This study will evaluate the effect of treatment of obstructive sleep apnea on insulin sensitivity in pregnant women. Women in their third trimester of pregnancy will be randomized to receive treatment or no treatment for one month.
Obstructive Sleep Apnea (OSA) worsens over pregnancy and is related to increased risk of gestational diabetes. Despite the fact that sleep disturbances are common during pregnancy, OSA remains under-diagnosed, and poorly understood particularly in pregnancies affected by obesity. At least 25 percent of pregnancies are now affected by obesity, a leading risk factor for OSA, yet the effect of treatment of OSA on patterns of metabolic function and specifically decreased insulin sensitivity in pregnant women with obesity is a neglected area with major therapeutic implications to improve maternal health. Inflammation with OSA may decrease insulin sensitivity. Continuous positive airway pressure (CPAP) is a known effective treatment for OSA and has been shown to improve insulin sensitivity outside of pregnancy. Our overall hypothesis is that, compared with standard care, CPAP will improve nighttime breathing, blood and tissue oxygenation, decrease markers of inflammation, and increase insulin sensitivity. Using a randomized controlled trial, we will determine the effect of CPAP on metabolic dysfunction induced by OSA in pregnant women with obesity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
The device is an auto-adjusting pressure device with an integrated humidifier. Pressure is adjusted based on airway resistance.
Washington University in St. Louis
St Louis, Missouri, United States
Degree of Insulin Sensitivity measured by Matsuda Index by Oral glucose Tolerance Test
Change in whole body insulin sensitivity measured using Matsuda Index
Time frame: 1 month
Percent of Oxygen in blood by pulse oximetry
Change in oxygen saturation measured by pulse oximetry
Time frame: 1 month
Percent of Oxygen in Adipose Tissue measured by oxygen tension probe
Change in adipose tissue oxygenation measured by oxygen tension
Time frame: 1 month
Concentration of inflammatory gene expression in adipose Tissue measured by RNA and DNA sequencing
Change in adipose tissue gene expression of inflammatory markers
Time frame: 1 month
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