Sleep disorders
OSA in pregnancy: the SASM/SOAP consensus guideline
At a glance
| Study type | Expert opinion |
|---|---|
| Year | 2023 |
| Journal | Obstetrics & Gynecology 142(2):403–423 |
| Population | Pregnant, Postpartum |
Background
The 2023 SASM/SOAP consensus guideline (endorsed by ACOG) on screening, diagnosis, and treatment of obstructive sleep apnea in pregnancy. Pregnancy-specific screening criteria outperform Berlin/Epworth/BMI, Age, Neck, Gender).">STOP-BANG; CPAP is first-line; postpartum repeat testing is recommended.
Why doesn't a normal OSA screening tool work in pregnancy?
Standard tools (Berlin, Epworth, STOP-BANG) were developed in non-pregnant populations. They underweight pregnancy-specific risk factors and overweight features (e.g., neck circumference) that change non-monotonically across pregnancy. Pregnancy-specific tools like Facco, Louis, and BATE perform better but still need broader validation.
Who should be screened?
Pregnant patients with obesity, chronic hypertension, prior preeclampsia, gestational diabetes, or witnessed apneas/loud snoring/gasping. The guideline supports proactive screening rather than waiting for severe symptoms.
Is a home sleep test enough?
For elevated-risk pregnant patients, yes — home sleep apnea testing is an acceptable diagnostic tool per the guideline. In-lab polysomnography remains the gold standard but is not always required to start treatment.
What's the treatment, and does it actually help?
CPAP is the primary treatment. Evidence supports improvements in maternal symptoms and some metabolic and cardiovascular markers. The strength of the maternal/neonatal hard-outcome evidence is more limited, which is why this is a consensus guideline rather than a strong RCT recommendation.
What about after delivery?
Pregnancy-onset OSA often improves after delivery — the guideline recommends repeat testing postpartum to confirm whether ongoing treatment is needed.
How does Solas handle OSA risk?
Solas does not diagnose OSA. If onboarding signals match the guideline's elevated-risk criteria, the app surfaces the SASM/SOAP screening recommendation, links to the consensus paper, and points users toward home sleep testing through their clinician — not a behavioral nudge.
Source
Dominguez JE, Cantrell S, Habib AS, Izci-Balserak B, Lockhart E, Louis JM, Miskovic A, Nadler JW, Nagappa M, O'Brien LM, Won C, Bourjeily G
(2023).
Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology Consensus Guideline on the Screening, Diagnosis, and Treatment of Obstructive Sleep Apnea in Pregnancy Obstetrics & Gynecology 142(2):403–423.
DOI: 10.1097/AOG.0000000000005261
Read the original paper →
Solas does not own or distribute the underlying paper. Follow the link to the publisher for the full text. See our methodology.