Title	Incidence Of OSA May Increase During Pregnancy
Clinical Question	In pregnant woman, does the incidence of OSA increase?
Clinical Bottom Line	Incidence of OSA could increase during pregnancy. Exact prevalence of OSA in pregnant women is unknown. There are no specific guidelines for screening pregnant women with OSA, but because there is an association between OSA and risk of gestational hypertension or preeclampsia some authors have proposed that pregnant women with excessive daytime sleepiness, loud snoring, and witnessed apneas should be evaluated for OSA with an overnight polysomnography.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 19264939 Venkata/2009 Literature review Key results Research studies that evaluated OSA during pregnancy were limited by small sample sizes, some were based on questionnaires and were limited by a lack of polysomnographic confirmation of OSA. Izci mentioned in 2005 that “Snoring and sleepiness increased in the 3rd trimester”, in a cross sectional study in 2006, Izci said “all measures of upper airway caliber were smaller in pregnant woman compare with postpartum”. 22108083 Facco/2011 Literature review Key results “Weight gain, edema, and hyperemia of pregnancy can affect the upper airway, narrowing and increasing airway resistance, which can lead to snoring and OSA”. Although subjective OSA symptoms have been well studied in pregnancy, more research needs to be performed to understand the epidemiology of this disorder in pregnancy. 22990656 Ralls/2012 Literature review Key results Ralls, 2012 “Menopause, pregnancy and polycystic ovarian syndrome increase the risk for OSA in women.” Rising levels of estrogen and progesterone in women during pregnancy increase the risk for snoring and OSA.
Evidence Search	obstructive sleep apnea and pregnancy
Comments on The Evidence	Exact prevalence of OSA in pregnant women is unknown. Although subjective OSA symptoms have been well studied in pregnancy, more research needs to be performed to understand the epidemiology of this disorder in pregnancy. Research studies that evaluated OSA during pregnancy were limited by small sample sizes, some were based on questionnaires and were limited by a lack of polysomnographic confirmation of OSA.
Applicability	Until we know more about the epidemiology of OSA in pregnancy and because there is an association between OSA and risk of gestational hypertension or preeclampsia, women with excessive daytime sleepiness, loud snoring, and witnessed apneas should be evaluated for OSA.
Specialty	(Public Health) (General Dentistry) (Oral Surgery) (Orthodontics) (Prosthodontics)
Keywords	OSA, obstructive sleep apnea, pregnancy, sleep disordered breathing.
ID#	2460
Date of submission	03/01/2013
E-mail	barbozaargue@uthscsa.edu
Author	Concepcion Barboza, DDS
Co-author(s)	Sarah Percy
Co-author(s) e-mail	percy@livemail.uthscsa.edu
Faculty mentor
Faculty mentor e-mail
Basic Science Rationale (Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) by Ryushiro Sugita, DDS (San Antonio, Texas) on 11/17/2015 A PubMed search on the incidence of OSA during pregnancy was performed Oct 2015. A more recent publication was found: Cai 2013, PubMed: 23132352. This cross sectional study including 1993 pregnant women and 598 non-pregnant women showed that the prevalence of sleep disorder-related symptoms in pregnant women was significantly higher than non-pregnant women( 56.1 vs. 29.9 %, P < 0.05).