Women with insomnia or other sleep problems have an increased risk of giving birth prematurely, a new study suggests. 
 
 The observational study, in Obstetrics & Gynecology, included 2,172 women with a sleep disorder who gave birth between 2007 and 2012 to single children after 22 to 44 weeks of gestation. They were matched with the same number of women with the identical ethnic, health and behavioral characteristics, but who did not have a sleep disorder. 
 
 Over all, women with sleep disorders had a 14.6 percent prevalence of preterm birth (before 37 weeks of gestation), compared with 10.9 percent in those without a diagnosis. Those with insomnia had a 30 percent increased risk, and those with sleep apnea a 40 percent increased risk, compared with women without a sleep problem. 
 
 Women with insomnia were nearly twice as likely to deliver before 34 weeks gestation. 
 
 “More severe sleep disorders are often underdiagnosed, because poor sleep is common during pregnancy,” said the lead author, Jennifer N. Felder, a postdoctoral researcher in psychology at the University of California, San Francisco. “But for women having sleep problems that are severe, impairing and distressing, it’s important to talk to their health care providers.” 

 (Reuters Health) - Women who experience sleep disorders like insomnia and apnea during pregnancy may be more likely to deliver premature babies than pregnant women who don’t have trouble sleeping, a U.S. study suggests. 
 
 Compared with women who didn’t have sleep problems, women with insomnia were 30 percent more likely to have a preemie and the odds for women with sleep apnea, a breathing disorder, were 50 percent higher, the study found. 
 
 “It is normal to experience sleep changes during pregnancy - often due to discomfort, pain or frequent trips to the bathroom,” said lead study author Jennifer Felder, of the University of California, San Francisco. 
 
 “The current study focused on more impairing sleep problems that were severe enough to result in a sleep disorder diagnosis,” Felder said by email. 
 
 Apnea, a potentially serious sleep disorder that involves repeated stops and starts in breathing, has been linked to high blood pressure during pregnancy, which is an independent risk factor for preterm births. Obesity and advanced age can make apnea more likely. 
 
 Even though many pregnant women have insomnia at some point, previous studies haven’t offered a clear picture of how this type of sleep deprivation influences the odds of preterm births. 
 
 Worldwide, preterm birth is the leading cause of death for children under 5 years old, the researchers note in the journal Obstetrics and Gynecology. 
 
 Pregnancy normally lasts about 40 weeks, and babies born after 37 weeks are considered full term. The new study focused on preterm infants, delivered at 34 to 36 weeks’ gestation, and extremely premature babies delivered before 34 weeks. 
 
 In the weeks immediately after birth, preemies often have difficulty breathing and digesting food. They can also encounter longer-term challenges such as impaired vision, hearing, and cognitive skills as well as social and behavioral problems. 
 
 The study team examined data on more than 3 million births in California from 2007 to 2012. They focused on 2,172 women who had a sleep disorder diagnosis and compared their birth outcomes to a randomly selected group of 2,172 mothers who were similar in many ways but had no sleep issues. 
 
 Women with sleep disorders were more likely to be black, age 35 or older, obese, and to have other medical issues like high blood pressure, diabetes and infections as well as higher odds of smoking or using drugs and alcohol while pregnant. They were also more likely to have a history of preterm birth. 
 
 Overall, almost 15 percent of women with sleep disorders had a preterm birth, compared with 11 percent of women without sleep issues. 
 
 The study wasn’t a controlled experiment designed to prove how or even whether sleep disorders directly cause preterm births. 
 
 Even so, the results offer fresh evidence of the link between sleep disorders and early arrivals, said Dr. Ghada Bourjeily, a researcher at Warren Alpert Medical School of Brown University in Providence, Rhode Island, who wasn’t involved in the study. 
 
 “Sleep appears to get worse in pregnancy in many, even women who do not have a preexisting sleep disorder,” Bourjeily said by email. “Unfortunately, we do not know yet whether improving sleep quality before or during pregnancy would prevent development of negative outcomes such as preterm birth.” 
 
 Starting pregnancy at a healthy weight, however, may make sleep disorders less likely, said Dr. Amos Grunebaum, director of obstetrics at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York. 
 
 “Being overweight or obese increases your risk of having a sleep disorder,” Grunebaum, who wasn’t involved in the study, said by email. “It also increases pregnancy complications.” 
 
 When sleep disorders do surface during pregnancy, women should discuss symptoms in detail with their doctors, said Dr. Milena Pavlova, a researcher at Brigham and Women’s Hospital in Boston who wasn’t involved in the study. This includes any issues with breathing, gasping or choking at night or any uncomfortable leg or body sensations that prevent sleep. 
 
 Expectant mothers should also make sleep a priority in their schedules, Pavlova, who wasn’t involved in the study, said by email. 
 
 “Allow enough time for sleep - the life you save may be your baby’s,” Pavlova said. 
 
 SOURCE: bit.ly/2j2fR06 Obstetrics and Gynecology, online August 8, 2017. 

