Advertisement
  1. Health

Sleep apnea poses risk of complications for pregnant women

Jamillet Flores visits her newborn son, Jonah, recently at Tampa General Hospital in Tampa. Flores was diagnosed with sleep apnea while pregnant and was given a device to use during sleep to prevent dangerous pauses in her breathing.
Published May 12, 2014

TAMPA

Jamillet Flores was used to feeling sleepy, a side-effect of medication she takes.

But a nurse observing her during a routine visit to Tampa General Hospital noticed the signs of what would turn out to be far more serious: Obstructive sleep apnea that stopped her breathing at least 100 times a night.

It's a condition most often associated with overweight men who snore so badly they keep their partners up. But obstructive sleep apnea can be an issue at any age, and either gender.

It's particularly serious when it happens to women like Flores, 34, who was four months pregnant when she was diagnosed in December after a sleep study.

New research from the University of South Florida has found that pregnant women with obstructive sleep apnea are five times more likely to die in the hospital during and shortly after pregnancy, compared with women without the disorder. The study also found that pregnant women with apnea also were more likely to suffer the severe complications of pregnancy, including severe high blood pressure, an enlarged heart and pulmonary blood clots.

The USF study is the first large-scale analysis of the association between sleep apnea and maternal deaths. Researchers reviewed hospital discharge data from 55 million pregnant women from 1998 to 2009.

Lead author Dr. Judette Louis said the common apnea warning signs in women like snoring, excessive daytime sleepiness, difficulty concentrating, depression and anxiety are often dismissed as normal during pregnancy, so the women seldom seek treatment.

"Had she not been in the hospital for that other condition (a blood disorder that sent her to Tampa General for treatment), she may not have been diagnosed and treated for apnea," said Louis, a researcher and assistant professor of obstetrics and gynecology at the USF Health Morsani College of Medicine. "Apnea is generally under-diagnosed in young, pregnant women. It's still thought of by many people as a disease of older, obese men. But it's not limited to them and it can be a very serious condition, particularly in pregnant women."

In the study, published in the journal Sleep, Louis and her team focused on women with a diagnosis of sleep apnea and pregnancy-related health complications. Of the three major causes of death during pregnancy, two are worsened by apnea — blood clots and pre-eclampsia, serious high blood pressure that can lead to seizures.

"The data is out there and it's very clear in the general population that if you have sleep apnea you are more likely to have heart disease, heart attacks, strokes, and are more likely to die early," said Louis. "We just never knew until now the true impact of apnea on young, pregnant women."

Louis hopes the study will encourage people to take sleep apnea seriously and get treatment, especially during pregnancy. She also hopes more physicians who care for pregnant women will talk with their patients about apnea.

For women who think they don't have time for a conventional sleep study, Louis noted that studies can be conducted at home so patients don't have to be away from their families overnight. Also, if a patient needs a CPAP (continuous positive airway pressure) machine for apnea, there is an alternative to the traditional mask that covers the mouth and nose; newer models sit in front of the nostrils.

She noted, though, that not a great deal is known about apnea during pregnancy .

"We know that in non-pregnant people CPAP saves lives,'' Louis said. "We don't know that yet for pregnant women because it hasn't been specifically studied, but we can say that more women with sleep apnea die while pregnant than those who don't have apnea."

CPAP, the gold standard apnea treatment, keeps airways open by blowing air through a hose connected to a face mask. As soon as she had her diagnosis, Flores started using a CPAP machine faithfully, even when napping during the day.

"It gave me peace of mind knowing I was getting proper oxygen for myself and for the baby," said Flores, who lives near Orlando.

Jonah was born on April 28 and spent several days in the neonatal intensive care unit at Tampa General because he had jaundice, a result of his mother's blood disorder. But now he's doing well, and his mother credits her medical team for recognizing her apnea.

"When it was time to go to the hospital for the delivery, the CPAP machine was one of the first things I put in the car,'' she said. "It has made such a difference."

Irene Maher can be reached at imaher@tampabay.com.

ALSO IN THIS SECTION

  1. Fifty-two percent of Americans support a ban on the sale of electronic cigarettes with fruit and other flavors, according to new Kaiser Family Foundation poll. TONY DEJAK  |  AP
    But a smaller percentage supports banning all forms of the product. Most younger adults oppose both ideas.
  2. FILE - In this Thursday, Dec. 20, 2018 file photo, Juul products are displayed at a smoke shop in New York. On Thursday, Oct. 17, 2019, the company announced it will voluntarily stop selling its fruit and dessert-flavored vaping pods. SETH WENIG  |  AP
    The flavored pods affected by the announcement are mango, crème, fruit, and cucumber.
  3. Travis Malloy who runs an 8-acre farm with his assistant Shelby Alinsky on the east side of Temple Terrace, raises organic beef, pigs, turkeys and chickens. Malloy has also set up a number of...
  4. Dr. James Quintessenza, left, will return as the head of the Johns Hopkins All Children's heart surgery program department. UNIVERSITY OF KENTUCKY HOSPITAL  |  Times
    The heart surgery program’s mortality rate spiked after the surgeon left, a 2018 Times investigation revealed.
  5. Stephanie Vold, a medical assistant and intake specialist for OnMed, holds the door while Austin White, president and CEO of the company, talks with a nurse practitioner during a demonstration of their new telehealth system at Tampa General Hospital on Tuesday. The hospital is the first to deploy the OnMed station and plans to install them at other locations. OCTAVIO JONES  |  Times
    The closet-size “office” with a life-size screen is another example of the changing face of medicine.
  6. Marijuana plants grow in a greenhouse environment in this room at the Curaleaf Homestead Cultivation Facility. This environment controls the amount of natural sunlight and artificial light the plants are exposed to, as well as the temperature. EMILY MICHOT  |  Miami Herald
    An Atlanta broker is listing one license for $40 million and the other for $55 million.
  7. A page from the Medicare Handbook focuses on Medicare Advantage plans, which have become increasingly popular in recent years. Medicare's open enrollment period for 2020 begins Oct. 15 and lasts through Dec. 7. PABLO MARTINEZ MONSIVAIS  |  AP
    New benefits are giving an extra boost to Medicare Advantage, the already popular alternative to traditional Medicare.
  8. The Tampa Bay Times' annual Medicare Guide explains how the program is set up, helps you compare options available in the Tampa Bay area, and points the way toward help, including free, one-on-one assistance. This illustration will grace the cover of LifeTimes on Oct. 23, when the guide will be published in print. RON BORRESEN  |  Tampa Bay Times
    As the open enrollment period begins, it’s time to review your coverage.
  9. The Medicare Handbook for 2020 is a good resource to have as the annual open enrollment period gets under way. The government usually mails beneficiaries a copy. Find a PDF version to print at medicare.gov/pub/medicare-you-handbook, or call 1-800-633-4227 (1-800-MEDICARE) to order a copy. THOMAS TOBIN  |  Tampa Bay Times
    The open enrollment period, which lasts into December, is a time for millions of beneficiaries to review, and possibly change, their coverage.
  10. Medicare's online Plan Finder has been redesigned and is available at medicare.gov/find-a-plan. THOMAS TOBIN  |  Tampa Bay Times
    The most-used tool on Medicare.gov will look different this year.
Advertisement
Advertisement
Advertisement