medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2016, Number 6

Next >>

Rev Invest Clin 2016; 68 (6)

Obstructive Sleep Apnea and Perinatal Risk

Reyes-Zúñiga M, Torre-Bouscoulet L

Language: English
References: 37
Page: 281-285
PDF size: 66.67 Kb.


ABSTRACT

Obstructive sleep apnea is characterized by total or partial interruptions of airflow during sleep, despite ongoing efforts to breathe. These pauses result from repeated upper airway obstructions that generate a systemic inflammatory condition with consequences for the endothelial function that increase the risk of cardiometabolic events. The prevalence of obstructive sleep apnea during pregnancy is greater than that observed in the general population and increases in the third trimester. Although limited, the information currently available supports the notion that obstructive sleep apnea is an independent, and potentially modifiable, risk factor for maternal and perinatal morbidity and mortality. Experimental and prospective studies in humans have demonstrated an association between obstructive sleep apnea and low birth weight. Endothelial dysfunction may be the link that underlies the association of obstructive sleep apnea with high perinatal risk. The information reviewed herein suggests that treating obstructive sleep apnea with positive-pressure devices could be an effective strategy for decreasing perinatal morbidity and mortality.


REFERENCES

  1. Carrillo-Alduenda JL, Arredondo-del-Bosque F, Reyes-Zúñiga M, Castorena-Maldonado A, Vázquez-García JC, Torre-Bouscoulet L. [Obstructive sleep apnea syndrome in adult population.] Neumol Cir Torax. 2010;69:103-15.

  2. Torre-Bouscoulet L, Castorena-Maldonado A, Sada-Ovalle I, Meza- Vargas MS. [Mechanisms of cardiovascular damage in obstructive sleep apnea]. Rev Invest Clin. 2008;60:502-16.

  3. Young T, Palta M, Dempsey J, et al. The occurrence of sleep disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230-5.

  4. Bouscoulet LT, Vázquez-García JC, Muiño A, et al. Prevalence of sleep-related symptoms in 4 Latin American cities. J Clin Sleep Med. 2008;4:579-85.

  5. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, Hla KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013;177:1006-14.

  6. Marin JM, Carrizo SJ, Vicente E, Agusti AG. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005;365:1046-53.

  7. Garbarino S, Guglielmi O, Sanna A, Mancardi GL, Magnavita N. Risk of occupational accidents in workers with obstructive sleep apnea: Systematic review and meta-analysis. Sleep. 2016;39:1211-8.

  8. Karimi M, Hedner J, Häbel H, Nerman O, Grote L. Sleep apnearelated risk of motor vehicle accidents is reduced by continuous positive airway pressure: Swedish Traffic Accident Registry data. Sleep. 2015;38:341-9.

  9. Garvey JF, Pengo MF, Drakatos P, Kent BD. Epidemiological aspects of obstructive sleep apnea. J Thorac Dis. 2015;7:920-9.

  10. Nieto FJ, Peppard PE, Young T, Finn L, Hla KM, Farré R. Sleepdisordered breathing and cancer mortality: results from the Wisconsin Sleep Cohort Study. Am J Respir Crit Care Med. 2012; 186:190-4.

  11. Louis JM, Mogos MF, Salemi JL, Redline S, Salihu HM. Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009. Sleep. 2014;37:843-9.

  12. 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. 2014;210:52.e1-14.

  13. Ding XX, Wu YL, Xu SJ, et al. A systematic review and quantitative assessment of sleep-disordered breathing during pregnancy and perinatal outcomes. Sleep Breath. 2014;18:703-13.

  14. Louis J, Auckley D, Miladinovic B, et al. Perinatal outcomes associated with obstructive sleep apnea in obese pregnant women. Obstet Gynecol. 2012;120:1085-92.

  15. Pien GW, Pack AI, Jackson N, Maislin G, Macones GA, Schwab RJ. Risk factors for sleep-disordered breathing in pregnancy. Thorax. 2014;69:371-7.

  16. Wilson DL, Walker SP, Fung AM, O’Donoghue F, Barnes M, Howard M. Can we predict sleep-disordered breathing in pregnancy? The clinical utility of symptoms. J Sleep Res. 2013;22:670-8.

