Pre-eclampsia is associated with marked alterations in sleep architecture.
OBJECTIVE
Pre-eclampsia is currently the predominant cause of maternal and fetal morbidity and mortality. Diurnal blood pressure variation is flattened or reversed in pre-eclampsia; however, sleep has not been extensively investigated in this disease. Our objective was therefore to study sleep architecture in this group of patients.


METHODS
Full polysomnography using the Compumedics Sleepwatch System or Compumedics p-series.


METHODS
NA.


METHODS
25 pre-eclamptic patients and 17 primigravidas with normal pregnancies and no history of cardiovascular disease or sleep disorder. With the exception of one subject, all pre-eclamptics were taking clonidine (a known suppressant of rapid eye movement-REM-sleep) for control of their hypertension.


METHODS
NA.


RESULTS
Pre-eclamptic subjects had markedly altered sleep architecture, with a markedly increased percentage of time spent in slow-wave sleep (SWS) (21 * 2% versus 43 * 3%, p<0.001). There was a longer latency to rapid eye movement (REM) sleep (92 * 11 mins vs. 205 * 23 mins in control and pre-eclamptic subjects, respectively, p<0.001) and reduced time spent in REM (18 * 1% and 10 * 2% in control and pre-eclamptic subjects, respectively, p<0.001).


CONCLUSIONS
While the increased REM latency and decreased REM time are most likely due to clonidine, this is unlikely to also account for the increased SWS. Two possible explanations for this include cerebral edema and release of cytokines, which are known to alter sleep structure.
Edwards
N
N
Dept. Medicine, The University of Sydney, NSW, Australia. ne@blackburn.med.usyd.edu.au
Blyton
C M
CM
Kesby
G J
GJ
Wilcox
I
I
Sullivan
C E
CE
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003000:Clonidine / Q000008:administration & dosage / Q000627:therapeutic use; D004569:Electroencephalography; D004585:Electrooculography; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D017286:Polysomnography; D011225:Pre-Eclampsia / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000175:diagnosis; D012895:Sleep, REM / Q000502:physiology
D000959:Antihypertensive Agents; D006830:Hydralazine; D003000:Clonidine