Predictors of de novo development of obstructive sleep apnea in pregnancy

项目摘要 睡眠呼吸障碍在怀孕人群中更为常见；然而，目前还没有 到目前为止，已经评估了这种疾病怀孕开始发展的特定预测因素的研究。它是 有可能，随着怀孕生理的暴露，具有特定表型的女性更有可能 导致阻塞性睡眠呼吸暂停。 该项目的目的是：1)评估女性的人体测量和身体成分变量 妊娠早期无阻塞性睡眠呼吸暂停；2)检查生理和生物指标 妊娠期新发阻塞性睡眠呼吸暂停的纵向及相关变化； 3)探讨阻塞性睡眠呼吸暂停的发病机制中，鼻端液体移位的作用。 这项研究将招募肥胖孕妇。参与者将对身体进行测量 成分、相关人体测量、生物标记物--如女性激素、脂肪因子 和炎症标志物-肺功能测试和上呼吸道通畅度测量，随后是 家庭睡眠呼吸暂停测试。患有阻塞性睡眠呼吸暂停的女性将与没有的女性进行比较。 没有睡眠呼吸暂停的女性随后将被纵向追踪，以发展为阻塞性睡眠。 妊娠期间通过重复家庭睡眠呼吸暂停测试。早期妊娠的措施和变化 妊娠期的这些措施将被评估为新发阻塞性睡眠呼吸暂停和 阻塞性睡眠呼吸暂停与呼吸暂停低通气指数及其他多导睡眠监测指标的关系 从重复的居家睡眠研究中获得。这一目的将有助于识别特定的怀孕。 动态变化使一些女性有患阻塞性睡眠呼吸暂停的风险，而其他女性则不会 怀孕了。为了进一步了解睡眠中体液变化的作用，将邀请一组女性 在实验室内进行多导睡眠图测试，其中将测量腿围和颈围 除了评估从腿部流出的液体外，还可以获得。 从这项研究中获得的知识将帮助我们确定会使女性面临罹患癌症风险的因素 孕期发生新的阻塞性睡眠呼吸暂停为有针对性的筛查铺平道路 战略。这样的研究还将有助于确定有这些并发症风险的妇女 在干预性试验中被追踪。

Project Summary Sleep disordered breathing occurs more commonly in the pregnant population; however, there has been no research to date that has assessed specific predictors of pregnancy-onset development of this disorder. It is possible that, with the exposure to pregnancy physiology, women with a specific phenotype are more likely to develop obstructive sleep apnea. The aim of this project is to 1) assess anthropometric and body composition variables in women with and without obstructive sleep apnea in early pregnancy; 2) examine physiologic and biological measures longitudinally and relate changes to the development of new-onset obstructive sleep apnea in pregnancy; and 3) evaluate the role of rostral fluid shifts around sleep in the pathogenesis of obstructive sleep apnea. The study will enroll pregnant women with obesity. Participants will have measurements of body composition, relevant anthropometric measures, biological markers –such as female hormones, adipokines and inflammatory markers-, pulmonary function tests and upper airway patency measurements, followed by in-home sleep apnea testing. Women with obstructive sleep apnea will be compared to those without. Women without sleep apnea will then be followed longitudinally for the development of obstructive sleep apnea during pregnancy by repeat home sleep apnea testing. Early pregnancy measures and changes in these measures during gestation will be assessed as predictors of new onset obstructive sleep apnea and related to apnea hypopnea indices and other polysomnographic measures of obstructive sleep apnea obtained on repeat in-home sleep studies. This aim will facilitate the identification of specific pregnancy dynamic changes that predispose some women at risk, but not others, to develop obstructive sleep apnea in pregnancy. To further understand the role of fluid shifts during sleep, a subgroup of women will be invited to have an in-laboratory polysomnography test where measurement of leg and neck circumference will be obtained in addition to an assessment of fluid shifts from the lower extremities. The knowledge gained from this study will help us identify factors that would place a woman at risk for developing de novo obstructive sleep apnea during pregnancy paving the way for targeted screening strategies. Such research will also facilitate the identification of women at risk for these complications to be pursued in interventional trials.