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Sleep Disorders and Their Management in Pregnancy

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Neurological Disorders in Pregnancy

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Abstract

This chapter discusses the impact of changes in sleep architecture and sleep disorders in pregnancy both on maternal health and health of the baby. Changes in sleep architecture occur as a result of physiological and hormonal reasons as well as a result of the physical discomfort from an enlarging uterus. These changes in sleep architecture have been determined using both subjective and objective measures such as sleep diaries, actigraphy, and polysomnography. Physiological changes during pregnancy and comorbid conditions can lead to sleep fragmentation, changes in timing and duration of sleep, as well as sleep disorders such as sleep disordered breathing (SDB), restless leg syndrome (RLS), and insomnia. Each of these disorders in turn has an adverse impact on maternal and fetal health. Gestational diabetes, hypertensive disorders of pregnancy as well as peripartum depression and postpartum weight retention are well known consequences of SDB, RLS, and insomnia. The pathophysiological mechanisms by which SDB leads to gestational diabetes and hypertension include common pathways of oxidative stress, sympathetic activation, and activation of inflammatory mediators. Fetal consequences include intrauterine growth retardation, preterm births, and low gestational weight. Pregnancy complicates the management of pre-existing sleep disorders such as narcolepsy due to concerns for teratogenicity of drugs used for the treatment. Similarly, treatment of sleep disorders such as RLS and insomnia complicating pregnancy requires special consideration as well. Management of these conditions includes nonpharmacological and carefully considered pharmacological measures so as to ameliorate the effect of these sleep disorders on both the mother and the baby.

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References

  1. Mindell JA, Cook RA, Nikolovski J. Sleep patterns and sleep disturbances across pregnancy. Sleep Med. 2015;16(4):483–8.

    Article  PubMed  Google Scholar 

  2. Lee KA. Self-reported sleep disturbances in employed women. Sleep. 1992;15(6):493–8.

    Article  CAS  PubMed  Google Scholar 

  3. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.

    Article  CAS  PubMed  Google Scholar 

  4. Gay CL, Lee KA, Lee SY. Sleep patterns and fatigue in new mothers and fathers. Biol Res Nurs. 2004;5(4):311–8.

    Article  PubMed  Google Scholar 

  5. Lee KA, Gay CL. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol. 2004;191(6):2041–6.

    Article  PubMed  Google Scholar 

  6. Kamysheva E, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. A prospective investigation of the relationships among sleep quality, physical symptoms, and depressive symptoms during pregnancy. J Affect Disord. 2010;123(1–3):317–20.

    Article  PubMed  Google Scholar 

  7. Okun ML, Hall M, Coussons-Read ME. Sleep disturbances increase interleukin-6 production during pregnancy: implications for pregnancy complications. Reprod Sci. 2007;14(6):560–7.

    Article  CAS  PubMed  Google Scholar 

  8. Greenwood KM, Hazendonk KM. Self-reported sleep during the third trimester of pregnancy. Behav Sleep Med. 2004;2(4):191–204.

    Article  PubMed  Google Scholar 

  9. Dorheim SK, Bondevik GT, Eberhard-Gran M, Bjorvatn B. Subjective and objective sleep among depressed and non-depressed postnatal women. Acta Psychiatr Scand. 2009;119(2):128–36.

    Article  CAS  PubMed  Google Scholar 

  10. Matsumoto K, Shinkoda H, Kang MJ, Seo YJ. Longitudinal study of mothers’ sleep-wake behaviors and circadian time patterns from late pregnancy to postpartum—monitoring of wrist Actigraphy and sleep logs. Biol Rhythm Res. 2003;34(3):265–78.

    Article  Google Scholar 

  11. Swain AM, O'Hara MW, Starr KR, Gorman LL. A prospective study of sleep, mood, and cognitive function in postpartum and nonpostpartum women. Obstet Gynecol. 1997;90(3):381–6.

