Habitual snoring and depressive symptoms during pregnancy

Background: Depression is frequently observed in patients with untreated sleep-disordered breathing (SDB) in the general population. Pregnant women are particularly vulnerable since pregnancy increases the risk of both SDB and depressive symptoms. However, no study has investigated whether SDB symptoms prior to or in early pregnancy are associated with such mood problems. Methods: A retrospective chart review of pregnant women. Women were included if they attended prenatal clinics between June 2007 and July 2010, were >= 18 years old, pregnant with a single fetus, and had been screened for habitual snoring as well as depressive symptoms using the Edinburgh Postnatal Depression Scales (EPDS). Results: In total, 362 women were included and 32.3% reported habitual snoring. Twenty-nine percent of women had an EPDS score >= 10. Significantly more snoring women, compared to non-snorers, had an EPDS score >= 10 (42.7% vs. 22.9%, p < 0.001) despite the mean EPDS values not reaching statistical significance (6.1 +/- 4.9 vs. 5.4 +/- 5.0, p = 0.2). In a logistic regression model controlling for parity, the presence of pre-pregnancy obesity, presence of a partner, sleep quality, African American race, maternal educational level, pre-eclampsia, and diabetes, snoring was independently associated with a prenatal EPDS score >= 10 (O.R. 2.0, 95% CI 1.13-3.46; p = 0.023). Conclusion: Maternal snoring may be a risk factor for prenatal depressive symptoms. Further investigation of the temporal relationship between maternal snoring and depressive symptoms is warranted.