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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

Snoring during pregnancy and its relation to sleepiness and pregnancy outcome - a prospective study

Authors: Maria Sarberg, Eva Svanborg, Ann-Britt Wiréhn, Ann Josefsson

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

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Abstract

Background

The incidence of snoring and sleepiness is known to increase during pregnancy, and this might impact maternal health and obstetric outcome. However, the association between snoring and sleepiness during pregnancy is not fully understood. This study was aimed at investigating the development of snoring during pregnancy and prospectively assessing if there is an association between snoring and sleepiness or adverse pregnancy outcomes, such as preeclampsia, mode of delivery, and fetal complications.

Methods

Consecutively recruited pregnant women (n = 500) received a questionnaire concerning snoring and sleep at the 1st and 3rd trimester of pregnancy. The women who had rated their frequency of snoring at both occasions (n = 340) were divided into subgroups according to the development of snoring they reported and included in the subsequent analyses. Additional medical data were collected from the medical records.

Results

The frequency of snoring was 7.9% in the 1st trimester and increased to 21.2% in the 3rd trimester of pregnancy. The women who snored already in early pregnancy had significantly higher baseline BMI (p = 0.001) than the women who never snored, but snoring was not associated with the magnitude of weight gain during pregnancy. Snoring women were more likely to experience edema in late pregnancy than the non-snorers. Women who started to snore during pregnancy had higher Epworth Sleepiness Scores than the non snorers in both early and late pregnancy. No significant association between obstetric outcome and snoring was found.

