Clinical manifestations of obstructive sleep apnoea in pregnancy: More than snoring and witnessed apnoeas

Abstract

Sleep disordered breathing and its symptoms have been associated with a multitude of fetal and maternal complications including gestational hypertensive disorders, gestational diabetes and possibly pre-term labour and other markers of alterations in fetal wellbeing. The disease remains underdiagnosed in the general population but likely also in pregnancy, mostly because providers do not appropriately screen for the disorder. Sleep disordered breathing may manifest differently in women, since women report more fatigue and less snoring than men do. This paper discusses typical presentations of sleep disordered breathing but also reports some less obvious presentations to help providers recognise those manifestations and screen for the disorder when warranted. Our case series describes patients with diagnoses such as chronic hypertension, pre-eclampsia, pulmonary hypertension, nocturnal asthma and panic attacks, who were diagnosed with sleep disordered breathing and offered treatment with CPAP during pregnancy.

Keywords::

• Continuous positive airway pressure
• obesity
• obstructive sleep apnoea
• pregnancy

Acknowledgements

We would like to thank Susan M. Martin for her help with data collection and Gina Ankner, RN, MSN, Patrizia Curran and Beth Hott for their assistance with manuscript preparation.

Funding

Perkins Charitable Foundation. The foundation did not have a role in the design, data analysis or manuscript preparation.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.