May 23, 2007
Contact: Terri Guess
Phone: (973) 972-3000
Sleep Apnea Associated with Pregnancy-induced
Diabetes, High Blood Pressure
According to Research by UMDNJ Doctor
NEW BRUNSWICK — A study presented at the American Thoracic Society 2007 International Conference by a UMDNJ researcher found that when the women’ s weight was taken into account, sleep apnea was associated with a doubling of the incidence of gestational diabetes and a fourfold increase in the risk of pregnancy-induced hypertension.
The researchers which included Dr. Hatim Youssef, D.O. of UMDNJ-Robert Wood Johnson Medical School analyzed data from all pregnancies associated with sleep apnea, gestational diabetes (women who developed diabetes during pregnancy), and pregnancy-induced high blood pressure nationwide in 2003. Out of almost 4 million deliveries, 452 had sleep apnea. Of the 167,227 women who had gestational diabetes, 67 had sleep apnea. Of the 200,902 pregnancies with pregnancy-induced high blood pressure, 166 had sleep apnea.
In obstructive sleep apnea, the upper airway narrows, or collapses, during sleep. Periods of apnea end with a brief partial arousal that may disrupt sleep hundreds of times a night. Obesity is a major risk factor for sleep apnea.
“The repetitive decrease in oxygen that occurs during the night in someone with sleep apnea heightens the body’s ‘fight or flight’ state, which can raise blood pressure,” explained Youssef. “The body also secretes more hormones such as cortisol and epinephrine, and the body responds by producing more glucose coupled with a decreased sensitivity to insulin, which can lead to diabetes.”
The most effective treatment for sleep apnea is an apparatus called nasal CPAP, or Continuous Positive Airway Pressure, which delivers air through a mask while the patient sleeps, keeping the airway open.
Pregnancy can worsen sleep apnea, especially during the third trimester when a woman’s weight is greatest, the study determined. “When a mother’s oxygen level drops at night, it may also affect the oxygen level of the fetus, and we don’t know what the long-term effects are,” said Dr. Youssef. “That’s why it’s important for a pregnant woman with sleep apnea to be treated with CPAP during her pregnancy.”
It is not yet known whether CPAP treatment can reduce the risk of diabetes and hypertension during pregnancy. “In the non-pregnant population, research has shown that treating sleep apnea will reduce the risk of diabetes and hypertension,” Dr. Youssef explained. “In the future, we want to follow pregnant women whose sleep apnea is well-controlled to see if treatment prevents them from developing these conditions, or makes it less severe.”
Youssef recommends that pregnant women who are obese, hypersensitive or diabetic be closely evaluated for the presence of sleep apnea. If sleep apnea is present, treatment in the form of nasal CPAP should be used and her blood pressure and blood sugar should be closely monitored.
To arrange and interview with Dr. Youssef please call Terri Guess at 973-972-5000.
The University of Medicine and Dentistry of New Jersey (UMDNJ) is the nation’s largest free-standing public health sciences university with more than 5,700 students attending the state's three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and a school of public health on five campuses. Annually, there are more than two million patient visits at UMDNJ facilities and faculty practices at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates University Hospital, a Level I Trauma Center in Newark, and University Behavioral HealthCare, a statewide mental health and addiction services network.