Why This Sleep Disorder May Increase Miscarriage Risk
Sleep has a big influence on our reproductive health; sleep deprivation has been linked to sexual dysfunction, insomnia has been found to have a negative effect on fertility, and sleep apnea has been associated with low testosterone and erectile dysfunction.
Could sleep influence the outcome of your pregnancy, too? Research published in the journal Medical Hypotheses in 2014 set out to determine whether sleep-disordered breathing can contribute to miscarriage risk, and why.** The dangers of obstructive sleep apnea**
Obstructive sleep apnea (OSA) is a form of sleep-disordered breathing. It occurs when the upper airway collapses during sleep, leading to fragmented sleep and reduced oxygen in the blood.
Researchers performed a retrospective chart review to determine whether sleep-disordered breathing was associated with a higher risk of miscarriage.
The charts of 147 women were evaluated. All the women were under 50 years old, had a history of at least one pregnancy, and had been admitted to the Sleep Disorders Clinic at the Royal Ottawa Mental Health Center in Canada between 2007 and 2012.
The severity of sleep-disordered breathing was measured using the apnea hypopnea index (AHI) and respiratory disturbance index (RDI).
Researchers found that although both sleep-disordered breathing (as determined by AHI scores) and body mass index were significant predictors of miscarriage, sleep-disordered breathing may have the strongest influence on miscarriage risk.
Why does this link exist?It's important to note that this study did not (and could not) demonstrate a causal effect, as that would require a prospective study.
However, the association between sleep-disordered breathing and miscarriage risk may be down to the fact that sleep deprivation appears to have a negative effect on the production of estrogen and other fertility-related hormones.
Furthermore, both OSA and sleep-disordered breathing have been linked to pregnancy complications; OSA in pregnant women has been linked to gestational hypertension and higher rates of caesarean section, whilst sleep-disordered breathing has been linked to a higher risk for preeclampsia and gestational diabetes.
Finally, the decrease in oxygen levels in the blood — the result of the breathing interruptions associated with obstructive sleep apnea — can lead to inflammation, which also has been linked to negative pregnancy outcomes.
How to reduce the risk
The best way to reduce possible risk for miscarriage is through early diagnosis and treatment of sleep-disordered breathing.
This requires a better understanding of the potential differences in symptoms of sleep-disordered breathing in women compared to men, and an awareness that some forms of sleep-disordered breathing (such as upper airway resistance syndrome) are not always associated with being overweight or obese.
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Martin is the creator of Insomnia Land’s free sleep training for insomnia. His online course uses CBT for insomnia techniques to help participants fall asleep and stay asleep. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.