Saim Mahmood Khan, MBBS; Jawairya Muhammad Hussain, MBBS; Iman Azam, MBBS
WMJ. 2024;123(5):338.
We recently reviewed the article “Are Symptoms of Obstructive Sleep Apnea During Pregnancy Associated With Autism Spectrum Disorder in Children: A Case-Control Study” by Nick et al1 with great interest. Obstructive sleep apnea (OSA) is a common and serious condition. While treatments like continuous positive airway pressure (CPAP) and mandibular advancement splints are effective, many patients struggle with adherence.2
The study offers valuable insights into OSA but could be strengthened by exploring neuroinflammation in offspring due to gestational OSA and the sex-specific effects on children. These areas hold potential for uncovering new pathways and biomarkers, paving the way for more targeted treatments. Notably, a recent study revealed an increased soluble vascular endothelial growth factor receptor 1/PlGF ratio and reduced levels of pregnancy-associated plasma protein A in individuals with sleep disorder breathing, after adjusting for key factors.3
The study by Nick et al relied on self-reported symptoms and medical history rather than objective sleep testing, which may have influenced the findings. Previous research shows that increased daytime drowsiness is common during pregnancy, so this factor could affect results.4 While somnolence is not always a reliable indicator of severe sleep disorders in pregnancy, exploring more clinical markers could enhance the understanding of OSA’s impact. Including confounding factors, such as maternal health and social circumstances, in future studies would provide a more comprehensive analysis.5
REFERENCES
- Nick J, Seaborg K, Kastner K, Bazalakova M, Antony K. Are Symptoms of Obstructive Sleep Apnea During Pregnancy Associated With Autism Spectrum Disorder in Children: A Case-Control Study. WMJ. 2024;123(1):18-23.
- Carney AS, Antic NA, Catcheside PG, et al. Sleep apnea multilevel surgery (SAMS) trial protocol: a multicenter randomized clinical trial of upper airway surgery for patients with obstructive sleep apnea who have failed continuous positive airway pressure. Sleep. 2019;42(6):zsz056. doi:10.1093/sleep/zsz056
- Onslow ML, Wolsk J, Wisniewski S, et al. The association between sleep-disordered breathing and maternal endothelial and metabolic markers in pregnancies complicated by obesity. J Clin Sleep Med. 2023;19(1):97-109. doi:10.5664/jcsm.10254
- Pien GW, Pack AI, Jackson N, Maislin G, Macones GA, Schwab RJ. Risk factors for sleep-disordered breathing in pregnancy. Thorax. 2014;69(4):371-377. doi:10.1136/thoraxjnl-2012-202718
- Köseoğlu Hİ, İnanır A, Kanbay A, et al. Is there a link between obstructive sleep apnea syndrome and fibromyalgia syndrome?. Turk Thorac J. 2017;18(2):40-46. doi:10.5152/TurkThoracJ.2017.16036