Grant: Operating Grant

Symptoms of sleep apnea, such as snoring and breathing pauses, are common in pregnancy. In sleep apnea, intermittent breathing pauses during sleep occur, and accumulating evidence has been linking maternal sleep apnea to poor health for the mother and fetus. Gestational diabetes (GDM) is one such poor outcome and is defined as high blood sugar that is first recognized during pregnancy, and can lead to fetal death, delivery of large babies, and consequently, birth injuries and higher rates of caesarean section. Also, GDM can result in up to a 50% risk of diabetes for the mother later in life, in addition to childhood obesity and diabetes for the infant. Although we have shown that treatment of sleep apnea with the first-line therapy, continuous positive airway pressure (CPAP), improves blood sugar levels in non-pregnant patients, no studies have tried treating sleep apnea in pregnancy to see if blood sugar control will improve. As such, we propose doing a pilot study where pregnant participants with sleep apnea and GDM will randomly receive either CPAP or a nasal dilator strip (control group) to treat sleep apnea. Research subjects will first undergo a home sleep study for 1 night to see if they have sleep apnea. After treatment with CPAP or nasal strips is randomly assigned, we will test blood glucose levels through a continuous glucose monitor, which is a tiny sensor that is inserted under the skin to check glucose levels in tissue fluid over a 3 day period. Our main aims are to determine if pregnant patients with GDM adhere to CPAP use each night for the remainder of pregnancy, and if it is feasible to recruit and retain this special population into a randomized study with CPAP. The results of this study will help us design a larger trial that will be aimed to test the effect of CPAP treatment on maternal glucose levels and perinatal outcomes in GDM.