SLEEP 2011 Abstract Supplement

B. Clinical Sleep Science XIII. Sleep and Gender
4-7 months, we hypothesized that significant levels of sleep disturbance
and fatigue would exist and that sleep disturbance and fatigue would be
positively associated with two measures of emotional status: depression
and parenting hassles.
Methods: Twenty-three mothers (M age=31.18 ± 3.86 years) of infants
(M age=5.22 ± .86 months) completed self-report measures assessing
fatigue (IFS), depressive symptoms (CES-D) and parenting hassles
(Parenting Daily Hassles Scale; PDH). Additionally, participants recorded
their sleep for one week using actigraphy and sleep diaries. Nonparametric
correlations were calculated to test associations between
variables.
Results: Average total nightly sleep time was 6 hours, 57 minutes and
average wake after sleep onset was 49 minutes; 61% reported clinically
significant symptoms of fatigue (IFS>30). Non-parametric correlations
revealed that fatigue was associated with depressive symptoms (.622,
p=.002). Less 24-hour total sleep time was associated with greater parenting
hassles (-.414, p=.055). Actigraph-derived sleep characteristics
and fatigue were not associated with frequency of infant night-time waking
(crying) or infant sleep onset latency.
Conclusion: High levels of maternal fatigue persist after the newborn
phase; fatigue is also a robust indicator of depressive symptoms. As both
depression and parenting hassles are related to sleep measures and can
impair mother-infant relationship quality, assessment of maternal sleep
and fatigue beyond the newborn period is warranted. From a public
health perspective, these findings are particularly relevant as this agerange
captures the stage when mothers are returning to work, requiring
adaptation within the mother-infant relationship while also creating
changes in sleep schedules and routines.
Support (If Any): Dr. Ronzio received support from the Research Advisory
Council, Children’s National Medical Center.
0939
COMPARISON OF LABORATORY POLYSOMNOGRAPHY
AND AN AMBULATORY SLEEP APNEA MONITOR FOR
DETECTING OBSTRUCTIVE SLEEP APNEA IN PREGNANT
WOMEN
Sharkey KM 1,2,4 , Millman RP 1,4 , Bourjeily G 1,3
1
Medicine, Alpert Medical School of Brown University, Providence,
RI, USA, 2 Psychiatry & Human Behavior, Alpert Medical School of
Brown University, Providence, RI, USA, 3 Medicine, Women & Infants
Hospital, Providence, RI, USA, 4 Medicine, Rhode Island Hospital,
Providence, RI, USA
Introduction: The purpose of this study was to validate a portable
recorder, the Apnea Risk Evaluation System (ARES) Unicorder (Watermark
Medical, FL), with polysomnography (PSG) for detecting
obstructive sleep apnea (OSA) in pregnancy. The ARES is validated
in non-pregnant adults, but we hypothesized that facial edema during
pregnancy could affect ARES oximetry and change performance of the
device in pregnant women
Methods: We recruited pregnant patients referred for a sleep study for
clinical suspicion of OSA. PSG was scored using standard criteria to determine
PSG apnea/hypopnea index (AHI). ARES data were processed
using ARES software, which applies automated algorithms to identify
SaO2 changes, pulse rate, head movements, and snoring and combines
these factors to calculate an ARES AHI. We examined ARES AHI determined
with 4% and 3% desaturations. We used AHI≥5 events/hour as
the cutoff for OSA diagnosis for all methods. We computed sensitivity,
specificity, and Kappa coefficients to assess diagnostic consistency between
PSG and ARES.
Results: Fifteen women (mean age±SD = 29.6+5.5 years; mean gestational
age = 29.1±6.3 weeks, range= 17 to 38 weeks; mean BMI 44.8±7.3
kg/m 2 , range=30.3 to 61.2 kg/m 2 ) had concurrent data collection with the
ARES Unicorder and laboratory PSG. Eight women had OSA diagnosed
with PSG: AHI range=6.8 to 113 events/hour. The ARES AHI 4% algorithm
had sensitivity=0.63, specificity=1.0, and Kappa=0.61, p=.01. The
ARES AHI 3% algorithm had sensitivity=0.75, specificity=0.71, and
Kappa=.46, p=.07. Two patients with PSG AHIs of 8.4 and 8.9 events/
hour were not identified with either ARES algorithm.
