We know that sleep apnea is associated with many health risks. This can be even more serious when two lives are involved, as when a woman is experiencing sleep apnea during pregnancy.
A new, large study shows us more clearly than ever just how dangerous sleep apnea and other sleep disorders can be for pregnant women. Perhaps even more importantly, it shows us that pregnant women are not getting properly screened for sleep apnea and few are receiving treatment they need that could potentially save their life or that of their child.
A Large Study with Detailed Findings
This is not the first time people have looked at how sleep apnea affects the risk of preterm birth (birth at 37 weeks of gestation or before). But this study is the largest of its kind, utilizing data from the entire state of California. In the study population, less than 1% of women had been diagnosed with a sleep disorder, although this still gave them a sample size of 2265 women who had sleep disorders. And because the population was so large, researchers were able to match each woman with a sleep disorder to several women without sleep disorders, but who otherwise had similar risk factors. This helped them control for factors like previous preterm birth, hypertension, smoking, and other factors that can contribute to preterm birth risk so they could really tell the effect of sleep disorders.
In fact, this allowed them to even identify how much risk came from the two most common sleep disorders: insomnia and sleep apnea. They found that for women without a sleep disorder, the risk of preterm birth was 10.9 %, compared to a 14.6% risk for women with a sleep disorder. The risk was 1.3 times higher for insomnia and 1.5 times higher for sleep apnea. For early preterm birth–birth at 34 weeks of gestation or earlier–the risk was about double for women with sleep disorders, a little less for insomnia and a little more for sleep apnea.
Better Diagnosis and Treatment Needed
Researchers weren’t surprised that sleep disorders had this impact on preterm birth. It confirmed the results of smaller studies. What did surprise them was how few women had been diagnosed with sleep apnea and other sleep disorders. Some studies show that nearly 20% of women have obstructive sleep apnea in their third trimester! If only 1% of women are diagnosed, that means that 95% of women with sleep apnea are going undiagnosed, which puts them–and their child–at unnecessary risk.
Some of the reason for this is that doctors assume women are going to have disrupted sleep during pregnancy. When women report trouble sleeping, doctors are more likely to say “that’s normal,” and not delve any deeper. Or, even worse, women may simply assume their sleep difficulties are normal and not report it.
The good news is that some people are working on simple screening tools that can help women find out if they’re at risk. And studies like this can promote awareness among women and their doctors.
And, of course, once women are diagnosed, they need good treatment options. CPAP is a good treatment, but since it may take months for women to adapt to the treatment, it may not be the best choice for dealing with sleep apnea during pregnancy. Instead, simple, comfortable, and convenient oral appliances may be a better choice.
If you want to learn more about sleep apnea treatment options, please call 201-343-4044 today for an appointment with sleep dentist Dr. Marlen Martirossian at River Edge Dental, center for TMJ, sleep apnea, & reconstructive dentistry.