Miscarriages & Heart Disease, From Sleep Apnea?

If you’ve been following my blog, I alluded to how infertility and miscarriages can be aggravated by obstructive sleep apnea or upper airway resistance syndrome. A recent study showed that having 3 miscarriages increases your chances of having heart disease by over 5 times normal.

If you think about the physiology, it makes sense: Breathing pauses during sleep, whether or not it’s an apnea, can cause a physiologic state of stress. In other words, you’ll have too much adrenaline, which you need to fight or run from danger. It’s also common knowledge that if you’re in a fight or flight situation, the last thing you need to do is to reproduce. Physiologically, stress has a way of diminishing or reducing nervous innervation and blood flow to your reproductive organs and digestive system (as well as your skin, hands and feet).

Since people with obstructive sleep apnea or upper airway resistance syndrome have narrowed upper airways, it’s not surprising that women who have frequent miscarriages can develop heart disease later on in life. Every time I see a patient that has a history of miscarriages or infertility, I see the same upper airway anatomy: small jaws and narrowed space behind the tongue. Most will not be able to sleep on their backs, have either cold hands or feet, or suffer from various gastrointestinal problems.

How many women with sleep apnea who are reading this blog had a miscarriage or infertility issues?

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18 thoughts on “Miscarriages & Heart Disease, From Sleep Apnea?

  1. My wife had three early term miscarriages and two successful pregnancies and has sleep apnea. We have never thought about a connection.

  2. I had cold hands during teenage and young adult period for many years…snore and sleep longer than usual and foggy head at times….but was rather skinny during those days. Gone for deviate septum surgery twice. Later gained weight and apnea was worst until almost disaster happened. under cpap treatment for last 2.5 years. now more clear thinker and sexual capability improves. UARS couples with Apnea can be challenging. BMI once above 25 apnea goes higher relatively besides seasonal adjustment from winter to spring. For pregnant women I suspect same principles and logic applies. OXYGEN!


  3. The most common cause of infertility is PCOS–metabolically we are talking about Syndrome X. So it’s no big surprise that many women who are infertile go on to develop heart disease later in life and also may have OSA.

    BTW, don’t assume that all women with PCOS are obese, or that obesity causes PCOS. A certain number of people develop PCOS-like symptoms due to weight gain, but many more start having the symptoms long before the weight gain. I’m someone who had severe PCOS when I weighed 100 lbs soaking wet. The obesity and OSA came long afterward.

  4. Janknitz,

    More recently, doctors are describing Syndrome Z, which is Syndrome X plus obstructive sleep apnea. We also know that even young, thin women who don’t snore can have obstructive sleep apnea. PCOS is also strongly linked to obstructive sleep apnea. Poor sleep is known to cause weight gain. Since sleep apnea is a craniofacial problem which begins in early childhood, my opinion is that it was there long before PCOS.

  5. I have had 3 consecutive miscarriages. The doctors say I am perfectly healthy but I have a suspected Protein S deficiency. This means I might have a tendancy to have thicker blood, which can increase chances Deep Vein Thrombosis and of blood clots that can lead to miscarriages around 6-8 weeks, which is when I have miscarried in all 3 cases. Its only suspected because the values despite numerous tests are not quite not low enough to confirm it.

    I often have trouble sleeping I feel like I will run out of breath, although I also have this feeling during the day too. I went to an ear, nose and throat doc yesterday, he told me that I have an extremely small space in my nose to breathe, and the same in my mouth. We are still doing test to find out if i have sleep apnea. I am so pleased about this discovery because, I wont have to keep feeling like I am suffocating. They can give me something to widen the space and they can also if that does not work increase the space with laser.

    But now I started thinking, does this have something to do with my miscarriages.

    I really hope you right back soon with some info. I have been surprised how many women are asking similar questions in forums and how little info is available on this.

    Any ideas Doctor Steven?

  6. TP,

    Thanks for posting. Hopefully you’ll get the appropriate treatment from your doctors once your results come in. It’s also important to know that obstructive sleep apnea independently causes your blood to be thickened. Good luck.

