If you’re like most expectant women, you’re probably finding it harder and harder to sleep now that you’re growing a baby. Over three-quarters of all pregnant women say they experience more sleep disturbances than usual — and while it may make for one tired mom-to-be, it’s still considered very normal.
What’s less common, however, is a sleep condition called obstructive sleep apnea (OSA). This breathing-related disorder can occur during pregnancy due to hormonal changes. Obstructive sleep apnea causes your breathing to start and stop repeatedly during sleep and deprives your body of oxygen,[1] which can be serious for both you and your baby on board.
If you suspect you have sleep apnea, read on for more about the causes and the warning signs to watch for. And if you’ve already been diagnosed with OSA, treatment can help you get more of the sleep both you and your developing baby need.
What causes obstructive sleep apnea?
Sleep apnea is the most severe form of sleep-disordered breathing conditions.[2] It’s a chronic condition that occurs when the upper airways collapse during sleep, temporarily blocking airflow and causing interruptions in ventilation, or the movement and exchange of deoxygenated for oxygenated air. Temporary pauses in breathing, called apneas, can last anywhere from 10 seconds to a minute or more.
The level of sleep apnea you have is based on the number of times you stop breathing in your sleep. People with mild sleep apnea typically have five to 14 pauses in breathing an hour, those with moderate apnea have 15 to 29 and those with severe sleep apnea have more than 30 episodes an hour.
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Obstructive sleep apnea is actually one of three types of apnea. The others are:
- Central sleep apnea (CSA), which occurs when the brain has trouble controlling the muscles necessary for taking in air, leading to slower and more shallow breathing.
- Mixed or complex sleep apnea is a combination of both OSA and CSA at the same time. This type of sleep apnea is usually diagnosed overnight when events can be recorded.
Apnea is often accompanied by a pattern of heavy snoring, which gets louder just before it quiets completely while the airflow stops. After a few seconds, the body reacts to the temporary lack of air with a loud snort or gasp, and then the snoring resumes.
Typically, people with apnea don’t wake up fully and don’t remember these episodes, though their quality of sleep is greatly affected.
Who is at risk of obstructive sleep apnea?
All pregnant women have an increased risk of obstructive sleep apnea due to normal physiologic changes, including hormonal changes. For example, higher levels of estrogen during pregnancy can cause the mucus membranes in your nose to swell, leading to nasal congestion, which effectively narrows your breathing airway.
Also, as pregnancy progresses, the pressure of the uterus on your diaphragm leads to a decrease in lung function residual capacity (the volume of air you have left in your lungs after you breathe out). This reduced capacity contributes to an increased collapsibility of your airways.
If you’re overweight, obese or gained too much weight during pregnancy, you’re particularly at risk of obstructive sleep apnea. Extra tissue in your neck can block your airway and make it harder to breathe at night. Moms-to-be with gestational diabetes are also at higher risk.
Other reasons your airway may collapse or become blocked during sleep include congestion caused by allergies or illness, along with certain physical attributes, like a receding chin, enlarged adenoids, a large tongue, a deviated septum or an above-average neck circumference.
What are the risks of obstructive sleep apnea during pregnancy?
Over time, sleep apnea lowers your blood oxygen levels. The less air you breathe in each night, the less oxygen your body gets. This condition not only causes fatigue but can also increase your risk of high blood pressure, cardiovascular problems and other serious health conditions.
Pregnant women with sleep apnea may also be more likely to develop conditions that affect their babies’ health, like gestational diabetes and preeclampsia, another reason it’s so vital to be diagnosed and treated as soon as possible by your doctor.
What are the warning signs of sleep apnea?
While only your partner may hear your loud snoring and sudden gasps for air at night, you should clock how fatigued you feel during the day. Also, make sure to note whether you often fall asleep while reading, watching TV or working at the computer, or if you’re feeling especially irritable, impatient and forgetful. Sleepiness and moodiness during the day are signs of sleep apnea.
Other signs of OSA include waking up with a headache, sore throat or dry mouth; nighttime sweating; and a decreased libido. So if you find yourself popping a Tylenol as soon as you get out of bed, sleep apnea may be the culprit.[3]
To diagnose sleep apnea, your doctor will evaluate your signs and symptoms and examine your mouth, nose and throat.
Your practitioner may then refer you to a sleep specialist for another test called a polysomnography. This study — done at home or in a lab — measures your airflow, breathing patterns, blood oxygen levels and other factors while you’re asleep to confirm if what you have is in fact sleep apnea.
How is obstructive sleep apnea treated?
Treatment for sleep apnea usually starts with lifestyle changes. Your doctor may advise you not to sleep on your back. You may be able to arrange pillows or a pregnancy pillow to support your back. If you just can’t seem to stay off it, though, try taping a tennis ball to the back of your pajama top so that when you roll over, the ball reminds you to stay on your side.
You can also try adhesive breathing strips, which open up your nostrils. For apnea caused by congestion, try a saline spray or rinse, a humidifier or an OTC decongestant (but talk to your doctor first about all these “go-to’s” to ensure they’re safe).
If you’re overweight or obese, work with your health care provider on a weight management plan. Being at a healthy weight can really help with sleep apnea.
If apnea persists or is severe, you may need a CPAP (continuous positive airway pressure) machine, which provides a gentle flow of air to a mask that you’ll wear over your nose, keeping your airway open. Most people with sleep apnea find almost immediate relief with a CPAP machine, but some models can be unwieldy and uncomfortable.
Other alternatives include sleep apnea patches, which allow air in but restrict the amount breathed out, forcing it back down the airways to keep them open.The patches might not be covered by your insurance plan, but the CPAP usually is.
A special mouthpiece — fitted by an experienced dentist — can also help keep your throat open by bringing your lower jaw forward or holding your tongue in a different position.
Does sleep apnea go away after pregnancy?
Yes, there is some evidence that OSA in pregnancy will improve once you deliver. In fact, many studies indicate that sleep apnea gets better with weight loss, so once your sweet baby has arrived, your OSA symptoms should subside.
Weight loss alone, however, isn’t always a magic bullet for sleep apnea, and other approaches may be necessary.
Obstructive sleep apnea doesn’t have to ruin the quality sleep you need during pregnancy. If you keep track of the signs and symptoms of OSA and work with your doctor to treat the condition, you and your baby-to-be should be off to dreamland in no time.
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