Sleep Position and Pregnancy

Sleep-disordered breathing (SDB) has been shown to be associated with negative clinical sequelae such as systemic hypertension and cardiovascular disease. Pregnant patients can also be diagnosed with SDB, the negative consequences of which not only pertain to the patient but to the unborn fetus as well. Despite this, however, SDB is underdiagnosed in pregnant patients. In this chapter, we will discuss the physiologic respiratory changes that occur during pregnancy, SDB in pregnancy, supine hypotensive syndrome (SHS), the complications and current treatments for these events, and the potential role for positional therapy in pregnant women whose problems may be specifically position dependent.

[1]  I. Milsom,et al.  Factors influencing aortocaval compression in late pregnancy. , 1984, American journal of obstetrics and gynecology.

[2]  S. Redline,et al.  Perinatal Outcomes Associated With Obstructive Sleep Apnea in Obese Pregnant Women , 2012, Obstetrics and gynecology.

[3]  Jennifer Santiago,et al.  Sleep and Sleep Disorders in Pregnancy , 2001, Annals of Internal Medicine.

[4]  E. Sharpey-Schafer,et al.  Postural changes in the peripheral blood-flow of normal subjects with observations on vasovagal fainting reactions as a result of tilting, the lordotic posture, pregnancy and spinal anaesthesia. , 1950, Clinical science.

[5]  M. Kinsella,et al.  Supine hypotensive syndrome , 1994, Obstetrics and gynecology.

[6]  C. Redman,et al.  Closing volume during normal pregnancy. , 1978, Thorax.

[7]  M. Wa.  Postural shock in pregnancy. , 1951 .

[8]  F. Holmes.  INCIDENCE OF THE SUPINE HYPOTENSIVE SYNDROME IN LATE PREGNANCY , 1960, The Journal of obstetrics and gynaecology of the British Empire.

[9]  R. Wise,et al.  Respiratory physiologic changes in pregnancy. , 2000, Immunology and allergy clinics of North America.

[10]  H. Oxorn.  Postural hypotension in pregnancy. , 1960, Canadian Medical Association journal.

[11]  E. Quilligan,et al.  Postural effects on the cardiovascular status in pregnancy: a comparison of the lateral and supine postures. , 1959, American journal of obstetrics and gynecology.

[12]  W. Fishbein,et al.  Sex differences in paradoxical sleep: influences of estrus cycle and ovariectomy , 1996, Brain Research.

[13]  H. Tinteren,et al.  The role of sleep position in obstructive sleep apnea syndrome , 2006, European Archives of Oto-Rhino-Laryngology and Head & Neck.

[14]  A. Pack,et al.  Changes in symptoms of sleep-disordered breathing during pregnancy. , 2005, Sleep.

[15]  K. Schwartzman,et al.  Sleep disordered breathing in women of childbearing age & during pregnancy. , 2010, The Indian journal of medical research.

[16]  G. Marx,et al.  Arterial oxygen tension during apnoea in parturient women. , 1974, British journal of anaesthesia.

[17]  L. Bell,et al.  Obstructive sleep apnea in pregnancy. , 2004, The Journal of the American Board of Family Practice.

[18]  M. Kryger,et al.  Obstructive Sleep Apnea in Pregnancy , 2007 .

[19]  D. O. Walter,et al.  Changes in sleep-wakefulness in female rats during circadian and estrous cycles. , 1968, Brain research.

[20]  L. Courtney.  Supine hypotension syndrome during caesarean section. , 1970, British medical journal.

[21]  Birgit I. Witte,et al.  The sleep position trainer: a new treatment for positional obstructive sleep apnoea , 2013, Sleep and Breathing.

[22]  Ozcan Ozeke,et al.  Influence of the right- versus left-sided sleeping position on the apnea-hypopnea index in patients with sleep apnea , 2011, Sleep and Breathing.

[23]  R. Cartwright,et al.  Effect of sleep position on sleep apnea severity. , 1984, Sleep.

[24]  R. Bobrowski.  Pulmonary physiology in pregnancy. , 2010, Clinical obstetrics and gynecology.

[25]  F Jönsson,et al.  Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. , 2000, Chest.

[26]  M. Cosio,et al.  Therapy and Implications for Fetal Health , 1991 .

[27]  A. Oksenberg,et al.  The effect of body posture on sleep-related breathing disorders: facts and therapeutic implications. , 1998, Sleep medicine reviews.