  7. I have had 4 miscarriages and have always had an incredibly difficult time sleeping. I suffer from contant dreaming, sleep paralysis, and chronic fatigue when waking up. Cold hands, etc.

    Never made a connection. Will definitely be having a sleep study and see what the doctors have to say.

  8. Janine,

    Good luck with your sleep test. It’s important to realize that the sleep study may not show you have official sleep apnea, but you can still stop breathing multiple times every hour. This is called upper airway resistance syndrome. I’ve written extensively on this condition.

    Knowing what we know, sleep problems should be addressed routinely in every woman with fertility issues.

  9. I have OSA and have had two miscarriages at around 10 weeks. I have also had two healthy children, both needed c-section because of pre eclampsia. Interesting..I always wondered if there was a connection- It makes sense to me. Why isn’t there more research on this subject?

  10. Lisa,

    Sorry to hear about your miscarriages. I’m happy for you that you were able to have 2 healthy children. OB/GYNs are well aware of the link, but are overwhelmed with so many other issues that screening for OSA does not seem to be a priority. The other problem is that many women with narrowed airways and obstructed breathing won’t have obstructive sleep apnea on testing, since the pauses last shorter than 10 seconds. I’m working on these issues the the OBs in my hospital.

  11. Dr. Park,

    Thank you so much for posting this article! I, too, have experienced 3 consecutive miscarriages, and diagnosed with “unexplained secondary infertility” at the ripe old age of 28. As a slendar 34 year old woman who does not snore, I was plagued with years of debilitating fatigue. It took years and countless doctors to finally receive a diagnosis of sleep apnea. I believe firmly there is likely a connection between infertility and undiagnosed, untreated sleep apnea, and have been surprised to the lack of studies on this correlation.

    Thank you for bringing his issue into light.

    Laura Dover

  12. Hi Doctor

    I had 1 missed miscarriage at age 31 at wk 6, one abortion voluntary at age 34 and a recent missed miscarriage at age 36 at wk 6/7. I don’t know what’s wrong with me… I was diagnosed with Apnea and was on the CPAP at wk 5 of my pregnancy. As I’m dealing with both pregnancy and the mask at the same time, it took me a week or so to finally find the right fit (now using the nasal pillow mask) and get to have some quality sleep as my pregnancy “progresses”.

    However, despite wearing the mask every night I often fell asleep on the bed / sofa after lunch for like a short 30mins to 1.5hrs nap without the mask. On my 8wk scan, it was found the baby did not develop much after my 6wk scan, no heartbeat and there was blood inside me.

    I wonder…. is it because of me not using the mask during the naps and caused the miscarriage? Or is it because I didn’t use the mask earlier? What are the chances moving forward? Really confused… really don’t wish for another miscarriage….

  13. Anymore info on this? I am currently pregnant(barely), already diagnosed with OSA and use a cpap. I have two healthy kiddos and inhvr had two early losses and one loss at 21 weeks. I also have PCOS, incompetent cervix, and ALWAYS struggle with pre term labor. It doesn’t matter what med I take, or how long i lay down, or how much water I drink I always contract starting around 15 weeks until I deliver. I have always delivered early around 34 weeks. I am interested to see what difference the CPAP makes this time around as I was not diagnosed with OSA until my youngest was over a year old and after several doctors had pushed me aside.

  14. Ms. Menold,

    Thanks for sharing your story. Please keep us up to date on your progress with your current pregnancy.

    Good luck…

  15. Wai,

    I’m so sorry to hear. It’s difficult to say one way or another. The only way to more definitely answer this question is for doctors to perform large-scale studies on high-risk pregnancies to see if CPAP makes a significant difference.

  16. I had five miscarriages and one ectopic. I have sleep apnea. Back then the medical professionals weren’t alert to it but my husband would lie awake at night waiting for me to take my next breath. Now I’m reading the novel “Where Are You, Bernadette?” and it seems quite apparent that the heroine Bernadette, who had many miscarriages, also has sleep apnea. It makes way to much sense that if the mother isn’t getting enough oxygen, that the unborn baby would suffer even more.

  17. I have had 1 healthy full term baby and 5 consecutive miscarriages following. I also have sleep apnea and no other known health issues or known reasons for the miscarriages.