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Central sleep apnea in pregnant women with sleep disordered breathing

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Abstract

Purpose

Physiologic changes in the cardiac, respiratory, and renal systems in pregnancy likely impact ventilatory control. Though obstructive sleep apnea and snoring are common in the pregnant population, the predisposition to central respiratory events during sleep and the prevalence of such events is less well studied. The aim of this study was to assess the presence of central apneas during sleep in pregnant women and non-pregnant controls suspected of sleep disordered breathing.

Methods

Twenty-five pregnant women referred for polysomnography for sleep disordered breathing were compared with non-pregnant controls matched for age, body mass index, gender, and apnea hypopnea index (AHI). Central apnea index was defined as the number of central apneas per hour of sleep, and mixed apnea index was defined as the number of mixed apneas per hour of sleep.

Results

Sixty-four percent of pregnant women had a respiratory disturbance index >5 events per hour of sleep. Mean body mass index was 44.1 ± 6.9 kg/m2 pregnant compared to 44.0 ± 7.3 kg/m2 in controls. The total number of central apneas observed during sleep in the pregnant group consisted of two central apneas in one patient, and of 98 central apneas in 11 patients in the control group (p = 0.05). Median central apnea index was low in both groups (pregnant 0, interquartile range (IQR) 0, 0 vs. non-pregnant 0, IQR 0, 0.2, p = 0.04). Mixed apnea index was similarly low in both groups.

Conclusion

Despite some physiologic changes of pregnancy that impact ventilatory control, the prevalence of central sleep apnea was low in our sample of overweight pregnant women with sleep-disordered breathing.

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Conflict of interest

The authors have no potential personal or financial conflicts of interest.

Funding

This study was funded by an award from the American College of Chest Physicians’ Chest Foundation for clinical research in women’s lung health.

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Authors and Affiliations

  1. Department of Medicine, The Warren Alpert Medical School of Brown University, The Miriam Hospital, 146 West River St., Suite 11C, Providence, RI, 02904, USA

    Ghada Bourjeily

  2. The Warren Alpert Medical School of Brown University, Sleep Disorders Center, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA

    Katherine M. Sharkey & Richard Millman

  3. The Warren Alpert Medical School of Brown University, The Miriam Hospital, 164 Summit Avenue, Providence, RI, 02906, USA

    Jeffrey Mazer

  4. Department of Medicine, Sleep Disorders Center, Rhode Island Hospital, 593 Eddy St., Providence, RI, 02903, USA

    Robin Moore

  5. Women’s Medicine Collaborative, Department of Medicine, The Miriam Hospital, 146 West River St., Suite 1F, Providence, RI, 02904, USA

    Susan Martin

Authors
  1. Ghada Bourjeily
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  2. Katherine M. Sharkey
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  3. Jeffrey Mazer
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  4. Robin Moore
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  5. Susan Martin
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  6. Richard Millman
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Correspondence to Ghada Bourjeily.

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Bourjeily, G., Sharkey, K.M., Mazer, J. et al. Central sleep apnea in pregnant women with sleep disordered breathing. Sleep Breath 19, 835–840 (2015). https://doi.org/10.1007/s11325-014-1099-1

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  • DOI: https://doi.org/10.1007/s11325-014-1099-1

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