[28]  C. Guilleminault,et al.  Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. , 2004, Sleep medicine.

[29]  B. Grant,et al.  Prevalence of positional sleep apnea in patients undergoing polysomnography. , 2005, Chest.

[30]  Kathryn A. Lee,et al.  Sleep in late pregnancy predicts length of labor and type of delivery. , 2004, American journal of obstetrics and gynecology.

[31]  K. T. Choi,et al.  Arterial oxygen desaturation rate following obstructive apnea in parturients. , 1992, Journal of Korean medical science.

[32]  Y. Fischer,et al.  Effektivität und Langzeit-Compliance der Therapie mit Rückenlage-Verhinderungsweste bei obstruktiver Schlafapnoe , 2007 .

[33]  L. Weinstein,et al.  Oxygen Saturation in the Supine Hypotensive Syndrome , 1988, Obstetrics and gynecology.

[34]  M. Cosio,et al.  Obstructive sleep apnea during pregnancy. Therapy and implications for fetal health. , 1991, The American review of respiratory disease.

[35]  D. White.  Pathogenesis of obstructive and central sleep apnea. , 2005, American journal of respiratory and critical care medicine.

[36]  C. Doré,et al.  Increase in Mallampati score during pregnancy. , 1995, British journal of anaesthesia.

[37]  Sleep-Disordered Breathing in Pregnancy , 2008 .

[38]  C. Guilleminault,et al.  Medical therapy for obstructive sleep apnea: a review by the Medical Therapy for Obstructive Sleep Apnea Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. , 2006, Sleep.

[39]  R. Cartwright,et al.  Sleep position training as treatment for sleep apnea syndrome: a preliminary study. , 1985, Sleep.

[40]  B. K. Howard,et al.  Supine Hypotensive Syndrome in Late Pregnancy , 1953, Obstetrics and gynecology.

[41]  M. Goldsworthy,et al.  Poor long-term patient compliance with the tennis ball technique for treating positional obstructive sleep apnea. , 2009, Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

[42]  D. Caldarelli,et al.  A comparative study of treatments for positional sleep apnea. , 1991, Sleep.

[43]  N. de Vries,et al.  Evaluation of a new simple treatment for positional sleep apnoea patients , 2012, Journal of sleep research.

[44]  C. Sullivan,et al.  Sleep disordered breathing and pregnancy. , 2002, Thorax.

[45]  A. Oksenberg,et al.  Positional Therapy for Obstructive Sleep Apnea Patients: A 6‐Month Follow‐Up Study , 2006, The Laryngoscope.

[46]  T. Desudchit,et al.  Clinical and polysomnographic data of positional sleep apnea and its predictors , 2012, Sleep and Breathing.

[47]  G. Bourjeily.  Sleep disorders in pregnancy , 2009, Obstetric medicine.

[48]  A. Broström,et al.  Positional sensitivity as a confounder in diagnosis of severity of obstructive sleep apnea , 2013, Sleep and Breathing.

[49]  R. Daroff,et al.  The International Classification of Sleep Disorders , 1991, Neurology.

[50]  R. D. Nadler,et al.  Effects of estrogen and progesterone on sleep patterns of female rats. , 1971, Physiology & behavior.

[51]  K. Kleinman,et al.  Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum. , 2007, American journal of epidemiology.

[52]  N. de Vries,et al.  Reliable calculation of the efficacy of non-surgical and surgical treatment of obstructive sleep apnea revisited. , 2011, Sleep.

[53]  N. de Vries,et al.  The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea—a review of the literature , 2012, Sleep and Breathing.

[54]  Ronald R Grunstein,et al.  Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. , 2008, Proceedings of the American Thoracic Society.

[55]  S. Joel-Cohen,et al.  Fetal response to periodic sleep apnea: a new syndrome in obstetrics. , 1978, European journal of obstetrics, gynecology, and reproductive biology.

[56]  H. Tinteren,et al.  Acceptance and long-term compliance of nCPAP in obstructive sleep apnea , 2007, European Archives of Oto-Rhino-Laryngology.

[57]  A. Oksenberg,et al.  Positional vs Nonpositional Obstructive Sleep Apnea Patients* Anthropomorphic, Nocturnal Polysomnographic, and Multiple Sleep Latency Test Data , 1997 .