We know that sleep apnea carries many serious risks for people of all ages and health conditions. And we are coming to understand that it carries special risks for pregnant women, making it essential that we properly identify sleep apnea in pregnant women.
However, a new comprehensive review shows that current screening tools may be less accurate for pregnant women. This may lend support to a call for the definition of gestational sleep apnea.
High Rates of Complications
Researchers looked for studies that analyzed the relationship between sleep apnea and obstetric complications for both the mother and the fetus. They found 33 relevant studies. When they analyzed these studies, they were able to determine that sleep apnea was associated with a greater risk for:
- Gestational diabetes
- Gestational hypertension
- Pulmonary embolism
- Lower apgar scores
- Low birth weight
- Fetal heart rate deceleration
- Preterm birth
- Unplanned c-section
- Neonatal ICU admissions
They also found that sleep apnea seemed to progress during pregnancy, becoming more serious and more related to risks during the third trimester. With this high level of risk, it seems crucial to identify women at risk for sleep apnea earlier.
Unfortunately, sleep apnea screening tools currently in use seem to be much less accurate for pregnant women.
More Work Needed for Early Detection and Treatment
With many sleep apnea sufferers undiagnosed, there has been much work done on sleep apnea screening, including the development of many screening tools such as the Berlin Questionnaire, the Epworth Sleepiness Scale, and the STOP-BANG tool.
The lead researcher on this review said of the sleep apnea screening tools, “None of them worked very well in pregnant women.” He added, “Further work is needed to detect and treat OSA [obstructive sleep apnea] in pregnancy.” In particular, studies have failed to show that CPAP can improve outcomes when sleep apnea occurs in pregnancy. We need to find out how to effectively treat sleep apnea during pregnancy, whether that’s CPAP, oral appliances, or another treatment.
Until we develop better screening tools, and in consideration of the high level of risks associated with sleep apnea in pregnancy, it’s best to err on the side of caution. Pregnant women need to be vigilant for symptoms of sleep apnea, as do their partners. Partners who notice that women begin snoring as a result of pregnancy should encourage discussions about snoring and sleep apnea treatment. Even if sleep apnea isn’t a factor, snoring treatment can make the last months of pregnancy more comfortable for everyone.
If you are looking for an expert on sleep apnea that can direct you to the best sleep apnea treatment options in Omaha, please call (402) 493-4175 today for an appointment with sleep dentist Dr. Roger Roubal at the Advanced Dental Sleep Treatment Center.