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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.

Last updated: Aug 1, 2026•0 RCTs•1 Meta-analyses•📖 Read as article →

Evidence Score

Evidence Score49/100
Human RCT☆☆☆☆☆
Meta-analysis★★★☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Association between sleep disorders during pregnancy and hypertensive disorders of pregnancy: A systematic review and meta-analysis of cohort studies.

observational

Guo SJ, Xu JS, Cai J, Gao HF, Wei LQ · European journal of obstetrics, gynecology, and reproductive biology (2026)

Participants: N/A
Duration: N/A
Intervention: Presence of sleep disorders during pregnancy (including obstructive sleep apnea, sleep-disordered breathing, snoring, insomnia, poor sleep quality)
Outcome: Gestational hypertension, preeclampsia, hypertensive disorders of pregnancy
Effect Size: OR=1.50 (95% CI: 1.23-1.82) for GH; OR=1.83 (95% CI: 1.53-2.18) for PE; OR=1.56 (95% CI: 1.17-2.08) for HDP
Population: Pregnant women from multiple countries (19 cohort studies, 9,460,018 participants)

Result:

PubMed: 42526228DOI: 10.1016/j.ejogrb.2026.115332

Mechanism Graph

Sleep disorders cause intermittent hypoxia and oxidative stress
↓
Activation of sympathetic nervous system and inflammation
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Endothelial dysfunction and impaired placental perfusion
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Increased risk of hypertensive disorders of pregnancy

Limitations

  • ⚠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.

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References

  1. 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
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