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Inspiratory flow limitation during sleep in pre-eclampsia: comparison with normal pregnant and nonpregnant women

¹ Depts of Obstetrics and Gynaecology, Rotunda Hospital, and ² The Respiratory Sleep Disorders Unit, St. Vincent's University Hospital, Dublin, Ireland

CORRESPONDENCE: W.T. McNicholas, Dept of Respiratory Medicine, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland. Fax: 353 12697949

Keywords: hypertension, inspiratory flow limitation, pre-eclampsia, pregnancy, sleep apnoea

Received: June 16, 2000
Accepted April 4, 2001

Self-reported snoring is common in pregnancy, particularly in females with pre-eclampsia. The prevalence of inspiratory flow limitation during sleep in pre-eclamptic females was objectively assessed and compared with normal pregnant and nonpregnant females.

Fifteen females with pre-eclampsia were compared to 15 females from each of the three trimesters of pregnancy, as well as to 15 matched nonpregnant control females (total study population, 75 subjects). All subjects had overnight monitoring of respiration, oxygen saturation, and blood pressure (BP).

No group had evidence of a clinically significant sleep apnoea syndrome, but patients with pre-eclampsia spent substantially more time (31±8.4% of sleep period time, mean±sd) with evidence of inspiratory flow limitation compared to 15.5±2.3% in third trimester subjects and <5% in the other three groups (p=0.001). In the majority of pre-eclamptics, the pattern of flow limitation was of prolonged episodes lasting several minutes without associated oxygen desaturation. As expected, systolic and diastolic BPs were significantly higher in the pre-eclamptic group (p<0.001), but all groups showed a significant fall (p0.05) in BP during sleep.

Inspiratory flow limitation is common during sleep in patients with pre-eclampsia, which may have implications for the pathophysiology and treatment of this disorder.