    Article  CAS  PubMed  Google Scholar 

  12. Signal TL, Gander PH, Sangalli MR, Travier N, Firestone RT, Tuohy JF. Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post-partum. Aust N Z J Obstet Gynaecol. 2007;47(1):16–22.

    Article  PubMed  Google Scholar 

  13. Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, et al. Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep. 2007;30(4):519–29.

    Article  PubMed  Google Scholar 

  14. Coo S, Milgrom J, Trinder J. Mood and objective and subjective measures of sleep during late pregnancy and the postpartum period. Behav Sleep Med. 2014;12(4):317–30.

    Article  PubMed  Google Scholar 

  15. Bei B, Milgrom J, Ericksen J, Trinder J. Subjective perception of sleep, but not its objective quality, is associated with immediate postpartum mood disturbances in healthy women. Sleep. 2010;33(4):531–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Berndt C, Diekelmann S, Alexander N, Pustal A, Kirschbaum C. Sleep fragmentation and false memories during pregnancy and motherhood. Behav Brain Res. 2014;266:52–7.

    Article  PubMed  Google Scholar 

  17. Lee KA, Zaffke ME, McEnany G. Parity and sleep patterns during and after pregnancy. Obstet Gynecol. 2000;95(1):14–8.

    CAS  PubMed  Google Scholar 

  18. Driver HS, Shapiro CM. A longitudinal study of sleep stages in young women during pregnancy and postpartum. Sleep. 1992;15(5):449–53.

    Article  CAS  PubMed  Google Scholar 

  19. Brunner DP, Munch M, Biedermann K, Huch R, Huch A, Borbely AA. Changes in sleep and sleep electroencephalogram during pregnancy. Sleep. 1994;17(7):576–82.

    Article  CAS  PubMed  Google Scholar 

  20. Schorr SJ, Chawla A, Devidas M, Sullivan CA, Naef RW 3rd, Morrison JC. Sleep patterns in pregnancy: a longitudinal study of polysomnography recordings during pregnancy. J Perinatol. 1998;18(6 Pt 1):427–30.

    CAS  PubMed  Google Scholar 

  21. Ekholm EM, Polo O, Rauhala ER, Ekblad UU. Sleep quality in preeclampsia. Am J Obstet Gynecol. 1992;167(5):1262–6.

    Article  CAS  PubMed  Google Scholar 

  22. Dunlap JC, Loros JJ, DeCoursey PJ. Chronobiology: biological timekeeping. Sunderland, MA: Sinauer Associates; 2004.

    Google Scholar 

  23. Nakamura Y, Tamura H, Kashida S, Takayama H, Yamagata Y, Karube A, et al. Changes of serum melatonin level and its relationship to feto-placental unit during pregnancy. J Pineal Res. 2001;30(1):29–33.

    Article  CAS  PubMed  Google Scholar 

  24. Graf AH, Nutter W, Hacker GW, Steiner H, Anderson V, Staudach A, et al. Localization and distribution of vasoactive neuropeptides in the human placenta. Placenta. 1996;17(7):413–21.

    Article  CAS  PubMed  Google Scholar 

  25. Simonneaux V, Kienlen-Campard P, Loeffler JP, Basille M, Gonzalez BJ, Vaudry H, et al. Pharmacological, molecular and functional characterization of vasoactive intestinal polypeptide/pituitary adenylate cyclase-activating polypeptide receptors in the rat pineal gland. Neuroscience. 1998;85(3):887–96.

    Article  CAS  PubMed  Google Scholar 

  26. Swaab DF, Zhou JN, Ehlhart T, Hofman MA. Development of vasoactive intestinal polypeptide neurons in the human suprachiasmatic nucleus in relation to birth and sex. Dev Brain Res. 1994;79(2):249–59.

    Article  CAS  Google Scholar 

  27. Martin-Fairey CA, Zhao P, Wan L, Roenneberg T, Fay J, Ma X, et al. Pregnancy induces an earlier Chronotype in both mice and women. J Biol Rhythm. 2019;34(3):323–31.

