Preeclampsia Predicts Heart Disease—And Sleep Apnea Too?

In modern medicine, especially with specialization, we’ve segmented out most medical conditions, thinking that we’ve discovered a new leaf, when in fact we’ve missed the tree entirely. For example, preeclampsia is a dangerous condition that occurs in about 5% of pregnant women, or about 300,000 women per year. This condition leads to high blood pressure, kidney disease, and headaches, amongst others.

Since 99.9% of western medicine is based on studies that occur only in the daytime, it’s not surprising that sleep may be a common denominator amongst a variety of familiar medical conditions. For example, this study showed that women with preeclampsia had a 2-3 times increased risk of developing heart disease later on. It’s not too surprising, since obstructive sleep apnea can occur in pregnant women, especially as they gain weight. We know that rapid weight gain is a major risk for sleep apnea.

One protective aspect of pregnancy that I commonly write about is that progesterone increases significantly during pregnancy. Progesterone is a powerful upper airway muscle dilator as well as to respiratory stimulant. Sometimes the weight gain can overwhelm the protective effects of progesterone, and sleep-breathing problems can surface. In many cases obstructive sleep apnea can develop, but more often than not, the severity and duration of these breathing pauses won’t be long enough to be called apneas on formal sleep studies. Multiple obstructions and arousals that don’t qualify as apneas or hypopneas are seen in upper airway resistance syndrome.

We also know that untreated obstructive sleep apnea is strongly linked to increased risk of heart disease, heart attack and stroke. So the results of the study mentioned in the NY Times article is not too surprising. There’s plenty of research showing that preeclampsia can be effectively treated with CPAP, but this idea hasn’t caught on in mainstream obstetrics.

Of the women reading this who have obstructive sleep apnea, how many of you had preeclampsia if you were ever pregnant?

Please note: I reserve the right to delete comments that are offensive or off-topic.

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5 thoughts on “Preeclampsia Predicts Heart Disease—And Sleep Apnea Too?

  1. Hi Dr. Park,
    I had pre-eclampsia during my first pregnancy (most common in first-time mums), and was ordered to bed for the last two weeks of my pregnancy. I’m fairly certain that CPAPs were not routinely in use back in 1977 – and even if they were, there was virtually no awareness of any link between sleep breathing and complications of pregnancy like pre-eclampsia. Nor was there any awareness of the link between pre-eclampsia and subsequent heart disease, as studies like Dr. Graeme Smith of Queen’s University have shown.

    However, he maintains that pre-eclampsia doesn’t CAUSE heart disease – instead, it REVEALS it, comparing pregnancy to a “giant stress test”.

    When I did later have a massive heart attack, my cardiologists asked me if I were a smoker, or if I’d ever been diagnosed with diabetes, high cholesterol, or high blood pressure. Not one doctor asked if I’d ever had pre-eclampsia.

    While I believe that there is no one single causative factor for heart disease, it seems to make perfect sense to me that since all of our body functions work in complete partnership with every other bodily function, that an issue as serious as sleep health might impact heart health.

    Anecdotally, I can tell you that many of my fellow heart attack survivors are in fact being now treated for obstructive sleep apnea – but it’s AFTER THE FACT since their cardiac events took place.

    Thanks for this,
    Regards,
    C.

  2. PS: I have a question for you about pregnancy weight gain: since ALL women gain weight fairly rapidly during all pregnancies, why do you think some women develop obstructive sleep apnea while most don’t?

    Cheers,
    C.

  3. Most docs need more wider scopes of knowledge but many just treat when patients in crisis rather than pre-alert treatment for better health….genetic and trend setting for better health of individual maybe the way to go.

    cheers

  4. Carolyn;
    maybe most women DO develop a sleep breathing disorder during pregnancy, some OSA and some UARS, to one degree or another, such that only some develop more significant complications or end up being diagnosed. since we think that there is a large percentage of people who go undiagnosed with their OSA, probably that same percentage applies to pregnant women. there are stereotypes regarding the type of patient who would develop OSA that are outdated and there is insufficient awareness of sleep breathing disorders in medicine and in the general public.

  5. I had preeclampsia in 1986 & 1987. My first pregnancy was more severe – my daughter was delivered by crash C-section at 35 weeks when my placenta abrupted. I was told all my major organs were shutting down and I was in kidney failure. Needless to say, my second pregnancy was a complete surprise but under the care of an excellent doctor many complications were avoided. I’ve often wondered why the preeclampsia occurred. Your article caught my attention because I was diagnosed with severe sleep apnea about five years ago. My doctor believed I had been suffering from sleep apnea since childhood. Thank you for your enlightening article. My daughters are concerned that my history puts them at risk. Your information will help them.