Guideline on sleep-disordered breathing in pregnancy released by CHEST
The American College of Chest Physicians (CHEST) recently released a new clinical guideline on obstructive sleep apnea (OSA) in pregnancy. Published in the journal CHEST®, the guideline contains nine evidence-based recommendations that provide a trustworthy model for how best to care for pregnant patients with OSA.
OSA is increasingly recognized as being associated with significant morbidity in pregnancy, yet there is minimal guidance available on how best to screen, diagnose, treat, and reevaluate for sleep-disordered breathing (SDB) in pregnant patients. This CHEST guideline was developed to address the need for more specific guidance.
“What I want most from this guideline is to put sleep-disordered breathing on the radar for pregnant patients and their providers,” said Carolyn D’Ambrosio, MD, FCCP, lead author on the guideline. “All too often, symptoms during pregnancy are dismissed as frivolous or temporary, but the reality is that disordered breathing can have serious consequences both to the parent and the fetus. The guideline also serves as a reminder that not everything goes away postpartum.”
According to the guideline, measures of SDB have been associated with adverse fetal growth outcomes, a higher risk of admission to the neonatal intensive care unit at birth, a longer hospital stay, congenital anomalies, and preterm birth.
Due to limited available evidence, all nine conditional recommendations are noted with very low level of certainty of evidence. Of the nine recommendations, highlights include:
- In pregnant individuals, we suggest screening for SDB.
- In pregnant individuals diagnosed with OSA during pregnancy, we suggest that treatment be based on an AHI 5-15 with symptoms/sequelae or comorbidity (HTN, stroke, obesity, etc.) or AHI > 15 alone.
- In postpartum individuals previously diagnosed with OSA during pregnancy, we suggest reassessment for SDB.
Reference:
D’Ambrosio C, Dust C, Dominguez J ... Obstructive Sleep Apnea (OSA) in Pregnancy - An American College of Chest Physicians Clinical Practice Guideline CHEST, 2026, DOI: 10.1016/j.chest.2026.06.058
