472 Sleep Quality in Pregnancy: An Analysis of Cardiopulmonary Coupling in the nuMoM2b Cohort

Abstract

Abstract Introduction The impact of pregnancy on sleep quality and sleep-breathing is of interest due to concerns of an impact on maternal, intra-uterine and neonatal health. The Sleep Disordered Breathing (SDB) sub-study of the Nulliparous Pregnancy Outcomes Study (NuMoM2b) provided a large cohort of single gestational women who underwent home sleep apnea testing (HSAT) to evaluate for SDB. To evaluate changes in sleep during pregnancy, we utilized publicly available data from http://www.sleepdata.org for cardiopulmonary coupling (CPC) analysis to evaluate SDB, as well as sleep duration and quality. No outcomes data is currently available. Methods Standardized Level 3 HSAT was performed after visit 1 (V1), (6–15 weeks’ gestation) and visit 3 (V3), (22 -31 weeks’ gestation) on 3702 women from the NuMoM2b cohort. CPC-analysis was performed using clinically validated algorithms based on CPC-method using ECG and oxygen saturation data (SpO2) as the input signals. SleepImage Apnea Hypopnea Index (sAHI) was calculated to evaluate for SDB (FDA; 182618). Additional calculations to determine sleep latency, sleep duration, wake after sleep onset, and sleep quality (SQI) were performed. The SQI-metric incorporates measures of sleep stability and instability and is then presented on a scale of 0 – 100 where a higher number is desirable. Results 3,261 & 2,511 participants had data at visits 1 & 3, respectively. A total of 3,012 and 2,332 individuals had ECG data of sufficient quality. The mean age of the analyzed cohort was 27 years old. SDB events were overall low, but significantly increased across visits, sAHI [(1.6 ± 2.5)/hour (V1) vs (2.9 ± 4.1) (V3)], p< 0.001. There was a statistically significant increase in sleep latency [7.4 ± 12.7 (V1) vs 18.7 ± 27.8 (V3)], p< 0.001 and reduction in total sleep time [401.2 ± 85.6 (V1) vs 348.5 ± 79.3 (V3)], p< 0.001. Most notably, there was a >10% reduction in the SQI, indicative of increased unstable, fragmented sleep as pregnancy progressed [72.1 ± 13.8 (V1), 60.5 ± 16.2 (V3)], p < 0.001. Conclusion Using objective measures based on CPC analysis from HSAT derived signals, sleep disordered breathing, sleep duration and sleep quality are all adversely impacted as gestation progresses. Support (if any):