    Article  CAS  Google Scholar 

  28. Nolten WE, Lindheimer MD, Rueckert PA, Oparil S, Ehrlich EN. Diurnal patterns and regulation of cortisol secretion in pregnancy*. J Clin Endocrinol Metabol. 1980;51(3):466–72.

    Article  CAS  Google Scholar 

  29. Matthews SG, Owen D, Kalabis G, Banjanin S, Setiawan EB, Dunn EA, et al. Fetal glucocorticoid exposure and Hypothalamo-pituitary-adrenal (HPA) function after birth. Endocr Res. 2004;30(4):827–36.

    Article  CAS  PubMed  Google Scholar 

  30. Bourjeily G. Sleep disorders in pregnancy. Obstet Med. 2009;2(3):100–6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Sedov ID, Cameron EE, Madigan S, Tomfohr-Madsen LM. Sleep quality during pregnancy: a meta-analysis. Sleep Med Rev. 2018;38:168–76.

    Article  PubMed  Google Scholar 

  32. Izci BB. Sleep disordered breathing in pregnancy. Breathe. 2015;11(4):268–77.

    Article  Google Scholar 

  33. Robertson NT, Turner JM, Kumar S. Pathophysiological changes associated with sleep disordered breathing and supine sleep position in pregnancy. Sleep Med Rev. 2019;46:1–8.

    Article  PubMed  Google Scholar 

  34. Gooley JJ, Mohapatra L, Twan DCK. The role of sleep duration and sleep disordered breathing in gestational diabetes mellitus. Neurobiol Sleep Circadian Rhythms. 2018;4:34–43.

    Article  PubMed  Google Scholar 

  35. Sarberg M, Svanborg E, Wiréhn A-B, Josefsson A. Snoring during pregnancy and its relation to sleepiness and pregnancy outcome—a prospective study. BMC Pregnancy Childbirth. 2014;14:15.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Pien GW, Pack AI, Jackson N, Maislin G, Macones GA, Schwab RJ. Risk factors for sleep-disordered breathing in pregnancy. Thorax. 2014;69(4):371–7.

    Article  PubMed  Google Scholar 

  37. Johns EC, Denison FC, Reynolds RM. Sleep disordered breathing in pregnancy: a review of the pathophysiology of adverse pregnancy outcomes. Acta Physiol. 2020;229(2):e13458.

    Article  CAS  Google Scholar 

  38. Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989-2007. Int J Obes. 2010;34(3):420–8.

    Article  CAS  Google Scholar 

  39. Luque-Fernandez MA, Bain PA, Gelaye B, Redline S, Williams MA. Sleep-disordered breathing and gestational diabetes mellitus a meta-analysis of 9,795 participants enrolled in epidemiological observational studies. Diabetes Care. 2013;36(10):3353–60.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Reutrakul S, Zaidi N, Wroblewski K, Kay HH, Ismail M, Ehrmann DA, et al. Sleep disturbances and their relationship to glucose tolerance in pregnancy. Diabetes Care. 2011;34(11):2454–7.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Louis JM, Mogos MF, Salemi JL, Redline S, Salihu HM. Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009. Sleep. 2014;37(5):843–9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Xu T, Feng Y, Peng H, Guo D, Li T. Obstructive sleep apnea and the risk of perinatal outcomes: a meta-analysis of cohort studies. Sci Rep. 2014;4(1):6982.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Wieser V, Moschen AR, Tilg H. Inflammation, cytokines and insulin resistance: a clinical perspective. Arch Immunol Ther Exp. 2013;61(2):119–25.

    Article  CAS  Google Scholar 

  44. Fialová L, Malbohan I, Kalousová M, Soukupová J, Krofta L, Stípek S, et al. Oxidative stress and inflammation in pregnancy. Scand J Clin Lab Invest. 2006;66(2):121–7.

