Sleep Quality in Pregnancy and Its Impact on Pregnancy Outcomes

NCT ID: NCT02016638

Last Updated: 2013-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2014-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Hypothesis:Sleep Disorders are very common during pregnancy but the their exact role in causation of pregnancy related disorders is yet to be determined. OSA can complicate pregnancy given the risk factors of weight gain, upper displacement of the diaphragm, and hormonal-induced hyperaemia of the nasopharyngeal passages. SDB confers the risk of hypertensive disorders of pregnancy and is associated with adverse maternal and foetal outcomes.

The study would involve pregnant females which would be prospectively followed in pregnancy and post partum to know the prevalence of sleep disorders in pregnancy. Diagnosis of sleep disorders would be confirmed by overnight polysomnography and ambulatory blood pressure monitoring. Pregnancy outcomes, both maternal and fetal would be recorded and its relation with sleep disorders in pregnancy would be analysed.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Objectives

1. To assess sleep quality during pregnancy
2. To know prevalence of various sleep disorders during pregnancy including restless leg syndrome, symptomatic obstructive sleep apnea etc.
3. To study the effect of sleep disorders on maternal and fetal outcome
4. To study the relation of obstructive sleep apnea with pregnancy induced hypertension.

Material \& Methods

Study Design: Longitudinal prospective case-control study

* Consecutive patients undergoing antenatal check up at the Antenatal Clinic at AIIMS hospital during will be evaluated using questionnaires for sleep quality. Preliminary screening question for sleep disturbance in pregnancy to all patients
* Questionnaires used: Pittsburgh Sleep Quality Index (covers insomnia, RLS, snoring and sleep related breathing disorders); Epworth Sleepiness Score (for Excessive daytime sleepiness); Modified Wisconsin Score; Modified Berlin Questionnaires
* To now association between Obstructive sleep apnea and pregnancy induced hypertension patients who develop symptomatic OSA will be offered polysomnographic evaluation during the second/third trimester.
* An offer of similar services will be made to pregnant females who do not develop pregnancy induced hypertension at a similar gestational age.

Case: patient with OSA

Control: patients without OSA

* We proposed to determine that what proportion of the cases were exposed to sleep disorders and what proportion are not.
* We also planned to determine what proportion of controls is exposed and what proportion is not.

Cases and controls would be matched for age ,parity, BMI,previous h/o pre-eclampsia in first trimester.

Outcome parameters

1. Prevalence of various sleep disorders in pregnancy
2. Maternal outcome: Development of pregnancy induced hypertension (PIH), gestational diabetes mellitus, complicated pregnancy requiring admission, preterm delivery, ante-partum hemorrhage, delivery requiring intervention (Caesarian section, forceps/ventouse application)
3. Fetal outcome: APGAR scores at 1 and 5 min, IUGR, IUD, low birth weight

Sample Size:

A sample of convenience of 200 patients (who respond to questionnaire) and satisfy inclusion and exclusion criteria will be followed up prospectively to assess the effect of sleep disorders on pregnancy outcome.As per estimates from literature sample size for case control part would be 20 for cases and 40 controls.

Investigation specifically related to projects:

1. Using Somnomedic systems, GmbH polysomnography machine by trained staff nurses and technicians at:

* Obstetrics ward, AIIMS hospital
* Home based portable PSG in non admitted
2. Ambulatory blood pressure by the Oscar 2™ system from SunTech Medical, USA. The Oscar 2 is clinically validated to all three internationally recognized standards.

* British Hypertension Society1 (A/A)
* European Society of Hypertension International Protocol2
* AAMI SP103

Patient comfort The Oscar 2 and the Orbit™ BP cuff make patient comfort a priority.
* The SunTech Medical, Inc. patented Orbit cuff uses an innovative stretch-sleeve design to maintain cuff placement and promote patient comfort.
* The Oscar 2 is a light, compact monitor that uses motion tolerant algorithms to reduce re-inflates and failed readings. The auto-intelligent inflation pressure also reduces measurement time, promoting patient comfort by controlling cuff inflation.
3. Screening Polysomnography using Apnea linkTM PLUS

* A quick and easy sleep-screening tool designed to help identify more patients at risk for obstructive sleep apnea (OSA).
* A premium, compact device that can be used at home

Additional Investigation Required

* Routine clinical antenatal examination
* Blood pressure measurement
* Blood parameters (done routinely in ANC)

* Fasting blood sugar
* Renal and hepatic function tests
* Hemoglobin levels/s ferritin
* Serum TSH levels
* Urine examination

* Routine and spot sample for protein.
* Sonography: To rule out twin pregnancy and molar gestation/IUGR/Anomalies.
* These investigations are routinely done in ante natal clinic at AIIMS.

Data Analysis

* Data will be collected on a pre-designed proforma.
* Statistical analysis will be performed using STATA 11 for Windows software (intercooled version, Stata Corporation, Houston, TX, USA).
* After assessing for approximate normal distribution, all continuous variables will be summarized as mean ± SD or median (interquartile range).
* Categorical variables will be expressed as n (%).
* The cases and controls will be compared using unpaired t-test if the data was normally distributed and the Mann-Whitney U test if not.
* A p values of \<0.05 will be considered statistically significant.
* Confounding factors influencing pregnancy outcomes will be subject to multivariate analysis to determine significance.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Obstructive Sleep Apnea Pregnancy Induced Hypertension High-Risk Pregnancy Restless Leg Syndrome Infant, Very Low Birth Weight

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Obstructive Sleep Apnea in pregnancy Pregnancy induced hypertension Restless leg syndrome Sleep

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

polysomnography and AMBP on pregnant females

Consecutive patients undergoing antenatal check up at the Antenatal Clinic at AIIMS hospital and obstetrics wards will be recruited and followed.Using Somnomedic systems, GmbH polysomnography machine by trained staff nurses and technicians at:

Obstetrics ward, AIIMS hospital

Group Type EXPERIMENTAL

Polysomnography and ambulatory blood pressure recording

Intervention Type OTHER

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Polysomnography and ambulatory blood pressure recording

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age 20-45 years
* Singleton pregnancy

Exclusion Criteria

* Known hypertensives i.e SBP\>140/DBP\>90/on anti-hypertensive medications prior to pregnancy
* Known diabetics (FBS\>100, 75 g OGTT positive/on medications)
* Hypothyroidism
* Chronic renal failure
* Chronic liver disease
* Twin pregnancy
* Known systemic inflammatory condition e.g APLA Syndrome,SLE
* Molar gestation
* Patients on nephrotoxic medications e.g.NSAIDS
Minimum Eligible Age

20 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

All India Institute of Medical Sciences

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

S.K.SHARMA

Professor and Head

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Surendra K Sharma, MD, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

All India Institute of Medical Sciences

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

All India Institute of Medical Sciences, New Delhi

New Delhi, , India

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

India

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Abhimanyu Nehra, MBBS

Role: CONTACT

Phone: 9868057741

Email: [email protected]

Surendra K Sharma, MD, Ph.D.

Role: CONTACT

Phone: 26593303

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Abhimanyu Nehra, MBBS

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SKS/Med/Sleep_Preg

Identifier Type: -

Identifier Source: org_study_id