Although sleep apnea is more commonly considered a man’s problem, there are two times in their lives when women are at very elevated risk for sleep apnea. One of them is after menopause, when women’s risk of sleep apnea approaches and may even exceed a man’s of the same age.
But the other time women are at an elevated risk of sleep apnea is during pregnancy. Because sleep apnea during pregnancy is associated with many elevated risks for complications during pregnancy, some researchers are now calling for the official designation of gestational sleep apnea to ensure that women receive appropriate monitoring and care if they develop the condition.
Potential Pregnancy Risks Related to Sleep Apnea
Women who develop sleep apnea are at risk for many significant pregnancy complications that can affect the health of the mother and baby. For example, recent research has shown that the intermittent oxygen shortages experienced by the mother during sleep apneic episodes can also affect the fetus. Up to 92% of fetuses in women with sleep apnea have blood markers indicating oxygen shortage, and 57% of fetuses in women with sleep apnea had normoblastemia, a release of immature blood cells to try to counteract oxygen shortages. In normal, healthy women, only 6% of fetuses experience this condition.
Pregnant women may be at a higher risk for serious pregnancy complications such as pulmonary blood clots, and they’re up to five times more likely to die during and shortly after pregnancy. And they may be at elevated risk for anesthesia-related complications near pregnancy.
In addition, sleep apnea can be associated with gestational hypertension and gestational diabetes.
Challenges for Diagnosing and Treating Sleep Apnea in Pregnancy
However, although we understand that there are many potential risks related to sleep apnea, it is hard to diagnose and treat in pregnant women. Sleep apnea diagnosis is already a problem, with an estimated 80% of sufferers undiagnosed. That’s because the disorder occurs when people are sleeping and may not be observed by the person suffering or others around them. And the primary symptom of sleep apnea that women may notice–daytime sleepiness–is often an expected complication of pregnancy, and may be dismissed by women, their partners, and their doctors.
And because the woman may not have had a previous record of health problems, doctors may attribute other changes in health to pregnancy as well, making it hard to diagnose the condition. In the short time frame of a pregnancy, the timeframe for diagnosis is truncated and will have to be acted on quickly.
Without diagnosis, women will not get the treatment they need to avoid risks and complications.
How a Designation Can Help
Researchers writing in the International Journal of Obstetric Anesthesia have called for the designation of gestational diabetes. Designating a category like gestational diabetes can help in many ways. It can increase awareness among women, their partners, and their doctors.
Awareness can go a long way toward increasing diagnosis. In particular, it can help men sleeping with pregnant women to realize that snoring should not be ignored because it’s a sign of a potentially serious condition. And it helps doctors to remember to ask about sleep problems and act on suspicions so that women can get appropriate treatment.
A designation can help define the condition better so that consistent diagnostic criteria are used, which can help pinpoint appropriate treatment.
A designation can also spur more research into the condition, as it allows for grants to be defined and written with precision. That way we can answer important questions such as whether CPAP or an oral appliance is a better treatment option for pregnant women with sleep apnea.