Sleep Apnea and Pregnancy - The Overlooked Risk to Mom & Baby

For many people, including many expectant moms, a restful night’s sleep ends up being anything but. Sleep Apnea, a condition that affects the breathing during sleep, affects as many as 26 percent of pregnant women, according to Contemporary OB/GYN. The connection between Sleep Apnea and pregnancy must be better understood because this serious condition puts both mom and baby at risk.

Sleep Apnea, also known as Obstructed Sleep Apnea, is a sleep disorder that interrupts an individual's breathing during sleep. In Obstructed Sleep Apnea, the soft tissue at the back of the throat collapses while the person is sleeping, blocking the airway and making it impossible to breathe for a period.

The most common symptom of Sleep Apnea is excessive snoring, but daytime sleepiness is another symptom. Unfortunately, both of these are also symptoms of pregnancy, and many pregnant women go undiagnosed when doctors assume their complaints are simply a normal part of pregnancy.

So why are pregnant women more prone to problems with Sleep Apnea? The answer is tied to hormones.

During pregnancy, a woman experiences higher estrogen and progesterone levels. This causes fluid retention and the characteristic swollen ankles. When a woman lays down to sleep, that fluid redistributes in the body and accumulates around the neck, swelling the nasal passages and mucous membranes.

In addition, these hormones alter the body’s muscle tone, relaxing many of the muscles in preparation for the growing baby. This can relax and partially close the upper airway, giving a mom less room to inhale and exhale. This combination of a smaller airway combined with fluid retention and congestion leads to Sleep Apnea for many women.

Sleep Apnea during pregnancy is difficult to diagnose because many of the symptoms are written off as part of the pregnancy experience. The most common symptoms include:

• Snoring
• Waking with gasping or choking feelings
• Frequent nighttime urination
• Breathing pauses during sleep
• Excessively sleepy during the day

The risk for these problems will increase as the pregnancy progresses, with third-trimester moms suffering more symptoms than first trimester moms.

Most pregnant moms, even in their healthiest, will suffer from daytime sleepiness and increased snoring. So how can a mom know when this problem warrants a talk with her doctor?

If you are experiencing excessive sleepiness after the first trimester when such tiredness is normal, or if you are overly irritable, impatient, or forgetful, talk to your doctor. Also, if you find yourself waking feeling unrested or waking with a headache, ask your doctor.

While all women are at slight risk for Sleep Apnea during pregnancy, some factors can increase that risk significantly. According to a study published in the National Institutes of Health, these factors include:

• Obesity
• Older age
• Abnormalities in the shape of the face or neck
• Smoking
• Excessive pregnancy weight gain
• Trouble breathing at night

Also, many women have Sleep Apnea before pregnancy that was not diagnosed, and pregnancy hormones can make the problem worse. Women who have any of these factors need to discuss Sleep Apnea risk with their doctors.

So why is Sleep Apnea during pregnancy so dangerous? Is it more than just snoring during pregnancy, or do the breathing problems Sleep Apnea creates actually have another risk?

According to Live Science, moms who have Sleep Apnea have a higher risk many complications. One of these is the risk of c-section delivery, with 65 percent of surveyed moms with Sleep Apnea requiring surgical births compared to 33 percent of moms who did not have the condition.

Sleep Apnea also increases the risk of a serious pregnancy complication called preeclampsia. Only 17 percent of moms without Sleep Apnea develop this complication, but 42 percent of those with Sleep Apnea will also develop preeclampsia.

Moms are not the only ones at risk when they develop Sleep Apnea. Another National Institutes of Health study found that Sleep Apnea increased the risk of a NICU stay substantially.

Yet another study of moms in Taiwan also found that babies born to moms with known Sleep Apnea are also at higher risk for low birth weight or preterm delivery. Both of these problems can affect a baby’s health in the first few weeks of life, and increase the risk of a stay in the NICU.

Finally, babies born to moms with Sleep Apnea are at harbinger risk to have their own complications as adults. Diabetes, obesity, and other weight issues may plague adults who were born to moms with Sleep Apnea due to the oxygen deprivation they suffered in the womb. More long-term study on this risk is needed.

If Sleep Apnea risk increases because of pregnancy hormones, does that mean the condition goes away after a mom delivers her baby? For some women, Sleep Apnea is a pregnancy condition that resolves itself after the pregnancy hormones regulate. For others, the condition lingers, especially if they gained significant weight during pregnancy.

Sleep during pregnancy is incredibly important, both for mom and baby. The only way to determine if your sleep troubles are due to Sleep Apnea is to get evaluated for the condition from a medical doctor. A sleep study is the most valuable diagnostic tool to determine what is truly happening.

If you are diagnosed with Sleep Apnea, you need to treat it quickly. Your health and the health of your baby is at risk. A CPAP machine, which keeps continual positive airway pressure during sleep, is the best treatment for Sleep Apnea, and it is safe to use during pregnancy. Close monitoring from your medical professional will help ensure that the proper pressures are used during pregnancy, as the need may change as the body changes.

After pregnancy, continue using the CPAP machine until your doctor deems you do not need to use it. While it may be inconvenient to get up with your new baby and manage the machine, the quality of your sleep will be critical in those first few months of your life with a new baby in the home.

Thankfully, with the right treatment, the risks of Sleep Apnea and pregnancy are greatly reduced. If you are struggling with breathing problems during sleep, talk to your doctor about Sleep Apnea testing and treatment, so you can avoid complications.

Have you struggled with Sleep Apnea and pregnancy? How did you know that it was time to seek help, and how did your Sleep Apnea treatment affect your pregnancy?