Feinsilver S H, Hertz G
State University of New York, Stony Brook.
Clin Chest Med. 1992 Dec;13(4):637-44.
Several changes in maternal physiology may profoundly alter sleep, especially during late pregnancy. Any condition that causes maternal hypoxemia will be worsened during sleep, particularly in the supine position. Although high circulating levels of progesterone increase respiratory drive during sleep, in at least some women this protective mechanism is insufficient to prevent sleep-disordered breathing and hypoxemia. The true incidence of sleep-disordered breathing during pregnancy remains unknown. Although many women report sleep disturbance during pregnancy, those with severe snoring, observed irregular breathing with sleep, or excessive daytime somnolence should be referred for clinical polysomnography. With few data thus far available, nasal CPAP would appear to be the treatment of choice. Given the possible consequences of sleep apnea for fetal outcome, any significant sleep-disordered breathing is probably an indication for treatment.
孕期母体生理的一些变化可能会深刻改变睡眠，尤其是在妊娠晚期。任何导致母体低氧血症的情况在睡眠期间都会恶化，尤其是仰卧位时。尽管孕期循环中高浓度的孕酮会增加睡眠期间的呼吸驱动力，但至少对部分女性而言，这种保护机制不足以预防睡眠呼吸紊乱和低氧血症。孕期睡眠呼吸紊乱的真实发生率尚不清楚。尽管许多女性报告孕期有睡眠障碍，但对于那些严重打鼾、睡眠时观察到呼吸不规则或白天过度嗜睡的女性，应转诊进行临床多导睡眠监测。由于目前可用的数据很少，鼻持续气道正压通气（CPAP）似乎是首选治疗方法。鉴于睡眠呼吸暂停对胎儿结局可能产生的影响，任何明显的睡眠呼吸紊乱可能都是治疗的指征。
