Pregnancy and Snoring, A Wakeup Call

If you are pregnant and have recently begun to snore, it could be a bigger problem than just keeping your partner awake. University of Michigan researchers report that women who begin snoring after they get pregnant are at increased risk for high blood pressure and preeclampsia.

Along with the morning sickness, mood swings, food cravings, and an increased need to run to the bathroom, another symptom that may develop during pregnancy is snoring. It's well established that habitual snoring, which is defined as snoring three to four nights per week, is associated with sleep-disordered breathing, whether it occurs in men or women.

In the findings of this latest study, which included 1,719 third-trimester pregnant women recruited from March 2007 through December 2010, habitual snoring had a significant role in high blood pressure and was also found to present an increased risk to the mother's cardiovascular health.

The researchers discovered the following:

• 34% of the women reported that they snored
• 25% reported that snoring had started during pregnancy
• Snoring that started during pregnancy, but not snoring that was present before pregnancy more than doubled the risk of high blood pressure and significantly increased the risk of preeclampsia when compared with women who did not snore

Dangers of preeclampsia and high blood pressure
Preeclampsia develops in about 5 to 8 percent of pregnant women typically after 20 weeks gestation and up to six weeks postpartum. Worldwide, an estimated 76,000 women and 500,000 infants die each year because of preeclampsia, which is characterized by a rapidly progressive rise in blood pressure and protein in the urine, and may also include sudden weight gain, headache, vision changes, shortness of breath, and other symptoms.

The impact on infants born to women with preeclampsia can be considerable:

• Worldwide, preeclampsia is associated with up to 20% of the 13 million preterm births that occur each year, or about 100,000 births in the United States
• Reduced blood flow to the placenta, which limits the amount of nutrients the infant receives and can result in an infant who is small for its gestational age. About 15% (4.5 million) of infants are born with this condition each year as a result of preeclampsia.
• Approximately 10,500 infants die in the US each year from preeclampsia. In countries without the means to keep premature babies alive, the death rate can be considerable.
• Infants born prematurely because of preeclampsia may face challenges such as epilepsy, learning disabilities, cerebral palsy, deafness, and blindness.

What this study means
According to Louise O'Brien, PhD, the study's lead author and associate professor in the University of Michigan's Sleep Disorders Center, about 19 percent of disorders associated with high blood pressure during pregnancy could be alleviated if sleep-disordered breathing was treated.

Sleep disordered breathing is a term used to describe various respiratory abnormalities, of which obstructive sleep apnea is the most common. Among the most common ways to treat sleep apnea is continuous positive airway pressure (CPAP), a device worn during sleep that uses air pressure to keep an individual's airways open.

O'Brien is conducting further research into the effectiveness of CPAP in treating pregnant women who snore. In the meantime, she noted that physicians should ask pregnant women whether they have started snoring and try to identify which women are at high risk for high blood pressure and preeclampsia so they can take preventive steps.

SOURCES:
O'Brien LM et al. Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study. American Journal of Obstetrics and Gynecology 2012; doi:10.1016/j.ajog.2012.08.034
Preeclampsia Foundation

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