluntary disruption of one’s sleep routine, were also found to play a role during this period. Types SDB Among the various type of sleep disturbances, SDB was shown to hold a prominent place. Pregnancy-induced alterations in respiratory and sleep physiology contribute to this and the rate of clinical diagnosis is much lower than its actual prevalence.Reports based on subjective measurements estimate snoring by 3-64% of pregnant women during the third trimester, depending on the definition used.
While 15-43% of obese women had OSA by objective standards, it was mostly mild up to the early third trimester, with 14-19% being severe. In late pregnancy, the prevalence was 38-67%. Risk factors include unmodifiable factors like elderly age at the time of pregnancy and poorly modifiable factors such as gestational weight gain . Pre-existing obesity is a clear risk factor for OSA during pregnancy. In GDM pregnancies, a higher third-trimester BMI and a greater GWG predict more severe OSA at all levels of blood glucose.
OSA in mid-pregnancy increases the risk of gestational hypertension by 73% and GDM by 3.5 times, though the latter is not borne out by other studies. RLS RLS is thought to be associated with the hormonal changes of pregnancy and is transient. It becomes most severe in late pregnancy and usually disappears after delivery. It is difficult to estimate the prevalence due to the use of different definitions as well as geographic variations, but it may affect about a fifth of all pregnancies.
Pregnant women are at higher risk for this condition, and it becomes more common as pregnancy advances. Insomnia is more likely in women with pre-existing mental illness, especially anxiety or depression, the latter being associated with a two-fold higher risk. A history of insomnia, the presence of obesity, and HDP are all risk factors.
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