Polysomnographic analysis of maternal sleep position and its relationship to pregnancy complications and sleep-disordered breathing

Sleep

article

Wilson, Danielle L¹  Fung, Alison M³  Pell, Gabrielle²  Skrzypek, Hannah³  Barnes, Maree¹  Bourjeily, Ghada⁵  Walker, Susan P²  Howard, Mark E¹ 

[1] Institute for Breathing and Sleep, Austin Health;Department of Obstetrics and Gynaecology, University of Melbourne;Mercy Perinatal, Mercy Hospital for Women;Department of Medicine, University of Melbourne;Department of Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University

关键词: pregnant;    sleep study;    lateral;    supine;    birthweight;    fetal health;    sleep apnea;    polysomnography;    sleep onset;   

DOI  :  10.1093/sleep/zsac032

学科分类：生理学

来源: American Academy of Sleep Medicine

【 摘 要 】

Links between supine “going to sleep” position and stillbirth risk have led to campaigns regarding safe maternal sleep position. This study profiles the distribution of sleep positions overnight and relationships to sleep onset position during pregnancy, and the relationships between supine sleep, sleep-disordered breathing (SDB), and pregnancy outcomes. Data from three prospective cohort studies evaluating SDB in healthy and complicated pregnancies were pooled. All participants underwent one night of polysomnography in late pregnancy and birth outcome data were collected. 187 women underwent polysomnography at a median gestation of 34 weeks'. The left lateral position was preferred for falling asleep (52%) compared to supine (14%), but sleep onset position was the dominant sleep position overnight in only half (54%) of women. The median percentage of sleep time in the supine position was 24.2%; women who fell asleep supine spent more time supine overnight compared to those who began non-supine (48.0% (30.0,65.9) vs. 22.6% (5.7,32.2), p < .001). Women with growth-restricted fetuses were more likely to fall asleep supine than those with well-grown fetuses (36.6% vs. 7.5%, p < .001). Positional SDB was observed in 46% of those with an RDI ≥ 5. Sleep onset position was the dominant position overnight for half of the sample, suggesting that sleep onset position is not always a reliable indicator of body position overnight. Supine sleep was related to fetal growth restriction and birthweight at delivery, though causality cannot be inferred. It is critical that we pursue research into verifying the important relationship between supine sleep and increased stillbirth risk, and the mechanisms behind it.

【 授权许可】

All Rights reserved