Sleep study while pregnant?

Should a pregnant woman have a sleep study? I am trying to talk my wife into a sleep study she thinks she needs to wait until after the baby comes. She is always tired but usually has trouble falling asleep at night.

Tformhals wrote:Should a pregnant woman have a sleep study? I am trying to talk my wife into a sleep study she thinks she needs to wait until after the baby comes. She is always tired but usually has trouble falling asleep at night.

better for the baby to start treatment of sleep apnea as soon as possible.
if she's got apnea, then her body is stressed by it, the low oxygen is bad for her organs, bad for her health... that translates to a bad environment to grow a baby.

There's no medical reason to not have it just because of a pregnancy than I can think of.
There's absolutely nothing done that is invasive at all and if sleep apnea is a real suspect it would be better for her and the baby if it was addressed sooner than later.
Now realize that fatigue and not being able to sleep can have other causes besides sleep apnea but having it checked out to make sure that something isn't going on that could be easily fixed would be a good thing.
If she doesn't have sleep apnea then you start looking for other potential culprits and if she does then start therapy sooner than later. Either way you get a head start on a potential problem instead of putting it off. That's always a good thing.

She's trying the old "stall" tactic...I used that one myself but I didn't use pregnancy as the excuse...but I recognize the tactic.

https://www.ncbi.nlm.nih.gov/pubmed/26872044
Dated 2016

Abstract:

PURPOSE OF REVIEW:

This review aims to provide an update on recent advances in the diagnosis and treatment of obstructive sleep apnea (OSA) during pregnancy and its effect on maternal and fetal outcomes.

RECENT FINDINGS:

Current OSA screening tools may not perform well in this population. There are some pieces of evidence linking poorer maternal and neonatal outcome with pregnant patients having OSA. At present, there are inadequate data on which to base fetal or maternal parameters for treatment of OSA, and no evidence that treatment in the short-term impacts maternal or neonatal outcomes.

SUMMARY:

Further research is needed to help in the detection and treatment of OSA in pregnancy.


My answer would be to wait till after pregnancy.

The extra oxygen may very well give you a smarter baby.
No proof one way or the other; but why not give the kid his/her best shot?
We already know that smoking adversely impacts mental development in a fetus.

avi123 wrote:https://www.ncbi.nlm.nih.gov/pubmed/26872044
Dated 2016

Abstract:

PURPOSE OF REVIEW:

This review aims to provide an update on recent advances in the diagnosis and treatment of obstructive sleep apnea (OSA) during pregnancy and its effect on maternal and fetal outcomes.

RECENT FINDINGS:

Current OSA screening tools may not perform well in this population. There are some pieces of evidence linking poorer maternal and neonatal outcome with pregnant patients having OSA. At present, there are inadequate data on which to base fetal or maternal parameters for treatment of OSA, and no evidence that treatment in the short-term impacts maternal or neonatal outcomes.

SUMMARY:

Further research is needed to help in the detection and treatment of OSA in pregnancy.


My answer would be to wait till after pregnancy.

1) if it were my kid, I wouldn't want to roll the dice on whether or not its development would be hindered by mom's potential apnea.
2) also be aware that this poster, offering such critical advice, has previously advised people to never take the advice of anybody from this forum.... one would have to extend that to his advice.

I couldn't see the entire article that was linked...requires a subscription and I am not going to do that but I would want to see what they based the conclusion on before commenting or how much faith I would put in that article.

There's a thing called common sense...and with sleep apnea there is the potential for oxygen levels to drop during the apnea and that alone merits concern...if mom isn't getting enough oxygen and her levels drop..no telling what might be going on with the baby. Sometimes babies keep all of what they need up to par by robbing mom. Either way someone could get hurt.

Lacking full provenance of the linked article,
I would not allow much more than incidental notice.
Considering the source here, even less so.

Thanks for the info. I think I have her talked into asking her doctor for a sleep study.

P, these articles don't require subscriptions:

This one is from 2016 which I mentioned in my above post:

Link: https://www.ncbi.nlm.nih.gov/pubmed/26872044


Curr Opin Anaesthesiol. 2016 Jun;29(3):317-24. doi: 10.1097/ACO.0000000000000317.

Diagnosis and treatment of obstructive sleep apnea during pregnancy.

Abdullah HR1, Nagappa M, Siddiqui N, Chung F.

This is the whole content:

PURPOSE OF REVIEW:

This review aims to provide an update on recent advances in the diagnosis and treatment of obstructive sleep apnea (OSA) during pregnancy and its effect on maternal and fetal outcomes.

RECENT FINDINGS:

Current OSA screening tools may not perform well in this population. There are some pieces of evidence linking poorer maternal and neonatal outcome with pregnant patients having OSA. At present, there are inadequate data on which to base fetal or maternal parameters for treatment of OSA, and no evidence that treatment in the short-term impacts maternal or neonatal outcomes.