    Article  PubMed  Google Scholar 

  45. Karacay O, Sepici-Dincel A, Karcaaltincaba D, Sahin D, Yalvaç S, Akyol M, et al. A quantitative evaluation of total antioxidant status and oxidative stress markers in preeclampsia and gestational diabetic patients in 24-36 weeks of gestation. Diabetes Res Clin Pract. 2010;89(3):231–8.

    Article  CAS  PubMed  Google Scholar 

  46. Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans. Circulation. 2002;106(16):2067–72.

    Article  CAS  PubMed  Google Scholar 

  47. Spiegel K, Leproult R, L'Hermite-Balériaux M, Copinschi G, Penev PD, Van Cauter E. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab. 2004;89(11):5762–71.

    Article  CAS  PubMed  Google Scholar 

  48. Kirwan JP, Hauguel-De Mouzon S, Lepercq J, Challier J-C, Huston-Presley L, Friedman JE, et al. TNF-α is a predictor of insulin resistance in human pregnancy. Diabetes. 2002;51(7):2207–13.

    Article  CAS  PubMed  Google Scholar 

  49. Xu J, Zhao YH, Chen YP, Yuan XL, Wang J, Zhu H, et al. Maternal circulating concentrations of tumor necrosis factor-alpha, leptin, and adiponectin in gestational diabetes mellitus: a systematic review and meta-analysis. ScientificWorldJournal. 2014;2014:926932.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Nedeltcheva AV, Kessler L, Imperial J, Penev PD. Exposure to recurrent sleep restriction in the setting of high caloric intake and physical inactivity results in increased insulin resistance and reduced glucose tolerance. J Clin Endocrinol Metab. 2009;94(9):3242–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Rizza RA, Mandarino LJ, Gerich JE. Cortisol-induced insulin resistance in man: impaired suppression of glucose production and stimulation of glucose utilization due to a postreceptor detect of insulin action. J Clin Endocrinol Metab. 1982;54(1):131–8.

    Article  CAS  PubMed  Google Scholar 

  52. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.

    Article  PubMed  Google Scholar 

  53. Dominguez JE, Habib AS, Krystal AD. A review of the associations between obstructive sleep apnea and hypertensive disorders of pregnancy and possible mechanisms of disease. Sleep Med Rev. 2018;42:37–46.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Bellamy L, Casas JP, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335(7627):974.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Bourjeily G, Danilack VA, Bublitz MH, Lipkind H, Muri J, Caldwell D, et al. Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort. Sleep Med. 2017;38:50–7.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Champagne K, Schwartzman K, Opatrny L, Barriga P, Morin L, Mallozzi A, et al. Obstructive sleep apnoea and its association with gestational hypertension. Eur Respir J. 2009;33(3):559–65.

    Article  CAS  PubMed  Google Scholar 

  57. Facco FL, Parker CB, Reddy UM, Silver RM, Louis JM, Basner RC, et al. NuMoM2b sleep-disordered breathing study: objectives and methods. Am J Obstet Gynecol. 2015;212(4):542.e1–127.

    Article  PubMed  Google Scholar 

  58. O'Brien LM, Bullough AS, Chames MC, Shelgikar AV, Armitage R, Guilleminualt C, et al. Hypertension, snoring, and obstructive sleep apnoea during pregnancy: a cohort study. BJOG. 2014;121(13):1685–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Lockhart EM, Ben Abdallah A, Tuuli MG, Leighton BL. Obstructive sleep apnea in pregnancy: assessment of current screening tools. Obstet Gynecol. 2015;126(1):93–102.

    Article  PubMed  Google Scholar 

  60. Milne F, Redman C, Walker J, Baker P, Bradley J, Cooper C, et al. The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community. BMJ. 2005;330(7491):576–80.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Zamudio S, Wu Y, Ietta F, Rolfo A, Cross A, Wheeler T, et al. Human placental hypoxia-inducible factor-1alpha expression correlates with clinical outcomes in chronic hypoxia in vivo. Am J Pathol. 2007;170(6):2171–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Nanduri J, Peng Y-J, Yuan G, Kumar GK, Prabhakar NR. Hypoxia-inducible factors and hypertension: lessons from sleep apnea syndrome. J Mol Med (Berl). 2015;93(5):473–80.

