Sleep disorders during pregnancy are associated with increased risk of hypertensive disorders of pregnancy
This meta-analysis of 19 cohort studies involving 9,460,018 pregnant women found that sleep disorders during pregnancy significantly increased the risk of gestational hypertension (OR=1.50), preeclampsia (OR=1.83), and hypertensive disorders of pregnancy overall (OR=1.56). Obstructive sleep apnea showed the strongest associations, with ORs of 1.60 for gestational hypertension and 2.13 for preeclampsia.
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Sleep disorders during pregnancy are associated with increased risk of hypertensive disorders of pregnancy The current body of evidence comprises 1 study and 1 meta-analysis. EvidenceHub rates the overall confidence at 49/100 (low).
The Claim
Sleep disorders during pregnancy are associated with increased risk of hypertensive disorders of pregnancy
This conclusion is most relevant to: Pregnant women from multiple countries (19 cohort studies, 9,460,018 participants).
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Association between sleep disorders during pregnancy and hypertensive disorders of pregnancy: A systematic review and meta-analysis of cohort studies. (European journal of obstetrics, gynecology, and reproductive biology, 2026) —
How It Works
The proposed biological pathway:
- ▸Sleep disorders cause intermittent hypoxia and oxidative stress
- ▸Activation of sympathetic nervous system and inflammation
- ▸Endothelial dysfunction and impaired placental perfusion
- ▸Increased risk of hypertensive disorders of pregnancy
Who Might Benefit
Evidence fit by population:
- ▸Pregnant women from multiple countries (19 cohort studies, 9,460,018 participants)
Recommended Dose
N/A
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Observational cohort studies cannot establish causality
- ▸Heterogeneity in sleep disorder definitions and diagnostic methods across studies
Frequently Asked Questions
Which sleep disorder is most strongly linked to preeclampsia?▼
Obstructive sleep apnea showed the strongest association with preeclampsia (OR=2.13, 95% CI: 1.97-2.30).
Is insomnia associated with hypertensive disorders during pregnancy?▼
No, insomnia and poor sleep quality measured by the Pittsburgh Sleep Quality Index were not significantly associated with hypertensive outcomes in this meta-analysis.
Does the timing of sleep-disordered breathing matter?▼
Yes, mid-pregnancy sleep-disordered breathing with increased apnea-hypopnea index was significantly associated with hypertensive disorders, but early-pregnancy increased AHI was not.
How many pregnant women were included in this analysis?▼
The meta-analysis included 19 cohort studies with a total of 9,460,018 pregnant women from multiple countries.
References
- 1.Guo SJ, Xu JS, Cai J, Gao HF, Wei LQ. “Association between sleep disorders during pregnancy and hypertensive disorders of pregnancy: A systematic review and meta-analysis of cohort studies..” European journal of obstetrics, gynecology, and reproductive biology, 2026. PMID: 42526228 DOI: 10.1016/j.ejogrb.2026.115332