 Andrew Lichtenstein/Corbis/Getty 
 
 Despite strides in maternal medicine, premature birth remains a vexing problem for obstetricians worldwide. But an analysis of medical records from almost 3 million pregnant women in California1 suggests that a surprisingly simple intervention — better sleep — might help to address the issue. 
 
 Researchers found that women who had been diagnosed with insomnia or sleep apnoea were about twice as likely as women without sleep disorders to deliver their babies more than six weeks early. 
 
 “It seems obvious, but strangely this study has not been done before,” says Laura Jelliffe-Pawlowski, an epidemiologist at the University of California, San Francisco (UCSF), and an author of the research, which was published on 8 August in the journal Obstetrics and Gynecology1. “Seeing this relationship is important because we are just starved for interventions that can make a difference.” 
 
 Public-health experts say that better treatment for pregnant women with serious sleep disorders could save babies' lives, and do so with approaches that avoid the use of medication. Every year, 15 million babies worldwide are born prematurely — more than three weeks before the typical full-term pregnancy of 40 weeks. These children have less time to develop in the womb, and 1.1 million will die from birth-related complications. Many others are left with hearing impairment, learning disabilities, cerebral palsy and other health issues. 
 
 The new study is part of the UCSF Preterm Birth Initiative, an ambitious US$100-million effort to study prematurity, focusing on California and East Africa. The researchers working on the effort plan to mine large quantities of historical data, ensuring that any findings are statistically significant. They hope to use these findings to identify medical and social interventions that could reduce preterm births, and test them in trials of pregnant women.The programme is funded by the Bill and Melinda Gates Foundation and philanthropists Lynne and Marc Benioff. 
 
 Forty winks for forty weeks 
 
 Jennifer Felder, a postdoctoral researcher in clinical psychology at UCSF who led the study, says that she had been troubled by the lack of research on sleep and pregnancy. Because pregnant women often have some difficulty sleeping, she suspects that doctors and researchers had not thought to examine the consequences of sleep disorders more closely. 
 
 Felder and her colleagues acquired the records of almost three million births that took place in California between 2007 and 2012, which were scrubbed of identifying information but linked to hospital-discharge papers from the women who had given birth. Each record contained a medical history of the mother and notes taken throughout her pregnancy and baby's delivery. Doctors had diagnosed about 2,300 of the women with a sleep disorder during their pregnancy. Insomnia and sleep apnoea were the main problems, although narcolepsy, excessive sleepiness and restless leg syndrome were also seen. 
 
 Insomnia, the researchers found, increased a woman's risk of preterm birth by 30%, while sleep apnoea increased the risk by 40%. Sleep disorders also increased the risk of very premature births: 5.3% of women with sleep issues delivered their babies at less than 34 weeks' pregnancy, compared to 2.9% for women without such a diagnosis. 
 
 Felder says that a lack of sleep is unlikely to be a direct cause of early births. But it could trigger other processes, such as inflammation, that eventually result in prematurity. A 2010 review of studies linked premature birth to the presence of the inflammatory proteins C-reactive protein and interleukin-6, in amniotic fluid2. To explore the idea, the UCSF initiative will soon begin to examine immune-system proteins in pregnant women using blood stored in a repository associated with California’s department of public health. The scientists will compare samples with an attention to premature birth and insomnia. 
 
 And in the meantime, sleep troubles in expectant mothers can alert doctors to potential danger. “I counsel women on how to have the best pregnancy outcome,” says Louis Muglia, the director of the Center for Prevention of Preterm Birth at Cincinnati Children’s Hospital Medical Center in Ohio. “Now I might start asking, 'do you get a good night’s sleep?'.”
– A new study suggests that one way to cut down on premature births is to make sure pregnant women get good sleep. The observational study, published in the journal Obstetrics & Gynecology, found that women diagnosed with some kind of sleep disorder were more likely to give birth early, reports the New York Times. Overall, 15% of such women had preemies, compared to 11% among women without a sleep disorder. More specifically, a diagnosis of insomnia raised the risk of having a pre-term birth by 30% and sleep apnea by 40%. Similarly, sleep disorders were associated with more births characterized as "very premature," reports Nature. The study found that 5.3% of women with such disorders delivered 34 weeks or earlier, compared with 2.9% for those without a disorder. “It seems obvious, but strangely this study has not been done before,” says co-author Laura Jelliffe-Pawlowski, an epidemiologist at the University of California, San Francisco. "Seeing this relationship is important because we are just starved for interventions that can make a difference.” The authors make clear they're referring to women with diagnosed problems, not merely to women who occasionally have trouble sleeping while pregnant, which is fairly common. They found that sleep disorders are more common among women who are black, 35 or older, obese, and have other medical issues, reports Reuters. Based on the study, one piece of advice for women planning to have kids is to try to start the pregnancy at a healthy weight. (Some evidence supports therapy over pills to treat insomnia.)