    Article  CAS  PubMed  Google Scholar 

  63. Ravishankar S, Bourjeily G, Lambert-Messerlian G, He M, De Paepe ME, Gündoğan F. Evidence of placental hypoxia in maternal sleep disordered breathing. Pediatr Dev Pathol. 2015;18(5):380–6.

    Article  PubMed  Google Scholar 

  64. Leon-Garcia SM, Roeder HA, Nelson KK, Liao X, Pizzo DP, Laurent LC, et al. Maternal obesity and sex-specific differences in placental pathology. Placenta. 2016;38:33–40.

    Article  PubMed  Google Scholar 

  65. Sharma S, Norris WE, Kalkunte S. Beyond the threshold: an etiological bridge between hypoxia and immunity in preeclampsia. J Reprod Immunol. 2010;85(1):112–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. de Lima FF, Mazzotti DR, Tufik S, Bittencourt L. The role inflammatory response genes in obstructive sleep apnea syndrome: a review. Sleep Breath. 2016;20(1):331–8.

    Article  PubMed  Google Scholar 

  67. Venkatesha S, Toporsian M, Lam C, Hanai J, Mammoto T, Kim YM, et al. Soluble endoglin contributes to the pathogenesis of preeclampsia. Nat Med. 2006;12(6):642–9.

    Article  CAS  PubMed  Google Scholar 

  68. Ciccone MM, Favale S, Scicchitano P, Mangini F, Mitacchione G, Gadaleta F, et al. Reversibility of the endothelial dysfunction after CPAP therapy in OSAS patients. Int J Cardiol. 2012;158(3):383–6.

    Article  PubMed  Google Scholar 

  69. Campos-Rodriguez F, Queipo-Corona C, Carmona-Bernal C, Jurado-Gamez B, Cordero-Guevara J, Reyes-Nunez N, et al. Continuous positive airway pressure improves quality of life in women with obstructive sleep apnea. A randomized controlled trial. Am J Respir Crit Care Med. 2016;194(10):1286–94.

    Article  PubMed  Google Scholar 

  70. Antic NA, Catcheside P, Buchan C, Hensley M, Naughton MT, Rowland S, et al. The effect of CPAP in normalizing daytime sleepiness, quality of life, and neurocognitive function in patients with moderate to severe OSA. Sleep. 2011;34(1):111–9.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Whitehead C, Tong S, Wilson D, Howard M, Walker SP. Treatment of early-onset preeclampsia with continuous positive airway pressure. Obstet Gynecol. 2015;125(5):1106–9.

    Article  PubMed  Google Scholar 

  72. Aurora RN, Kristo DA, Bista SR, Rowley JA, Zak RS, Casey KR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults—an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012;35(8):1039–62.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Mollica G, et al. Pregnancy as a risk factor for restless legs syndrome. Sleep Med. 2004;5(3):305–8.

    Article  PubMed  Google Scholar 

  74. Garbazza C, Manconi M. Management strategies for restless legs syndrome/Willis-Ekbom disease during pregnancy. Sleep Med Clin. 2018;13(3):335–48.

    Article  PubMed  Google Scholar 

  75. Chen SJ, Shi L, Bao YP, Sun YK, Lin X, Que JY, et al. Prevalence of restless legs syndrome during pregnancy: a systematic review and meta-analysis. Sleep Med Rev. 2018;40:43–54.

    Article  PubMed  Google Scholar 

  76. Wesström J, Skalkidou A, Manconi M, Fulda S, Sundström-Poromaa I. Pre-pregnancy restless legs syndrome (Willis-Ekbom disease) is associated with perinatal depression. J Clin Sleep Med. 2014;10(5):527–33.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Bazalakova M. Sleep disorders in pregnancy. Semin Neurol. 2017;37(6):661–8.

