Sleep-disordered breathing in pregnancy: a review of the physiology and potential role for positional therapy

Abstract

Sleep disordered breathing (SDB) has been shown to be associated with negative clinical sequelae such as systemic hypertension and cardiovascular disease. It has been reported in the literature that approximately 53-56 % of patients with obstructive sleep apnea (OSA) have positional OSA, known as POSA. These findings have led to a resurgence of positional therapy as an effective treatment for select patients with SDB. Pregnant patients can also be diagnosed with SDB, the negative consequences of which not only pertain to the patient but to the unborn fetus as well. Despite this, however, SDB is under-diagnosed in pregnant patients and research looking at SDB in pregnant patients and potential therapies are scarce. This article reviews the literature regarding the physiologic respiratory changes that occur during pregnancy, SDB in pregnancy, supine hypotensive syndrome (SHS), complications and current treatments for these events and potential roles for positional therapy in pregnant women whose problems may be specifically position dependent.