For pregnant women, controlling blood sugar is an important way to stay healthy. Women with higher blood sugar during pregnancy are more likely to develop diabetes, and their babies are more likely to be obese.
Unfortunately, a new study shows that sleep apnea during pregnancy can lead to higher blood sugar all day long, even for women without gestational diabetes. And the sleep apnea risk increases for women during pregnancy. This suggests that diagnosing and treating sleep apnea is an important way to help women have a healthy pregnancy.
Monitored under Controlled Conditions
This is a relatively small study, involving just 18 pregnant women with obesity. Of these, 12 (67%) had at least mild sleep apnea (an AHI of at least 5). All 18 women were put on a controlled diet for three days, during which time they wore a glucose monitor. The women also had their sleep apnea monitored using the WatchPAT, a home sleep test system. Then women fasted for two hours before being given a glucose test.
The data showed that the severity of sleep apnea, as measured by AHI and ODI (oxygen desaturation index), correlated with higher glucose levels. Sleep apnea severity was also correlated with:
- Hepatic IR
- Fasting free fatty acids
- Waking cortisol
Hepatic IR is a measure of insulin resistance, the key characteristic of type 2 diabetes. The fasting free fatty acids level is also associated with a higher risk of type 2 diabetes. Elevated cortisol levels can increase the production of blood sugar, contributing to type 2 diabetes risk.
All these increases point to the fact that sleep apnea can contribute to dysregulation of the body’s blood sugar levels. This means that pregnant women should be aware of their risk of sleep apnea and its complications to try to maintain their health and the health of their babies.
Diagnosing and Treating Sleep Apnea During Pregnancy
This study adds to other studies that point to increased pregnancy risks related to sleep apnea. It looks more specifically at the mechanisms and intermediate stages that can contribute to increased risk of gestational diabetes among women with sleep apnea.
To try to combat these risks, women need to talk to their doctors about sleep apnea. One challenge of diagnosing sleep apnea during pregnancy is that many common symptoms of sleep apnea are also common symptoms of sleep disturbance during pregnancy, such as: daytime drowsiness, fatigue, frequent nighttime urination, and more. This means that we need new and better screening tools to identify women at risk for the condition.
And once women are diagnosed with sleep apnea, they need to have their condition treated. Under these conditions, oral appliance therapy might be a better treatment approach than CPAP. Many people struggle to adapt with CPAP. Even those that do adapt successfully may take months to make the transition to using the breathing device during sleep. By the time women adapt, the baby could be born, and the negative effects of the condition already manifest. However, oral appliance therapy is easy to adapt to, which makes it a great choice for achieving results on the short time frame necessary to help pregnant women stay healthy.