Conclusion

Snoring does increase during pregnancy, and this increase is associated with sleepiness, higher BMI at the start of pregnancy and higher prevalence of edema, but not with weight gain.
Literature
1.
Santiago JR, Nolledo MS, Kinzler W, Santiago TV: Sleep and sleep disorders in pregnancy. Ann Intern Med. 2001, 134 (5): 396-408. 10.7326/0003-4819-134-5-200103060-00012.CrossRefPubMed
2.
Hutchison BL, Stone PR, McCowan LM, Stewart AW, Thompson JM, Mitchell EA: A postal survey of maternal sleep in late pregnancy. BMC Pregnancy Childbirth. 2012, 12: 144-10.1186/1471-2393-12-144.CrossRefPubMedPubMedCentral
3.
Neau JP, Texier B, Ingrand P: Sleep and vigilance disorders in pregnancy. Eur Neurol. 2009, 62 (1): 23-29. 10.1159/000215877.CrossRefPubMed
4.
Loube DI, Poceta JS, Morales MC, Peacock MD, Mitler MM: Self-reported snoring in pregnancy. Asso with fetal outcome. Chest. 1996, 109 (4): 885-889.
5.
Guilleminault C, Querra-Salva M, Chowdhuri S, Poyares D: Normal pregnancy, daytime sleeping, snoring and blood pressure. Sleep Med. 2000, 1 (4): 289-297. 10.1016/S1389-9457(00)00046-0.CrossRefPubMed
6.
Pien GW, Fife D, Pack AI, Nkwuo JE, Schwab RJ: Changes in symptoms of sleep-disordered breathing during pregnancy. Sleep. 2005, 28 (10): 1299-1305.PubMed
7.
Ursavas A, Karadag M, Nalci N, Ercan I, Gozu RO: Self-reported snoring, maternal obesity and neck circumference as risk factors for pregnancy-induced hypertension and preeclampsia. Respiration. 2008, 76 (1): 33-39. 10.1159/000107735.CrossRefPubMed
8.
Izci B, Martin SE, Dundas KC, Liston WA, Calder AA, Douglas NJ: Sleep complaints: snoring and daytime sleepiness in pregnant and pre-eclamptic women. Sleep Med. 2005, 6 (2): 163-169. 10.1016/j.sleep.2004.12.007.CrossRefPubMed
9.
Izci B, Vennelle M, Liston WA, Dundas KC, Calder AA, Douglas NJ: Sleep-disordered breathing and upper airway size in pregnancy and post-partum. Eur Respir J. 2006, 27 (2): 321-327. 10.1183/09031936.06.00148204.CrossRefPubMed
10.
O'Brien LM, Bullough AS, Owusu JT, Tremblay KA, Brincat CA, Chames MC, Kalbfleisch JD, Chervin RD: Pregnancy-onset habitual snoring, gestational hypertension, and preeclampsia: prospective cohort study. Am J Obstet Gynecol. 2012, 207 (6): 487-e481-489CrossRefPubMedPubMedCentral
11.
Ayrim A, Keskin EA, Ozol D, Onaran Y, Yiidirim Z, Kafali H: Influence of self-reported snoring and witnessed sleep apnea on gestational hypertension and fetal outcome in pregnancy. Arch Gynecol Obstet. 2011, 283 (2): 195-199. 10.1007/s00404-009-1327-2.CrossRefPubMed
12.
Perez-Chada D, Videla AJ, O'Flaherty ME, Majul C, Catalini AM, Caballer CA, Franklin KA: Snoring, witnessed sleep apnoeas and pregnancy-induced hypertension. Acta Obstet Gynecol Scand. 2007, 86 (7): 788-792. 10.1080/00016340701281919.CrossRefPubMed
13.
Franklin KA, Holmgren PA, Jonsson F, Poromaa N, Stenlund H, Svanborg E: Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest. 2000, 117 (1): 137-141. 10.1378/chest.117.1.137.CrossRefPubMed
14.
Bourjeily G, Raker CA, Chalhoub M, Miller MA: Pregnancy and fetal outcomes of symptoms of sleep-disordered breathing. Eur Respir J. 2010, 36 (4): 849-855. 10.1183/09031936.00021810.CrossRefPubMed
15.
Zielinski J, Zgierska A, Polakowska M, Finn L, Kurjata P, Kupsc W, Young T: Snoring and excessive daytime somnolence among Polish middle-aged adults. Eur Respir J. 1999, 14 (4): 946-950. 10.1183/09031936.99.14494699.CrossRefPubMed
16.
Johns MW: Daytime sleepiness, snoring, and obstructive sleep apnea. The Epworth Sleepiness Scale. Chest. 1993, 103 (1): 30-36.PubMed
17.
Bourjeily G, Raker C, Chalhoub M, Miller M: Excessive daytime sleepiness in late pregnancy may not always be normal: results from a cross-sectional study. Sleep Breath. 2013, 17 (2): 735-740. 10.1007/s11325-012-0753-8.CrossRefPubMed
18.
Bourjeily G, El Sabbagh R, Sawan P, Raker C, Wang C, Hott B, Louis M: Epworth sleepiness scale scores and adverse pregnancy outcomes. Sleep Breath. 2013, 17 (4): 1179-1186. 10.1007/s11325-013-0820-9.CrossRefPubMed
19.
Lee KA, Gay CL: Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol. 2004, 191 (6): 2041-2046. 10.1016/j.ajog.2004.05.086.CrossRefPubMed
20.
Chang JJ, Pien GW, Duntley SP, Macones GA: Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship?. Sleep Med Rev. 2010, 14 (2): 107-114. 10.1016/j.smrv.2009.05.001.CrossRefPubMed