Conclusion: The ARES Unicorder demonstrated reasonable consistency
with PSG in this small, heterogeneous sample of pregnant women.
The ARES algorithm with higher sensitivity (ARES AHI 3%) should be
utilized in pregnancy because of potential adverse maternal and neonatal
outcomes associated with untreated sleep-disordered breathing.
Support (If Any): ARES Unicorders provided to GB by Advanced
Brain Monitoring, Inc.
0940
SLEEP TIMING DURING POSTPARTUM WEEKS 1 AND 7
Donie SK 1,2 , Claffey DJ 1,2 , Stone KC 1,2
1
Women & Infants Hospital, Providence, RI, USA, 2 The Warren Alpert
Medical School of Brown University, Providence, RI, USA
Introduction: Prior research has linked postpartum sleep duration and
fragmentation to poor daytime outcomes. In the general population,
sleep schedule variability and circadian shifting have also been linked to
poor daytime functioning, but have not been investigated in postpartum
women. This study investigates how postpartum women’s sleep schedules
vary, if women are more likely to extend their total sleep time by
advancing their bedtime or delaying their final morning wake time, and
if these behaviors increase total sleep time.
Methods: Participants included 10 postpartum mothers (M = 23.1
years; 70% unmarried; 80% multiparous; 100% low SES) with a history
of smoking who were participating in an intervention to remain smokefree.
Actigraphic data corroborated by sleep diaries from postpartum
weeks 1 and 7 were used to measure sleep onset/offset and nocturnal
total sleep time. Standard deviations were used to measure variability of
sleep start and end times.
Results: Variability of sleep start time was negatively correlated with
nocturnal total sleep time: (r = -.511, p = .025). Women were more likely
to extend their total sleep time by waking after 8 am (53.3%) than by
going to sleep before 11 pm (19.7%). Participants significantly increased
their sleep duration by either going to sleep before 11 pm or waking after
8 am (M = 367.67 min, SD = 107.14) or by doing both (M = 520 min,
SD = 82.45) as compared to women who did neither (M = 299.23 min,
SD = 80.83): F (121) = 28.1, p < .001.
Conclusion: This study documents late bedtimes (M = 12:02 am) and
wake times (M = 8:17 am) for mothers in the first seven weeks postpartum,
which may represent a shift from pre-pregnancy sleep schedules.
Future studies should investigate a possible early postpartum circadian
shift and whether poor daytime outcomes result from such a shift.
Support (If Any): NIH-NIDA R21DA026448
0941
SDB IS ASSOCIATED WITH AN INCREASED RISK OF
ADVERSE PREGNANCY OUTCOMES
Facco F 1 , Ouyang D 2 , Grobman W 1 , Kick A 1 , Stewart N 2 , Adams MG 2 ,
Zee P 3
1
Obstetrics and Gynecology, Northwestern University, Chicago, IL,
USA, 2 Obstetrics and Gynecology, NorthShore University Health
System, Evanston, IL, USA, 3 Neurology, Northwestern University,
Chicago, IL, USA
Introduction: The term sleep-disordered breathing (SDB) describes
a group of disorders characterized by abnormal respiratory patterns or
quality of ventilation during sleep, resulting in hypoxia and nocturnal
arousals. In non-pregnant populations SDB has been associated with
cardiovascular and metabolic morbidities and mortality. Few studies
have examined the relationship between SBD in pregnancy and adverse
obstetrical outcomes. The objective of this study was to examine the association
between SDB and adverse pregnancy outcomes (APO).
A321
SLEEP, Volume 34, Abstract Supplement, 2011