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Copyright ©ERS Journals Ltd 2006
Pre-eclampsia is associated with sleep-disordered breathing and endothelial dysfunction
1 Sleep laboratory, and 2 Dept of Obstetrics and Gynecology, Rambam Medical Center and Technion - Israel Institute of Technology, Haifa, Israel, 3 Sleep Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
CORRESPONDENCE: G. Pillar, Sleep Lab, Rambam Medical Center, Haifa 31096, Israel. Fax: 972 48537404. E-mail: gpillar{at}tx.technion.ac.il
Keywords: Endothelial dysfunction, hypertension, pre-eclampsia, sleep-disordered breathing
Received: January 31, 2005
Accepted September 28, 2005
Pre-eclamptic toxaemia (PET) may be associated with both endothelial dysfunction (ED) and sleep-disordered breathing (SDB). It was hypothesised that females with PET would demonstrate both SDB and ED, and that a correlation between these two would suggest a potential causative association.
A total of 17 females with PET and 25 matched females with uncomplicated pregnancy were studied. They underwent a nocturnal ambulatory sleep study (using Watch_PAT100) and noninvasive evaluation of endothelial function utilising the reactive hyperaemia test (using Endo_PAT 2000). A higher ratio of post- to pre-occlusion pulse-wave amplitude (endothelial function index (EFI)) indicated better endothelial function.
Females with PET had a significantly higher respiratory disturbance index (RDI) and lower EFI than controls (18.4±8.4 versus 8.3±1.3·h–1, and 1.5±0.1 versus 1.8±0.1, respectively). Blood pressure significantly correlated with RDI and with EFI. EFI tended to correlate with RDI.
In conclusion, these results suggest that both sleep-disordered breathing and endothelial dysfunction are more likely to occur in females with pre-eclamptic toxaemia than in females with uncomplicated pregnancies. The current authors speculate that respiratory disturbances contribute to the functional abnormality of the blood vessels seen in females with pre-eclamptic toxaemia, although causality cannot be determined based on this study.
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