21.
Izci-Balserak B, Pien GW: Sleep-disordered breathing and pregnancy: potential mechanisms and evidence for maternal and fetal morbidity. Curr Opin Pulm Med. 2010, 16 (6): 574-582. 10.1097/MCP.0b013e32833f0d55.CrossRefPubMedPubMedCentral
22.
August EM, Salihu HM, Biroscak BJ, Rahman S, Bruder K, Whiteman VE: Systematic review on sleep disorders and obstetric outcomes: scope of current knowledge. Am J Perinatol. 2013, 30 (4): 323-334.CrossRefPubMed
23.
Pamidi S, Pinto LM, Marc I, Benedetti A, Schwartzman K, Kimoff RJ: Maternal sleep-disordered breathing and adverse pregnancy outcomes - a systematic review and meta-analysis. Am J Obstet Gynecol. 2013,  -
24.
Fung AM, Wilson DL, Lappas M, Howard M, Barnes M, O'Donoghue F, Tong S, Esdale H, Fleming G, Walker SP: Effects of maternal obstructive sleep apnoea on fetal growth: a prospective cohort study. PloS one. 2013, 8 (7): e68057-10.1371/journal.pone.0068057.CrossRefPubMedPubMedCentral
25.
The Swedish Medical Birth Register 1973–2011: Stockholm: Centre for Epidemiology, National Board of Health and Welfare. 2013, Stockholm, Sweden: Centre for Epidemiology, National Board of Health and Welfare
26.
Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991, 14 (6): 540-545.PubMed
27.
Walters AS: Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord. 1995, 10 (5): 634-642. 10.1002/mds.870100517.CrossRefPubMed
28.
International statistical classification of diseases and related health problems: ICD-10. 2009, Geneva, Switzerland: World Health Organization
29.
Elkus R, Popovich J: Respiratory physiology in pregnancy. Clin Chest Med. 1992, 13 (4): 555-565.PubMed
30.
Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S: The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993, 328 (17): 1230-1235. 10.1056/NEJM199304293281704.CrossRefPubMed
31.
Svensson M, Lindberg E, Naessen T, Janson C: Risk factors associated with snoring in women with special emphasis on body mass index: a population-based study. Chest. 2006, 129 (4): 933-941. 10.1378/chest.129.4.933.CrossRefPubMed
32.
Frederick IO, Qiu C, Sorensen TK, Enquobahrie DA, Williams MA: The prevalence and correlates of habitual snoring during pregnancy. Sleep Breath. 2013, 17 (2): 541-547. 10.1007/s11325-012-0717-z.CrossRefPubMed
33.
Cedergren MI: Maternal morbid obesity and the risk of adverse pregnancy outcome. Obstet Gynecol. 2004, 103 (2): 219-224. 10.1097/01.AOG.0000107291.46159.00.CrossRefPubMed
34.
Sarberg M, Josefsson A, Wirehn AB, Svanborg E: Restless legs syndrome during and after pregnancy and its relation to snoring. Acta Obstet Gynecol Scand. 2012, 91 (7): 850-855. 10.1111/j.1600-0412.2012.01404.x.CrossRefPubMed
35.
Ohayon MM, Roth T: Prevalence of restless legs syndrome and periodic limb movement disorder in the general population. J Psychosom Res. 2002, 53 (1): 547-554. 10.1016/S0022-3999(02)00443-9.CrossRefPubMed
36.
Peppard PE, Young T, Palta M, Skatrud J: Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 2000, 342 (19): 1378-1384. 10.1056/NEJM200005113421901.CrossRefPubMed
37.
Bazzett LB, Yaron Y, O'Brien JE, Critchfield G, Kramer RL, Ayoub M, Johnson MP, Evans MI: Fetal gender impact on multiple-marker screening results. Am J Med Genet. 1998, 76 (5): 369-371. 10.1002/(SICI)1096-8628(19980413)76:5<369::AID-AJMG1>3.0.CO;2-I.CrossRefPubMed
38.
Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM: Does fetal sex affect pregnancy outcome?. Gend Med. 2007, 4 (1): 19-30. 10.1016/S1550-8579(07)80004-0.CrossRefPubMed
39.
Johns MW: Sleepiness in different situations measured by the Epworth sleepiness scale. Sleep. 1994, 17 (8): 703-710.PubMed
40.
Baumgartel KL, Terhorst L, Conley YP, Roberts JM: Psychometric evaluation of the Epworth sleepiness scale in an obstetric population. Sleep Med. 2013, 14 (1): 116-121. 10.1016/j.sleep.2012.10.007.CrossRefPubMed
41.
Hernandez-Diaz S, Toh S, Cnattingius S: Risk of pre-eclampsia in first and subsequent pregnancies: prospective cohort study. Bmj. 2009, 338: b2255-10.1136/bmj.b2255.CrossRefPubMedPubMedCentral
Metadata
Title
Snoring during pregnancy and its relation to sleepiness and pregnancy outcome - a prospective study
Authors
Maria Sarberg
Eva Svanborg
Ann-Britt Wiréhn
Ann Josefsson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-15

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