DO NASAL DILATOR STRIPS IMPACT SITE OF OBSTRUCTION AND SEVERITY OF SLEEP DISORDERED BREATHING DURING PREGNANCY?

SESSION TITLE: Sleep Disorders Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Women with sleep disordered breathing (SDB) in pregnancy are at a greater risk of developing serious adverse pregnancy-related outcomes, including hypertensive disorders of pregnancy and gestational diabetes mellitus (GDM). However, the pathogenesis of SDB is not well understood in this population. Nasal congestion, a common occurrence in pregnancy, may be an important contributor to reduced airway patency. This study aims to assess the role of nasal obstruction in SDB during pregnancy by examining the impact of nasal dilator strips (NDS) on measures of SDB. METHODS: Pregnant women over the age of 18 with a singleton pregnancy, BMI > 30, and significant habitual snoring history (> 3 nights per week) are consented in their first trimester or third trimester to complete two consecutive home sleep apnea tests (HSAT) using NoxT3 sleep monitors, recording a minimum of four hours of sleep per night. Participants are instructed to wear a NDS for the duration of the second HSAT recording. HSAT recordings are scored by a polysomnography technician to calculate an Apnea Hypopnea Index (AHI), which indicates SDB severity. The primary outcome measure is a reduction in AHI with NDS use. Subjective assessments of the perceived impact of NDS are also obtained using validated surveys. A power analysis for a dependent t-test estimating a large effect size was performed to calculate required sample size (n=54). RESULTS: 12 first-trimester participants (11.0 ± 2.0 weeks of gestation and BMI 36.9 ± 3.9) and 29 third-trimester participants (32.1 ± 2.1 weeks of gestation and BMI 39.5 ± 3.9), with a median age of 32 years, have completed the HSAT recordings. Zero participants have withdrawn from the study. Of the 38 participants who have delivered, nine participants were diagnosed with a hypertensive disorder of pregnancy and eight participants were diagnosed with GDM. Recruitment of the remaining participants is ongoing. Preliminary results show a mean decrease in AHI of 0.19 ± 3.6 events per hour (n=41) between the first and the second HSAT recordings with the use of NDS. CONCLUSIONS: Results from this study will inform the use of nasal dilator strips as a potential therapeutic intervention for symptomatic relief and disease severity modification for sleep disordered breathing during pregnancy, or support their use as an appropriate placebo condition in clinical trials. CLINICAL IMPLICATIONS: This study will offer insight into the role that nasal resistance plays in SDB pathogenesis in pregnancy, further clarifying potential adjunctive treatments of the condition. If there is no difference in AHI in the setting of perceived improvement with NDS use, their use may be validated as a placebo condition in future studies of SDB. DISCLOSURES: No relevant relationships by Christine Allenson, source=Web Response No relevant relationships by Ghada Bourjeily, source=Web Response No relevant relationships by Margaret Bublitz, source=Web Response No relevant relationships by Mariko Maxwell, source=Web Response No relevant relationships by Kristina Monteiro, source=Web Response No relevant relationships by Tamara Sequeira, source=Web Response