Sleep apnea risk in women may increase with gestational diabetes during pregnancy. Obstructive sleep apnea (OSA) is far more common in men, but women are not immune to this sleep disorder that causes the stoppage of breathing throughout the night.
A Thailand study found that obese Asian women with gestational diabetes are at highest risk of obstructive sleep apnea, even if their diabetes is controlled. Furthermore, severity of obstructive sleep apnea was associated with high blood glucose levels, along with greater daytime fatigue.
The researchers looked at 25 women with diet-controlled gestational diabetes and found a 56 percent prevalence of obstructive sleep apnea. Study investigator Sirimon Reutrakul said, “OSA may be an important comorbidity [coexisting illness] in women with gestational diabetes mellitus. Our results will have to be confirmed in a larger study but potentially have an impact for patient care.”
Nearly 9.2 percent of pregnant women can develop gestational diabetes and being overweight or obese is a risk factor.
Women were classified as obese based on the World Health Organization body mass index prior to pregnancy of 25 kg/m2, and obstructive sleep apnea was diagnosed using a home monitoring system worn on the participant’s wrists. The device detects overnight changes in breathing.
Fourteen of the women were diagnosed with sleep apnea – 12 case were mild and two were severe. The researchers found lower oxygen saturation was closely associated with greater reported daytime sleepiness.
Reutrakul added, “If a future study confirms our results, the next step is to explore if treating OSA in these pregnant women will lead to better glucose control and pregnancy outcomes.”
An alternative study explored that sleep apnea in pregnant women can increase the risk of pregnancy complications. The higher risk of complications is associated with higher cases of gestational diabetes and preterm births. Principal investigator Dr. Francesca L. Facco said, “Our findings suggest that moderate to severe sleep-disordered breathing may be associated with adverse pregnancy outcomes, particularly gestational diabetes and preterm birth. However, it is unclear if sleep-disordered breathing is a risk factor for adverse pregnancy outcomes independent of obesity.”
The researchers looked at medical records and identified 150 women who underwent sleep evaluations. Eighty-seven percent of them were found to be overweight or obese at time of delivery.
Facco added, “Further studies, principally large prospective studies utilizing objective measures of sleep-disordered breathing, are needed to confirm this relationship, and to examine the interaction between sleep-disordered breathing and body mass index. If a relationship is confirmed, further studies would be needed to ascertain the role of treatment of sleep-disordered breathing in pregnancy.”
CPAP therapy is recommended for sleep apnea treatment, consisting of a mask worn nightly that provides continuous airflow to prevent the stoppage of breathing.