Having an asthma attack in the middle of the night can be a frightening and terrifying experience. Typically, these attacks happen in the early morning hours, just before awakening.
Now there’s research showing that poorly controlled asthma during pregnancy can increase a woman’s chances of developing preeclampsia (50%) and premature births (25%). Furthermore, infants born to mothers with poorly controlled asthma delivered babies that were about 0.2 pounds less than those born to mothers without asthma.
We typically think of asthma being a separate, distinct condition from obstructive sleep apnea, and it’s treated in completely different ways. However, it’s not just coincidence that nocturnal awakenings from asthma and the most intense periods of apnea occur at the same time in the middle of the night—the early morning hours. The early morning hours are when REM sleep is most prominent, and this is the time when throat muscles are most relaxed. Having an apnea also is known to cause reflex, which is known to reach the throat as well as the nose and the lungs. In one small study in people with sleep apnea and asthma, treating sleep apnea with CPAP significantly improved nocturnal asthma symptoms.
We know that any degree of stress on the mother’s body can lead to a higher rate of pregnancy-related complications and low birth rates. Even snoring by the mother alone was found to result in lower Apgar scores in newborn infants. Apneas are also known to raise blood pressure and promote insulin resistance. Stress hormones are also known to increase when you have apneas.
In light of all these findings, it’s not surprising that pregnant women with poorly controlled asthma have higher complications rates. This is another great example of “connecting the dots” between two seemingly unrelated conditions, which only adds to support my sleep-breathing paradigm.