Pregnancy and sleep symptoms - where does respiratory disease start?

Sleep breathing disorders (SBD) during pregnancy are often underestimated by women and healthcare professionals. However, they have been related to maternofetal and neonatal complications, with few focused studies. To characterize pregnancy SBDs symptoms and to assess if demographic and anthropometric parameters are related to them. Retrospective analysis of the consecutive adult pregnant women attending Obstetrics appointments in Hospital da Luz Lisboa, July-December 2023, that filled dedicated forms. Data including women’ age (years), gestational age (weeks) and BMI (Kg/m2), SBD symptoms (snoring, witnessed apneas, gasping, daytime sleepiness, fatigue, unrestful sleep, difficulty concentrating) and Epworth Sleepiness Scale (ESS) were analyzed. The cohort included 308 patients (pts) with 34±4.9 years and gestational age of 21.6±9.0 weeks. Mean BMI was 25.5±4.5 and 22.7% had an ESS >10. The most frequent reported symptoms were fatigue (64.9%), difficulty concentrating (52.3%) and unrestful sleep (50.3%). Older pts were more likely to snore (p=0.002), have non-restorative sleep (p=0.043) and difficulty concentrating (p=0.024). A higher BMI showed a significant relationship with snoring (p<0.001) and gasping (p=0.049). Also, as pregnancy progressed, fatigue and daytime sleepiness (ESS>10) increased (p=0.010 and p=0.015). No relationship was found with the other symptoms. Respiratory symptoms are common in pregnant women. The link between higher BMI, maternal and gestacional age with SBD symptoms may imply increased possibility of SBDs. Therefore, they should be considered as possible risk factors. However, there is still a pressing need to validate scores to guide sleep tests in this poorly studied population.