Sleep in multiple pregnancy: Breathing patterns, oxygenation, and periodic leg movements☆,☆☆,★
Section snippets
SUBJECTS AND METHODS
We studied nocturnal breathing patterns and oxygenation in 10 mothers (26 to 39 years old) with multiple pregnancies at 30 to 36 gestational weeks. Eight of the mothers had twins, one had triplets, and one had quadruplets. All the women were healthy and none of them smoked or used alcohol or drugs during pregnancy. The body mass index before pregnancy was normal in nine subjects (mean 22.3 kg/m2, range 19.4 to 24.4 kg/m2) and slightly elevated in one (28.4 kg/m2).
Questionnaires were used
RESULTS
None of the subjects reported sleep disturbances before pregnancy. In all mothers the general sleep quality had been worsened by pregnancy. During the study night 4 women reported poor or very poor sleep, whereas the remaining 6 slept reasonably well. Still, 8 mothers considered their sleep quality worse in the laboratory than lately at home. All 10 mothers woke up several times during the night for reasons such as numbness of feet or hands, restless legs, need of urination, sweating, fetal
COMMENT
We found that in multiple pregnancy sleep apnea was rare and oxygenation well preserved throughout the night. The physical effects of the enlarging uterus lead to displacement of the lungs and tracheobronchial tree and result in an increase in upper airway resistance. These effects are accentuated in the lying position and further by sleep state through depression of the ventilatory responses to hypoxia and hypercapnia. We therefore suspected that mothers with a particularly large uterus (i.e.,
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Cited by (50)
Upper-airway flow limitation and transcutaneous carbon dioxide during sleep in normal pregnancy
2017, Sleep MedicineCitation Excerpt :Pregnancy is a challenge for the cardiorespiratory system, particularly during sleep when the body needs to rest without compromising fetal oxygen supply and carbon dioxide removal. In normal pregnancy, breathing during sleep is well preserved [1]. Plasma concentrations of progesterone are elevated during pregnancy and contribute to the increased ventilatory responses to hypoxia [2] and hypercapnia [3].
Sleep in Women
2012, Therapy in Sleep MedicineSleep-disordered Breathing in Pregnancy
2011, Clinics in Chest MedicineCitation Excerpt :REM sleep seems to be reduced in pregnancy.17 Some studies have shown no oxygen desaturation during sleep in normal pregnant women,64,65 whereas others suggest significant desaturations.66,67 Circulating levels of progesterone increase very early in gestation.
Sleep Disturbances and Sleep-Related Disorders in Pregnancy
2010, Principles and Practice of Sleep Medicine: Fifth Edition
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From the Departments of Obstetrics and Gynecology,aClinical Neurophysiology,band Physiology and the Diseases of the Chest,cTurku University Central Hospital.
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Reprint requests: Eeva Nikkola, BM, Department of Obstetrics and Gynecology, University of Turku, Kiinamyllynkatu 4-8, FIN-20520 Turku, Finland.
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0002-9378/96 $5.00 + 0 6/1/70418