Logo image
Back
Continuous positive airway pressure versus usual care for obstructive sleep apnoea in pregnancy: a two-step pilot trial
Journal article   Open access   Peer reviewed

Continuous positive airway pressure versus usual care for obstructive sleep apnoea in pregnancy: a two-step pilot trial

Rachael Nugent, Caroline de Costa, Leonie Callaway, Shiv Erigadoo, Elise Gilbertson, Chris Brown, Joanna Perry-Keene, Rebekah Shakhovskoy and Lauren Kearney
Pilot and Feasibility Studies, Vol.11(1), pp.1-11
2025
DOI: https://doi.org/10.1186/s40814-025-01645-1
PMCID: PMC12139340
PMID: 40474294
pdf
s40814-025-01645-1919.99 kBDownloadView
Published VersionCC BY V4.0,  Open Access

Abstract

Pregnancy Obesity Obstructive sleep apnoea Continuous positive airway pressure UniSC Diversity Area - Life Stages
Background Obstructive sleep apnoea (OSA) is associated with increasing body mass index (BMI) and affects up to 15% of pregnant women. OSA in pregnancy can be associated with adverse maternal and neonatal outcomes. Continuous positive airway pressure (CPAP) may be an effective treatment for OSA during pregnancy. Aim To examine the feasibility and acceptability of screening women with a BMI ≥ 35 kg/m2 for OSA in pregnancy, followed by randomisation to treatment with CPAP or no CPAP for women diagnosed with moderate to severe OSA. Methods This study was a single-centre, two-stage pilot study. Firstly, all consenting participants were screened for OSA and then, only if diagnosed with moderate to severe OSA (AHI ≥ 15), randomised to CPAP or no CPAP. The feasibility of the OSA screening was determined by recruitment rates. A priori criteria of > 20% recruitment to the sleep study were considered feasible. The acceptability of the sleep study was examined using the completion rate and reasons for withdrawal prior to the sleep study. The acceptability of CPAP randomisation was assessed by completion rates for women randomised, adherence to CPAP, reasons for withdrawal, and the review of quality-of-life measures over the course of pregnancy. Results Ninety-six women with a BMI ≥ 35 kg/m2 before 26 completed weeks of pregnancy were invited to participate from the Sunshine Coast University Hospital and Health Service. Overall, 36 women enrolled, giving a recruitment rate of 37%. A total of 75% (n = 26) of recruited women completed OSA screening (clinical history, questionnaires, and formal sleep study). Subsequently, six (6%) of invited women had an apnoea hypopnoea index (AHI) ≥ 15/h and were diagnosed with moderate to severe OSA and underwent randomisation to receive treatment with CPAP (n = 4) or no CPAP (n = 1) until birth. One woman withdrew after randomisation to treatment. Nine women withdrew prior to full completion of OSA screening and one following an inconclusive sleep study. Women who had a sleep study found it acceptable, and in women randomised to CPAP, adherence averaged 4.86 h/night. Quality-of-life measures were similar when measured over two time points in pregnancy. Discussion A definitive trial screening women for OSA and subsequent randomisation to treatment or no treatment may be feasible. Future trials should be resourced to expand inclusion criteria, improve accessibility for participants, evaluate clinical and cost-effectiveness, and investigate partial treatment effects. Trial registration ACTRN, ACTRN12621001523897. Registered 9 September 2021 — retrospectively registered, https://www.anzctr.org.au/Trial/Update/Step8_Update.aspx?id=382640.

Details

Metrics

31 File views/ downloads
33 Record Views

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types
Domestic collaboration
Web Of Science research areas
Medicine, Research & Experimental

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: InCites

Logo image