Sleep-Disordered Breathing in Pregnancy

Sleep-disordered breathing (SDB) is common in pregnancy. Studies have described the relationship between SDB and abnormal glucose metabolism and gestational diabetes mellitus (GDM) in late pregnancy. A recent study suggests that sleep-disordered breathing in early pregnancy is associated with insulin resistance. The study findings were published in the journal Sleep on January 06, 2022.

The considerable prevalence of SDB in pregnant women has drawn increasing attention. As suggested by recent studies, SDB has potentially increased the risk of advanced pregnancy complications such as GDM, pregnancy-induced hypertension (PIH), and preeclampsia (PEC). However, it remains unclear whether this relationship starts in early pregnancy or develops following exposure to SDB in pregnancy. Therefore, Dr. Laura Sanapo and her team conducted a study to examine the association between maternal SDB and glucose metabolism in early gestation.

In this present study, the researchers monitored the sleep of 221 pregnant women with overweight or obesity from the 11th through 15th week of their pregnancies and measured their insulin resistance (homeostatic model assessment (HOMA)-IR) and β-cell function (HOMA %B). They performed linear regression analyses to evaluate the association between continuous measures of SDB (respiratory event index (REI), and oxygen desaturation index (ODI)) and glucose metabolism parameters (HOMA-IR and HOMA %B). They also adjusted analysis for a set of a priori selected variables which included gestational age, maternal age, BMI, ethnicity, race, and parity.

Key Findings of the Study:

• After adjustment for covariates, the researchers found REI and ODI as continuous variables of SDB and were associated with HOMA-insulin resistance (IR).
• However, after adjustment for BMI, they noted that obstructive sleep apnea diagnosis (REI value: more than five events per hour) was not associated with HOMA-IR.
• They observed no association for any of the parameters with β-cell function.

The authors concluded, "SDB and insulin resistance are associated in early pregnancy, with a dose-response association between respiratory event index severity and insulin resistance. Further studies are needed to establish if pregnant women with overweight and obesity may benefit from early SDB screening to improve glucose metabolic outcome."

For Further Information:

DOI: https://doi.org/10.1093/sleep/zsab281