    Article  PubMed  Google Scholar 

  78. Terzi H, Terzi R, Zeybek B, Ergenoglu M, Hacivelioglu S, Akdemir A, et al. Restless legs syndrome is related to obstructive sleep apnea symptoms during pregnancy. Sleep Breath. 2015;19(1):73–8.

    Article  PubMed  Google Scholar 

  79. Innes KE, Kandati S, Flack KL, Agarwal P, Selfe TK. The Association of Restless legs syndrome to history of gestational diabetes in an appalachian primary care population. J Clin Sleep Med. 2015;11(10):1121–30.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Lawson A, Parmar R, Sloan EP. Sleep disorders. In: Uguz F, Orsolini L, editors. Perinatal psychopharmacology. Cham: Springer; 2019. p. 341–76.

    Chapter  Google Scholar 

  81. Emamian F, Khazaie H, Okun ML, Tahmasian M, Sepehry AA. Link between insomnia and perinatal depressive symptoms: a meta-analysis. J Sleep Res. 2019;28(6):e12858.

    Article  PubMed  Google Scholar 

  82. Gaynes BN, Gavin N, Meltzer-Brody S, Lohr KN, Swinson T, Gartlehner G, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evid Rep Technol Assess (Summ). 2005;119:1–8.

    Google Scholar 

  83. Behrendt HF, Konrad K, Goecke TW, Fakhrabadi R, Herpertz-Dahlmann B, Firk C. Postnatal mother-to-infant attachment in subclinically depressed mothers: dyads at risk? Psychopathology. 2016;49(4):269–76.

    Article  PubMed  Google Scholar 

  84. Okun ML. Sleep and postpartum depression. Curr Opin Psychiatry. 2015;28(6):490–6.

    Article  PubMed  Google Scholar 

  85. Sivertsen B, Hysing M, Dorheim SK, Eberhard-Gran M. Trajectories of maternal sleep problems before and after childbirth: a longitudinal population-based study. BMC Pregnancy Childbirth. 2015;15:129.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Dorheim SK, Bjorvatn B, Eberhard-Gran M. Can insomnia in pregnancy predict postpartum depression? A longitudinal, population-based study. PLoS One. 2014;9(4):e94674.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Okun ML, Luther J, Prather AA, Perel JM, Wisniewski S, Wisner KL. Changes in sleep quality, but not hormones predict time to postpartum depression recurrence. J Affect Disord. 2011;130(3):378–84.

    Article  CAS  PubMed  Google Scholar 

  88. Hachul H, Bittencourt LR, Andersen ML, Haidar MA, Baracat EC, Tufik S. Effects of hormone therapy with estrogen and/or progesterone on sleep pattern in postmenopausal women. Int J Gynaecol Obstet. 2008;103(3):207–12.

    Article  CAS  PubMed  Google Scholar 

  89. Christian LM, Carroll JE, Teti DM, Hall MH. Maternal sleep in pregnancy and postpartum part I: mental, physical, and interpersonal consequences. Curr Psychiatry Rep. 2019;21(3):20.

    Article  PubMed  Google Scholar 

  90. Siega-Riz AM, Herring AH, Carrier K, Evenson KR, Dole N, Deierlein A. Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum. Obesity (Silver Spring). 2010;18(10):1996–2003.

    Article  PubMed  Google Scholar 

  91. Wang Y, Carreras A, Lee S, Hakim F, Zhang SX, Nair D, et al. Chronic sleep fragmentation promotes obesity in young adult mice. Obesity (Silver Spring). 2014;22(3):758–62.

    Article  CAS  PubMed  Google Scholar 

  92. Dominguez JE, Street L, Louis J. Management of Obstructive Sleep Apnea in pregnancy. Obstet Gynecol Clin N Am. 2018;45(2):233–47.

