Mariko Maxwell1, Laura Sanapo2,3, Kristina Monteiro1, Maggie Bublitz2,3,4, Ashanti Avalos2, Naya Habr2, Ghada Bourjeily2,3. 1. Warren Alpert School of Medicine at Brown University, Providence, Rhode Island. 2. Women's Medicine Collaborative, The Miriam Hospital, Providence, Rhode Island. 3. Department of Medicine, Warren Alpert Medical School at Brown University, Providence, Rhode Island. 4. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Abstract
STUDY OBJECTIVES: Women with sleep-disordered breathing (SDB) in pregnancy are at a greater risk of developing serious adverse perinatal outcomes. However, the pathogenesis of SDB in pregnancy is poorly understood. As nasal congestion is common in pregnancy, nasal obstruction may contribute to SDB in this population. This study aims to assess the impact of nasal dilator strips (NDS) on measures of SDB and their potential for use as a placebo condition. METHODS: Pregnant women ≥ 18 years old, body mass index ≥ 27 kg/m2, and habitual snoring were enrolled. Participants completed 2 consecutive level III home sleep apnea tests and used NDS during the second test. Objective measures including respiratory event index and pulse transit time drop index, a measure of increased arterial stiffness, were compared across tests. Subjective assessments of participants' perceived impact of NDS use was also obtained. RESULTS: 54 women, 59% White, 60% in the third trimester were enrolled. Median time between the 2 studies was 1 day (interquartile range [IQR] 4). There was no significant change between the night without NDS use and the night with NDS use in respiratory event index (5.30 [IQR 6.20] vs 4.80 [IQR 6.78], P = .8) or pulse transit time drop index (6.8 [IQR 13.3] vs 6.6 [IQR 15.8], P = .360). Subjective measures of sleep did not differ between the 2 nights. CONCLUSIONS: Despite the high prevalence of pregnancy-associated rhinitis, NDS do not have a significant impact on measures of SDB. Results from this study support the use of NDS as an appropriate placebo in prenatal clinical trials. CITATION: Maxwell M, Sanapo L, Monteiro K, et al. Impact of nasal dilator strips on measures of sleep-disordered breathing in pregnancy. J Clin Sleep Med. 2022;18(2):477-483.
STUDY OBJECTIVES: Women with sleep-disordered breathing (SDB) in pregnancy are at a greater risk of developing serious adverse perinatal outcomes. However, the pathogenesis of SDB in pregnancy is poorly understood. As nasal congestion is common in pregnancy, nasal obstruction may contribute to SDB in this population. This study aims to assess the impact of nasal dilator strips (NDS) on measures of SDB and their potential for use as a placebo condition. METHODS: Pregnant women ≥ 18 years old, body mass index ≥ 27 kg/m2, and habitual snoring were enrolled. Participants completed 2 consecutive level III home sleep apnea tests and used NDS during the second test. Objective measures including respiratory event index and pulse transit time drop index, a measure of increased arterial stiffness, were compared across tests. Subjective assessments of participants' perceived impact of NDS use was also obtained. RESULTS: 54 women, 59% White, 60% in the third trimester were enrolled. Median time between the 2 studies was 1 day (interquartile range [IQR] 4). There was no significant change between the night without NDS use and the night with NDS use in respiratory event index (5.30 [IQR 6.20] vs 4.80 [IQR 6.78], P = .8) or pulse transit time drop index (6.8 [IQR 13.3] vs 6.6 [IQR 15.8], P = .360). Subjective measures of sleep did not differ between the 2 nights. CONCLUSIONS: Despite the high prevalence of pregnancy-associated rhinitis, NDS do not have a significant impact on measures of SDB. Results from this study support the use of NDS as an appropriate placebo in prenatal clinical trials. CITATION: Maxwell M, Sanapo L, Monteiro K, et al. Impact of nasal dilator strips on measures of sleep-disordered breathing in pregnancy. J Clin Sleep Med. 2022;18(2):477-483.
Authors: Francesca L Facco; William A Grobman; Kathryn J Reid; Corette B Parker; Shannon M Hunter; Robert M Silver; Robert C Basner; George R Saade; Grace W Pien; Shalini Manchanda; Judette M Louis; Chia-Ling Nhan-Chang; Judith H Chung; Deborah A Wing; Hyagriv N Simhan; David M Haas; Jay Iams; Samuel Parry; Phyllis C Zee Journal: Am J Obstet Gynecol Date: 2017-06-07 Impact factor: 8.661
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