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Published on April 26, 2012

Pregnancy and Sleep Apnea: A Guide for Expectant Mothers

In Brief

  • Sleep apnea can affect anyone at any age, but a woman’s chances of suffering from sleep apnea can increase while pregnant.
  • OSA can put pregnant women at a greater risk of high blood pressure and even gestational diabetes, and it may have other adverse effects upon both maternal and fetal health.
  • Pregnant women who have signs and symptoms of OSA, such as snoring and feeling like you aren’t getting the proper rest each night, should have a sleep study done to determine the cause.

If you are a mom-to-be, you know that sleep and pregnancy are rarely used in the same sentence. This is because there are many problems associated with getting a good night of sleep while pregnant. One of the most common problems is sleep apnea, a disorder that occurs when a person's breathing is interrupted during sleep.

“Sleep apnea can affect anyone at any age, but a woman’s chances of suffering from sleep apnea can increase while pregnant,” says Asad Khan, M.D., pulmonologist and medical director of the Crozer-Keystone Sleep Center at Brinton Lake. “This is because weight gain and hormonal changes may interfere with breathing.”

According to the American Academy of Sleep Medicine (AASM), increases in the levels of progesterone and estrogen with pregnancy are likely to play a role in exacerbating sleep-disordered breathing, such as sleep apnea.

Pregnant women are more likely to suffer from obstructive sleep apnea (OSA), the most common form of the disorder. OSA occurs when the muscles in the back of the throat relax and the airways become narrow and they close as a person breathes in.

Because of this, a person’s breathing stops and the level of oxygen in the blood becomes low. A signal is then sent to the brain that it is not receiving enough oxygen, and the person is then forced to wake up. People rarely remember waking up throughout the night because it happens so briefly. This pattern can repeat itself five to 30 times or more each hour, all night long.

Central sleep apnea, which is far less common, occurs when your brain fails to transmit signals to your breathing muscles. People often wake up with shortness of breath or have difficulty getting or staying asleep.

“OSA can put pregnant women at a greater risk of high blood pressure and even gestational diabetes, and it may have other adverse effects upon both maternal and fetal health,” says Calvin Stafford, M.D., neurologist and medical director of the Crozer-Keystone Sleep Center at Taylor Hospital. “Pregnant women who have signs and symptoms of OSA, such as snoring and feeling like you aren’t getting the proper rest each night, should have a sleep study done to determine the cause. If a woman is, or was previously, diagnosed with sleep apnea, continuous positive airway pressure (CPAP) is a safe and effective treatment for sleep apnea during pregnancy.”

“Along with sleep apnea, it’s also common for pregnant women to suffer from insomnia and restless legs syndromes (RLS),” says Michael Weinstein, M.D., pulmonologist and medical director of the Crozer-Keystone Sleep Center at Delaware County Memorial Hospital. “With the fluctuation in hormones, gastroesophageal reflux or heartburn, back pain, discomfort from physical changes during pregnancy, and having frequent urges to urinate throughout the night, it can be hard to get a restful night of sleep.”

Because sleeping well throughout pregnancy can be challenging, the AASM offers these coping tips to minimize loss of sleep for an expectant mother:

  • Plan, schedule and prioritize sleep.
  • Sleep on your left side to improve the flow of blood and nutrients to your fetus and to your uterus and kidneys. Try to avoid lying on your back for extended periods of time.
  • Drink lots of fluids during the day, especially water, but cut down on the amount you drink in the hours before bedtime.
  • Snoring is very common during pregnancy, but if you have pauses in your breathing associated with your snoring, you should be tested for sleep apnea.
  • If you develop RLS, you should be evaluated for iron or folate deficiency.
  • If you can't sleep, don't lie in bed forcing yourself to sleep. Get up and read a book, knit or crochet something for your baby, write in a journal, or take a warm bath.
  • When sleeping, lie on your left side with your knees and hips bent. Place pillows between your knees, under your abdomen and behind your back. This may take pressure off your lower back.
  • Put a nightlight in the bathroom instead of turning on the light to use the bathroom — this will be less arousing and help you return to sleep more quickly.
  • Add daytime naps as necessary, but reduce them or nap earlier in the day if you have difficulty falling asleep at night.

Crozer-Keystone’s sleep program is the oldest nationally accredited sleep program in the Delaware Valley. We use the latest technology, and our sleep specialists and physicians are specially trained in the diagnosis and treatment of sleep disorders. We can treat a full-range of sleep disorders in adults and children, including sleep apnea, narcolepsy, restless legs syndrome, insomnia, REM behavior disorder and more.

For more information, or to schedule an appointment at one of the Crozer-Keystone Sleep Centers, call 1-888-SLEEP-03 (1-888-753-3703) or visit us online at http://sleepcenters.crozerkeystone.org.

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