    Article  Google Scholar 

  93. Johnson SM, Randhawa KS, Epstein JJ, Gustafson E, Hocker AD, Huxtable AG, et al. Gestational intermittent hypoxia increases susceptibility to neuroinflammation and alters respiratory motor control in neonatal rats. Respir Physiol Neurobiol. 2018;256:128–42.

    Article  PubMed  Google Scholar 

  94. Bacaro V, Benz F, Pappaccogli A, De Bartolo P, Johann AF, Palagini L, et al. Interventions for sleep problems during pregnancy: a systematic review. Sleep Med Rev. 2020;50:101234.

    Article  PubMed  Google Scholar 

  95. Silva-Perez LJ, Gonzalez-Cardenas N, Surani S, Etindele Sosso FA, Surani SR. Socioeconomic status in pregnant women and sleep quality during pregnancy. Cureus. 2019;11(11):e6183.

    PubMed  PubMed Central  Google Scholar 

  96. Thorpy MJ, Bogan RK. Update on the pharmacologic management of narcolepsy: mechanisms of action and clinical implications. Sleep Med. 2020;68:97–109.

    Article  PubMed  Google Scholar 

  97. Miller MA, Mehta N, Clark-Bilodeau C, Bourjeily G. Sleep pharmacotherapy for common sleep disorders in pregnancy and lactation. Chest. 2020;157(1):184–97.

    Article  CAS  PubMed  Google Scholar 

  98. Mullington J, Broughton R. Scheduled naps in the management of daytime sleepiness in narcolepsy-cataplexy. Sleep. 1993;16(5):444–56.

    Article  CAS  PubMed  Google Scholar 

  99. Thorpy M, Zhao CG, Dauvilliers Y. Management of narcolepsy during pregnancy. Sleep Med. 2013;14(4):367–76.

    Article  PubMed  Google Scholar 

  100. Wesensten NJ, Killgore WD, Balkin TJ. Performance and alertness effects of caffeine, dextroamphetamine, and modafinil during sleep deprivation. J Sleep Res. 2005;14(3):255–66.

    Article  PubMed  Google Scholar 

  101. Huybrechts KF, Bröms G, Christensen LB, Einarsdóttir K, Engeland A, Furu K, et al. Association between methylphenidate and amphetamine use in pregnancy and risk of congenital malformations: a cohort study from the international pregnancy safety study consortium. JAMA Psychiat. 2018;75(2):167–75.

    Article  Google Scholar 

  102. Pottegård A, Hallas J, Andersen JT, Løkkegaard EC, Dideriksen D, Aagaard L, et al. First-trimester exposure to methylphenidate: a population-based cohort study. J Clin Psychiatry. 2014;75(1):e88–93.

    Article  PubMed  Google Scholar 

  103. Kallweit U, Bassetti CL. Pharmacological management of narcolepsy with and without cataplexy. Expert Opin Pharmacother. 2017;18(8):809–17.

    Article  CAS  PubMed  Google Scholar 

  104. Cesta CE, Engeland A, Karlsson P, Kieler H, Reutfors J, Furu K. Incidence of malformations after early pregnancy exposure to Modafinil in Sweden and Norway. JAMA. 2020;324(9):895–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Damkier P, Broe A. First-trimester pregnancy exposure to modafinil and risk of congenital malformations. JAMA. 2020;323(4):374–6.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Abad VC. An evaluation of sodium oxybate as a treatment option for narcolepsy. Expert Opin Pharmacother. 2019;20(10):1189–99.

    Article  CAS  PubMed  Google Scholar 

  107. De la Herrán-Arita AK, García-García F. Current and emerging options for the drug treatment of narcolepsy. Drugs. 2013;73(16):1771–81.

    Article  PubMed  Google Scholar 

  108. Gowda CR, Lundt LP. Mechanism of action of narcolepsy medications. CNS Spectr. 2014;19(Suppl 1):25–33; quiz 25–7, 34.

