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?