  17. Antony KM, Agrawal A, Arndt ME, et al. Association of adverse perinatal outcomes with screening measures of obstructive sleep apnea. J Perinatol. 2014;34:441-8.

  18. Bourjeily G, Barbara N, Larson L, He M. Clinical manifestations of obstructive sleep apnoea in pregnancy: more than snoring and witnessed apnoeas. J Obstet Gynaecol. 2012;32:434-8.

  19. Gutiérrez JP, Rivera-Dommarco J, Shamah-Levy T, et al. Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales. 2a. ed. Cuernavaca, México: Instituto Nacional de Salud Pública (MX), 2013.

  20. World Health Organisation. Millennium objectives. Available at: http://www.who.int/topics/millennium_development_goals/ about/es/

  21. Pamidi S, Marc I, Simoneau G, Lavigne L, Olha A, Benedetti A, et al. Maternal sleep-disordered breathing and the risk of delivering small for gestational age infants: a prospective cohort study. Thorax. 2016;71:719-25.

  22. McIntire DD1, Bloom SL, Casey BM, Leveno KJ. Birth weight in relation to morbidity and mortality among newborn infants. N Engl J Med. 1999;340:1234-8.

  23. Tapia IE, Shults J, Doyle LW, et al. Perinatal risk factors associated with the obstructive sleep apnea syndrome in school-aged children born preterm. Sleep. 2016;39:737-42.

  24. Rosen CL, Larkin EK, Kirchner HL, et al. Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr. 2003;142: 383-9.

  25. White DP. Pathogenesis of obstructive and central sleep apnea. Am J Respir Crit Care Med. 2005;172:1363-70.

  26. Cooper VL, Pearson SB, Bowker CM, Elliott MW, Hainsworth R. Interaction of chemoreceptor and baroreceptor reflexes by hypoxia and hypercapnia - a mechanism for promoting hypertension in obstructive sleep apnoea. J Physiol. 2005;568:677-87.

  27. Schöbel C, Fietze I, Glos M, et al. Nocturnal snoring decreases daytime baroreceptor sensitivity. Respir Med. 2014;108:1049-55.

  28. Muñoz-Hernandez R, Vallejo-Vaz AJ, Sanchez Armengol A, et al. Obstructive sleep apnoea syndrome, endothelial function and markers of endothelialization. Changes after CPAP. PLoS One. 2015;10:e0122091.

  29. Varadharaj S, Porter K, Pleister A, et al. Endothelial nitric oxide synthase uncoupling: a novel pathway in OSA induced vascular endothelial dysfunction. Respir Physiol Neurobiol. 2015;207: 40-7.

  30. Korcarz CE, Stein JH, Peppard PE, Young TB, Barnet JH, Nieto FJ. Combined effects of sleep disordered breathing and metabolic syndrome on endothelial function: the Wisconsin Sleep Cohort study. Sleep. 2014;37:1707-13.

  31. Kaczmarek E, Bakker JP, Clarke DN, et al. Molecular biomarkers of vascular dysfunction in obstructive sleep apnea. PLoS One. 2013;8:e70559.

  32. Fleming WE, Ferouz-Colborn A, Samoszuk MK, Azad A, Lu J, Riley JS, et al. Blood biomarkers of endocrine, immune, inflammatory, and metabolic systems in obstructive sleep apnea. Clin Biochem. 2016;49:854-61.

  33. Kushida CA, Littner MR, Hirshkowitz M, et al.; American Academy of Sleep Medicine. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep-related breathing disorders. Sleep. 2006; 29:375-80.

  34. Batool-Anwar S, Goodwin JL, Kushida CA, et al. Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA). J Sleep Res. 2016. [Epub ahead of print].

  35. Martínez-Cerón E, Barquiel B, Bezos AM, et al. Effect of CPAP on glycemic control in patients with obstructive sleep apnea and type 2 diabetes. A randomized clinical trial. Am J Respir Crit Care Med. 2016;194:476-85.

  36. Guilleminault C, Kreutzer M, Chang JL. Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. Sleep Med. 2004;5:43-51.

  37. Poyares D, Guilleminault C, Hachul H, et al. Pre-eclampsia and nasal CPAP: part 2. Hypertension during pregnancy, chronic snoring, and early nasal CPAP intervention. Sleep Med. 2007;9:15-21.




2020     |     www.medigraphic.com