Sleep Apnea During Pregnancy
When you have sleep apnea, your sleep is severely disturbed – caused by breathing difficulties. Every time you stop breathing, your heart rate increases and blood oxygen levels drop.
The likelihood of developing sleep apnea during pregnancy is low (10%), due to the increased levels of progesterone (which activates muscles keeping the airways open).
However, higher levels of other hormones may relax the upper airway, or increase nasal congestion, which may result in sleep apnea.
Weight gain also puts pressure on the airways and the growing baby puts pressure on the lungs, increasing breathing difficulty.
Sleep apnea is more likely to develop after the sixth month of pregnancy.
Who is more likely to develop sleep apnea during pregnancy
Sleep apnea is more likely if you sleep on your back, are obese, gain weight too quickly during pregnancy, have a wide neck, a deviated septum (one nostril narrower than the other) or if you smoke.
What are the risks of sleep apnea during pregnancy?
Poor sleep during the third trimester can be linked with problems. Untreated sleep apnea during pregnancy can affect the mother by increasing the risk of gestational diabetes, gestational high blood pressure, prolonged labor, preeclampsia or obesity hypoventilation syndrome (low blood oxygen).
It can also increase the chances of needing an unplanned cesarean, preterm birth or stillbirth. In terms of the potential impact on your baby, their oxygen levels drop too which can cause acidosis, fetal growth restriction (meaning they are smaller than normal) or development issues.
Although sleep apnea can have serious consequences, not everyone that has it will experience all these concerns.
Treatment for sleep apnea
Mild sleep apnea during pregnancy can be managed by making lifestyle modifications such as sleeping on your side and minimizing weight gain.
For mild sleep apnea, an oral appliance (similar to a dental retainer) can be worn during sleep – and will reduce symptoms.
Those with moderate to severe sleep apnea can greatly benefit from gold standard treatment with a continuous positive airway pressure (CPAP) machine. This involves wearing a mask over your nose and/or mouth while asleep (you soon get used to it). Patients with mild sleep apnea have also shown improvement.
The machine pumps air into your upper airways at a specific air pressure level to prevent tissue collapsing while you are sleeping.
The pressure applied will be increased as you progress through your pregnancy, gaining weight.
Your sleep specialist will recommend a tailored treatment plan to meet your needs while pregnant, keeping you and your little one in the best health possible.
Do you have symptoms of sleep apnea?
It is difficult to detect sleep apnea by yourself. Your partner may notice night-time signs:
- Snoring, gasping, snorting, gagging or choking noises suggesting breathing is stopping and restarting
- Grinding your teeth
During the day, you may experience:
- Headache, dry mouth or feeling dizzy when waking up
- Not feeling refreshed
- Feeling drowsy while driving
- Mood swings, depression, irritability
- Forgetfulness and difficulty concentrating
How is sleep apnea diagnosed?
A sleep test you can perform at home will measure breathing, airflow, blood oxygen levels and snoring to indicate whether sleep apnea is likely. A detailed interpretation will recommend next steps for your doctor to discuss with you upon follow up. If you're having rare neurologic symptoms such as parasomnias or narcolepsy then an in-lab polysomnogram will be recommended.
If you're pregnant and have several signs of sleep apnea, mention it to your OB-GYN -- who can order a home sleep test or refer you directly to a sleep specialist.