Use of CPAP increases fetal movement during sleep

Researchers have found a possible link between sleep-disordered breathing and reduced fetal movements in pregnant women with preeclampsia. An article published in the January 2013 issue of the journal Sleep details the results of a study of patients with preeclampsia who received nasal continuous positive airway pressure (CPAP).

The researchers hypothesized that sleep-disordered breathing “may link preeclampsia with reduced fetal movements (a marker of fetal health), and that treatment of sleep disordered breathing might improve fetal activity during sleep.”

To test the hypothesis, fetal movement was measured overnight with concurrent polysomnography in 20 patients with preeclampsia and 20 control subjects during the third trimester of pregnancy. In 10 additional patients with preeclampsia, polysomnography and fetal monitoring were done simultaneously during a control night and a night of nasal CPAP.

The researchers found that women with preeclampsia had inspiratory flow limitation and an increased number of oxygen desaturations during sleep (P=0.008), particularly during REM sleep. Preeclampsia was associated with a reduced number of total fetal movements overnight (319 [SD 32]) versus controls (689 [SD 160], P <0.0001) and a change in fetal movement patterns. The number of fetal hiccups was also substantially reduced in preeclampsia subjects (P <0.0001). Treatment with CPAP increased the number of fetal movements and hiccups (P<0.0001 and P =0.0002, respectively).

"Maternal [sleep-disordered breathing] represents a unique opportunity to study the effect of in utero exposures on postnatal development and future risk. This has major implications for public health," wrote Louise M. O'Brien, PhD, MS, an associate professor at the University of Michigan, in a commentary on the study. "It raises the possibility that a simple, noninvasive therapy for [sleep-disordered breathing] may improve fetal well-being."