Management of Obstructive Sleep Apnea in Pregnancy

Dominguez, Jennifer E.; Street, Linda; Louis, Judette

doi:10.1016/j.ogc.2018.01.001

Cited by 56Obstructive Sleep Apnea ResearchPregnancy and preeclampsia studiesCardiovascular Issues in Pregnancy

Management of Obstructive Sleep Apnea in Pregnancy

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Dominguez, Jennifer E., Street, Linda, Louis, Judette·2018·Obstetrics and Gynecology Clinics of North America

DOI 10.1016/j.ogc.2018.01.001PMC PMC5995135

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Abstract

SYNOPSIS The spectrum of sleep disordered breathing (SDB) ranges from mild snoring to obstructive sleep apnea (OSA), the most severe form of SDB. Current recommendations are to treat these women with continuous positive airway pressure (CPAP) despite limited data. SDB in early and mid-pregnancy were associated with preeclampsia and gestational diabetes. Pregnant women with a diagnosis of OSA at delivery were at significantly increased risk of having cardiomyopathy, congestive heart failure, pulmonary embolism and in-hospital death. These effects were exacerbated in the presence of obesity. Postpartum, these women are at risk for respiratory suppression and should be monitored.

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Continuous pulse oximetry during labor and the postpartum period can identify hypoxic episodes and guide management.
“The use of continuous pulse oximetry during labor and the postpartum period can identify hypoxic episodes and guide management.1015”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1015]
The Clinical Care section on intrapartum and immediate postpartum management recommends continuous pulse oximetry after discharge from the recovery room for women at risk of postoperative respiratory suppression. It also says that noted hypoxemia may prompt CPAP or noninvasive ventilation. The passage does not recommend continuous pulse oximetry during labor, so the claim extends the recommendation beyond the setting described. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Obstructive sleep apnea patients taking opioids have increased risks for morbidity and mortality.
“given increased risks for morbidity and mortality among OSA patients taking opioids.1015,1017”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1015]
The Intrapartum and Immediate Postpartum Management section warns of opioid-associated sedation and hypoventilation in women with OSA. The Severe maternal morbidity section reports increased morbidity and in-hospital mortality among pregnant women with OSA, but does not link those outcomes to opioid use. The claim combines these findings and extends them beyond the pregnant population addressed by the paper; page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Pregnancies in women with obstructive sleep apnea are widely considered high risk.
“While pregnancies in women with OSA are widely considered high risk,1015”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [1015]

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Putra, R. A., Andonotopo, W., Setiawan, A., Suryawan, A., Rahardjo, T. M., Rumanti, R. T., Lengkey, R. F., & Andanaputra, W. E. K. (2026) · Current Medicine Research and Practice · doi:10.4103/cmrp.cmrp_160_25

Sleep disordered breathing in pregnant women: maternal and fetal risk, treatment considerations, and future perspectives
Truong, K. K., & Guilleminault, C. (2018) · Expert Review of Respiratory Medicine · doi:10.1080/17476348.2018.1432355 · Cited by 21 · see citing works
Sleep disordered breathing in pregnancy: the maternal and fetal implications
Carnelio, S., Morton, A., & McIntyre, D. H. (2016) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2016.1229273 · Cited by 34 · see citing works
Sleep-disordered breathing in pregnancy
Silvestri, R., & Aricò, I. (2013) · Current Respiratory Care Reports · doi:10.1007/s13665-013-0047-z · Cited by 1 · see citing works
Obstructive Sleep Apnea in Pregnant Women: A Review of Pregnancy Outcomes and an Approach to Management
Dominguez, J. E., Krystal, A. D., & Habib, A. S. (2019) · Obstetric Anesthesia Digest · doi:10.1097/01.aoa.0000552882.37610.55 · Cited by 6 · see citing works
Self-citation
Sleep-Disordered Breathing During Pregnancy
Venkata, C. V., & Venkateshiah, S. B. (2009) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2009.02.080057 · Cited by 115 · see citing works

Authors: Dominguez, J. E., Street, L., & Louis, J.
Affiliations: Duke University (US)
Augusta University (US)
University of South Florida (US)
Corresponding author: Louis, Judette
ORCID: Dominguez, Jennifer E.
Street, Linda
Louis, Judette
Venue: Obstetrics and Gynecology Clinics of North America
Publisher: Elsevier BV
Published: 2018-06
Volume: 45
Issue: 2
Pages: 233-247
ISSN: 0889-8545 (ISSN-L)
DOI: 10.1016/j.ogc.2018.01.001
PMC: PMC5995135
OpenAlex: W2802282532
Semantic Scholar: 31a3a5226b71b2f75bebaee2a9e22f0413065a5e
Cited by: 54
References: 106
Citations by year: 2026: 4 · 2025: 9 · 2024: 7 · 2023: 9 · 2022: 7 · 2021: 10 · 2020: 4 · 2019: 3 · 2018: 1
FWCI: 0.59
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Obstetrics and Gynecology Clinics of North America (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: NIH (5T32GM008600-20)
Topics: Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Issues in Pregnancy
Keywords: obstructive sleep apnea, pregnancy, sleep-disordered breathing, continuous positive airway pressure, preeclampsia, gestational diabetes mellitus, cardiomyopathy, congestive heart failure, pulmonary embolism, maternal mortality, obesity, postpartum monitoring
MeSH terms: Female, Humans, Pregnancy, Pregnancy Complications, Sleep Apnea, Obstructive

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Management of Obstructive Sleep Apnea in Pregnancy

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