Gestational obstructive sleep apnea

Biomarker screening models and lack of postpartum resolution

Linda Marie Street, Carol A. Aschenbrenner, Timothy T. Houle, Clark W. Pinyan, James C. Eisenach

Research output: Contribution to journalArticle

Abstract

Study Objectives: To measure prevalence and severity of third trimester obstructive sleep apnea and evaluate postpartum resolution. To assess a novel biomarker for screening for obstructive sleep apnea in pregnancy. Methods: This prospective observational study was performed at Wake Forest School of Medicine obstetrics clinics between April 2014 and December 2015. Fractional exhaled nitric oxide measurements and sleep studies were obtained and compared at 32 0/7 to 35 6/7 weeks gestation and postpartum. Exhaled nitric oxide and risk factors for the development of gestational sleep apnea were evaluated for predictive ability independently and in screening models. Results: Of 76 women enrolled, 73 performed valid sleep studies in pregnancy and 65 had an additional valid study 6 to 15 weeks postpartum. Twenty-four women (37%) had gestational sleep apnea compared with 23 (35%) with postpartum sleep apnea (P >.99). Eight of 11 women (73%) retested 6 to 8 months postpartum had persistent sleep apnea. Exhaled nitric oxide had moderate discrimination screening for sleep apnea in pregnancy (area under the receiver operating characteristic curve = 0.64). A model utilizing exhaled nitric oxide, pregnancy-specific screening, and Mallampati score improved ability to identify women at risk for gestational sleep apnea (sensitivity = 46%, specificity = 91% and likelihood ratio = 5.11, area under receiver operating characteristic curve = 0.75). Conclusions: Obstructive sleep apnea is common in the early postpartum period and often persisted at least 6 months. Exhaled nitric oxide as a sole biomarker to screen for sleep apnea in pregnancy has only modest discrimination. Combined with additional parameters sensitivity and specificity improved.

Original languageEnglish (US)
Pages (from-to)549-555
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume14
Issue number4
DOIs
StatePublished - Apr 15 2018

Fingerprint

Sleep Apnea Syndromes
Obstructive Sleep Apnea
Postpartum Period
Biomarkers
Nitric Oxide
Pregnancy
Aptitude
ROC Curve
Sleep
Sensitivity and Specificity
Third Pregnancy Trimester
Obstetrics
Observational Studies
Medicine
Prospective Studies

Keywords

  • Exhaled nitric oxide
  • Gestational obstructive sleep apnea
  • Postpartum
  • Pregnancy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Street, L. M., Aschenbrenner, C. A., Houle, T. T., Pinyan, C. W., & Eisenach, J. C. (2018). Gestational obstructive sleep apnea: Biomarker screening models and lack of postpartum resolution. Journal of Clinical Sleep Medicine, 14(4), 549-555. https://doi.org/10.5664/jcsm.7042

Gestational obstructive sleep apnea : Biomarker screening models and lack of postpartum resolution. / Street, Linda Marie; Aschenbrenner, Carol A.; Houle, Timothy T.; Pinyan, Clark W.; Eisenach, James C.

In: Journal of Clinical Sleep Medicine, Vol. 14, No. 4, 15.04.2018, p. 549-555.

Research output: Contribution to journalArticle

Street, Linda Marie ; Aschenbrenner, Carol A. ; Houle, Timothy T. ; Pinyan, Clark W. ; Eisenach, James C. / Gestational obstructive sleep apnea : Biomarker screening models and lack of postpartum resolution. In: Journal of Clinical Sleep Medicine. 2018 ; Vol. 14, No. 4. pp. 549-555.
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