    Article  PubMed  Google Scholar 

  109. Shyken JM, Babbar S, Babbar S, Forinash A. Benzodiazepines in Pregnancy. Clin Obstet Gynecol. 2019;62(1):156–67.

    Article  PubMed  Google Scholar 

  110. Wilkinson D, Shepherd E, Wallace EM. Melatonin for women in pregnancy for neuroprotection of the fetus. Cochrane Database Syst Rev. 2016;3(3):Cd010527.

    PubMed  Google Scholar 

  111. Picchietti DL, Hensley JG, Bainbridge JL, Lee KA, Manconi M, McGregor JA, et al. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2015;22:64–77.

    Article  PubMed  Google Scholar 

  112. Giannaki CD, Sakkas GK, Karatzaferi C, Hadjigeorgiou GM, Lavdas E, Kyriakides T, et al. Effect of exercise training and dopamine agonists in patients with uremic restless legs syndrome: a six-month randomized, partially double-blind, placebo-controlled comparative study. BMC Nephrol. 2013;14:194.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Lettieri CJ, Eliasson AH. Pneumatic compression devices are an effective therapy for restless legs syndrome: a prospective, randomized, double-blinded, sham-controlled trial. Chest. 2009;135(1):74–80.

    Article  PubMed  Google Scholar 

  114. Silber MH, Becker PM, Earley C, Garcia-Borreguero D, Ondo WG. Willis-Ekbom disease foundation revised consensus statement on the management of restless legs syndrome. Mayo Clin Proc. 2013;88(9):977–86.

    Article  PubMed  Google Scholar 

  115. McElhatton PR. The effects of benzodiazepine use during pregnancy and lactation. Reprod Toxicol. 1994;8(6):461–75.

    Article  CAS  PubMed  Google Scholar 

  116. Patorno E, Hernandez-Diaz S, Huybrechts KF, Desai RJ, Cohen JM, Mogun H, et al. Gabapentin in pregnancy and the risk of adverse neonatal and maternal outcomes: a population-based cohort study nested in the US Medicaid analytic eXtract dataset. PLoS Med. 2020;17(9):e1003322.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  117. Blyton DM, Skilton MR, Edwards N, Hennessy A, Celermajer DS, Sullivan CE. Treatment of sleep disordered breathing reverses low fetal activity levels in preeclampsia. Sleep. 2013;36(1):15–21.

    PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Aesha Jobanputra, Vandan Kumar Patel, Renuka Rajagopal, Krithika Namasivayam & Jag Sunderram

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  1. Aesha Jobanputra
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  2. Vandan Kumar Patel
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  3. Renuka Rajagopal
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  4. Krithika Namasivayam
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  5. Jag Sunderram
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Correspondence to Jag Sunderram .

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Editors and Affiliations

  1. Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Gaurav Gupta

  2. Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Todd Rosen

  3. Department of Neurology, Neurosurgery and Radiology, New York Medical College - Westchester Medical Center, Valhalla, NY, USA

    Fawaz Al-Mufti

  4. Department of Neurosurgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    Anil Nanda

  5. Department of Neurosurgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    Priyank Khandelwal

  6. Department of Neuroradiology, University Radiology, New Brunswick, NJ, USA

    Sudipta Roychowdhury

  7. Department of Neurology, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA

    Michael S. Rallo

  8. Department of Cerebrovascular & Endovascular Neurosurgery, Rutgers - Robert Wood Johnson Medical Sc, New Brunswick, NJ, USA

    Sanjeev Sreenivasan

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Jobanputra, A., Patel, V.K., Rajagopal, R., Namasivayam, K., Sunderram, J. (2023). Sleep Disorders and Their Management in Pregnancy. In: Gupta, G., et al. Neurological Disorders in Pregnancy. Springer, Cham. https://doi.org/10.1007/978-3-031-36490-7_29

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