A recent study has pointed out the considerable risk of cardiac dysfunction in women with obstructive sleep apnea and cardiac symptoms.
The use of echocardiograms should be considered in the clinical management of these women.
OSA is characterized by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. These pauses can last from at least ten seconds to minutes, and may occur five to 30 times or more an hour; this can lead to cardiovascular disease. The objective of the trial was to measure the incidence of OSA among pregnant and reproductive women.
The cohort was made up of 1,265 women between the ages of 15-45 who met the Apnea-Hypopnea Index (AHI) criteria for OSA based on nocturnal Polysomnogram testing. Data was gathered from 2005-2012 at a tertiary care center. Sleep lab data and individual transthoracic echocardiogram reports were reviewed.
"As obesity rates increase among reproductive age women, the frequency of obstructive sleep apnea and cardiovascular disease in pregnancy is anticipated to rise. The increased hemodynamic demands of pregnancy can cause women with underlying cardiac disease to decompensate," said Laura K.P. Vricella, MD, fellow, Maternal-Fetal Medicine at MetroHealth Medical Center.
"We found a 31 percent incidence of abnormal echocardiograms among symptomatic women with obstructive sleep apnea. Further investigation is needed to understand the relationship between obstructive sleep apnea and cardiovascular disease and their impact on pregnant women."
The results for the 1,265 women were broken into three categories of AHI:
- 665 (53%) mild
- 305 (24%) moderate
- 295 (23%) severe
Those with mild and severe AHI were similar in age, race and Body Mass Index.
Research revealed that women who all had cardiac symptoms had a 31 percent incidence of cardiac dysfunction. It was determined than an echocardiogram should be considered during the clinical management of these women.