title: Is sleep-disordered breathing associated with miscarriages? An emerging hypothesis.
abstract: Sleep-disordered breathing (SDB) is a common disorder that has numerous medical consequences including cardiovascular morbidity. The clinical presentation in women is frequently vague, leading to its under-recognition in this population. Sleep is known to influence several female hormonal cycles including estrogen, progesterone, prolactin, luteinizing hormone (LH), and follicle stimulating hormone (FSH); consequently, sleep disruption may have adverse effects on female health including pregnancy. Miscarriage, defined as the loss of a pregnancy in the first trimester, occurs in one in four pregnancies; in up to half of cases, the cause may be unknown. Risk factors for miscarriage include increased age, increased weight, and a history of polycystic ovarian syndrome, all of which are also risk factors for SDB. Since SDB is frequently accompanied by sleep fragmentation and intermittent hypoxemia, we speculate that these factors may contribute to miscarriage risk. If this is the case, then treatment of SDB may be a possible intervention for subsequent pregnancies.
authors.affiliation: Sleep Disorders Clinic, Royal Ottawa Mental Health Center (ROMHC), Ottawa, ON, Canada; University of Ottawa Institute for Mental Health Research (Same Building as ROMHC), 1145 Carling Avenue, Ottawa, ON K1Z7K4, Canada. Electronic address: Elliott.lee@theroyal.ca.
authors.forename: Elliott Kyung
authors.initials: EK
authors.lastname: Lee
authors.affiliation: Sleep Disorders Clinic, Royal Ottawa Mental Health Center (ROMHC), Ottawa, ON, Canada; University of Ottawa Institute for Mental Health Research (Same Building as ROMHC), 1145 Carling Avenue, Ottawa, ON K1Z7K4, Canada.
authors.forename: Spencer Thomas
authors.initials: ST
authors.lastname: Gutcher
authors.affiliation: Sleep Disorders Clinic, Royal Ottawa Mental Health Center (ROMHC), Ottawa, ON, Canada; University of Ottawa Institute for Mental Health Research (Same Building as ROMHC), 1145 Carling Avenue, Ottawa, ON K1Z7K4, Canada.
authors.forename: Alan Bruce
authors.initials: AB
authors.lastname: Douglass
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology*; D005260:Female; D006801:Humans; D008962:Models, Theoretical; D016012:Poisson Distribution; D011247:Pregnancy; D011248:Pregnancy Complications; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000150:complications*; D020181:Sleep Apnea, Obstructive / Q000150:complications