SUMMARY:

Further research is needed to help in the detection and treatment of OSA in pregnancy.

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX

The following article is from 2012:

J Perinatol. 2012 Jun;32(6):399-406. doi: 10.1038/jp.2012.14. Epub 2012 Feb 23.

Obstructive sleep apnea and pregnancy: the effect on perinatal outcomes.

Fung AM1, Wilson DL, Barnes M, Walker SP.

Abstract

Obstructive sleep apnea (OSA) is characterized by repeated episodes of upper airway obstruction, resulting in hypoxemia, hypercapnia and sleep fragmentation. Pathophysiological sequelae include sympathetic activation, increased oxidative stress and a generalized inflammatory response, culminating in endothelial dysfunction. These are the proposed mechanisms that mediate the increased risk of hypertension and cardiovascular disease among patients with OSA outside of pregnancy. It is intriguing to consider the consequences of these events on pregnancy outcomes. There is a growing literature on the impact of maternal OSA on hypertensive disorders of pregnancy, gestational diabetes and impaired fetal growth. The data, while promising, require confirmation with larger numbers to verify the findings. OSA may be an important mediator of the poor perinatal outcomes associated with maternal obesity; moreover, one which may be amenable to treatment. This review discusses OSA and summarizes the current literature linking OSA with adverse perinatal outcomes.

My: I will search if some of the physicians mentioned above have other information on it.

Pugsy wrote:I couldn't see the entire article that was linked...requires a subscription and I am not going to do that but I would want to see what they based the conclusion on before commenting or how much faith I would put in that article.

There's a thing called common sense...and with sleep apnea there is the potential for oxygen levels to drop during the apnea and that alone merits concern...if mom isn't getting enough oxygen and her levels drop..no telling what might be going on with the baby. Sometimes babies keep all of what they need up to par by robbing mom. Either way someone could get hurt.

If there is any medical information on the internet questioning the safety of doing the sleep study and thus endangering the mother and/or the fetus and something bad does happen then "you" (the PHYSICIAN not you P) are talking about law suits of millions of $.

avi123 wrote:P, these articles don't require subscriptions:

Well when I attempted to follow the links to the full article through the 2 options for viewing I was given a choice
of paying 558.00 for subscription to the publication it was printed in or just buying the article for some unknown price...I didn't go there.
I saw the overview/abstract but wanted to how they came up with their conclusions...I wanted original full study.

I couldn't find a way to access the original full publication that didn't require a transfer of money out of my pocketbook. I didn't want to read it that badly.
I think that this sort of decision is ultimately best left up to the patient and the doctor. Lots of pregnant women get sleep studies and even start cpap while pregnant.
Lots of potential complicating factors out there that we don't know about that could maybe be real important which it comes to pregnancy.

She needs to at least talk to the doctor about her husband's concerns and her own physical symptoms and then she and her doctor can decide what to do.
A quick and easy home sleep study would at least alleviate the oxygen level concerns...which would be my main initial worry.
I don't see how putting a recording pulse ox on the finger for overnight oxygen recording can possibly hurt anyone.
It doesn't have to be done in a sleep lab. Home studies are available.

What is your worry about legal liability? She can't get it done without a doctor and for all we know her doctor might think that article is the biggest pile of cow poop he has ever read.
You think somebody is gonna sue me because I said I would try to get it sooner than later??? The decision maker isn't me...it's the wife and her doctor. I just gave my opinion which is worth about as much as someone would get if they tried to sue me....nothing. I have nothing worth suing for...can't get money out of someone that has none.

Pregnancy is associated with bad sleep. There is both the lack of space to breathe in the last month as well as the hormones which act as a kind of muscle relaxant in order for then needed expansion as well as the giant head to pass through the vagina canal eventually. By the 6th month most women get clumsy and this is due to those hormones, not the change in shape. If you are an artist you will feel like you are working with mitts on.

Good O2 levels and sleep are viral for a pregnant woman in order for the baby to grow well.

Poor, poor Avi . . .
If he is aware of his mental decline, it must be maddening.
If not, then liability for any harm will be his alone, and his caretakers.
Having done my part, I wash my hands.
The OP's wife can let her DOCTOR assess any possible hazard.

If you suspect apnea, it's ALWAYS a good idea to have a sleep study and treat if warranted, particularly during a pregnancy where the fetus may be profoundly affected.

She will need a second study some time after pregnancy, because things change a lot when pregnant and several months later when the pregnancy is over. But that should not stop her from testing and treatment during the pregnancy.

Because of all the physical changes, if a CPAP is prescribed it's especially important for her to have an APAP--that way changes can be accommodated more easily.