Sleep-Disordered Breathing in Pregnancy: What Every Expecting Mom Should Know
Pregnancy brings countless changes to the body, some exciting, others challenging. While most women expect morning sickness and fatigue, few realize that pregnancy can also affect how you breathe during sleep. Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA), can quietly impact both maternal and fetal health if left untreated.
Understanding Sleep-Disordered Breathing
Sleep-disordered breathing refers to conditions where breathing repeatedly stops or becomes shallow during sleep. The most common form, obstructive sleep apnea, occurs when the airway collapses or becomes blocked.
During pregnancy, hormonal changes, increased fluid retention, and weight gain can narrow the upper airway, making it harder to breathe smoothly through the night.
Why Pregnancy Increases the Risk
Pregnancy changes how your body regulates breathing and oxygen levels. Several factors increase the likelihood of SDB during pregnancy:
- Weight gain and fluid retention, which narrow the airway
- Hormonal changes, particularly high estrogen, that cause nasal congestion
- Reduced lung capacity, as the growing uterus shifts diaphragm position
- More fragmented sleep, due to discomfort, frequent urination, or fetal movement
Even women who never snored before may notice new or louder snoring as pregnancy progresses, especially in the third trimester.
Warning Signs to Watch For
Recognizing the signs of sleep-disordered breathing can be difficult because fatigue and restless sleep are common in pregnancy. Still, there are red flags worth noting:
- Loud, habitual snoring
- Pauses in breathing reported by a partner
- Gasping or choking during sleep
- Morning headaches or dry mouth
- Daytime sleepiness or brain fog
- Mood changes or symptoms of depression
If these sound familiar, don’t dismiss them as “just pregnancy.” They could be signs of a deeper airway issue.
How Sleep Apnea Impacts Mom and Baby
Untreated sleep-disordered breathing isn’t just uncomfortable, it can have serious health consequences for both mother and child.
Maternal Risks
- Preeclampsia and gestational hypertension (high blood pressure disorders)
- Gestational diabetes mellitus (GDM)
- Increased risk of cesarean delivery
- Heart strain and poor oxygen regulation
Fetal Risks
- Low birth weight
- Preterm delivery
- Lower Apgar scores
- Potential growth restriction due to oxygen fluctuations
In fact, studies show that pregnant women with OSA are twice as likely to develop preeclampsia and up to three times as likely to develop gestational diabetes compared to women without SDB.
Diagnosis: What to Expect
The gold standard for diagnosing sleep-disordered breathing is an overnight, attended sleep study (polysomnography). While home sleep tests are sometimes used, they may underestimate the severity of symptoms in pregnant patients.
Your provider may recommend a sleep evaluation if you:
- Have chronic hypertension or obesity
- Are over age 35
- Have a twin pregnancy
- Have a history of preeclampsia or gestational diabetes
- Experience habitual snoring
Safe and Effective Treatment Options
Early treatment can make a world of difference, for you and your baby. The primary goals are to restore healthy breathing, improve sleep quality, and reduce risks during pregnancy.
1. Lifestyle & Positional Strategies
- Sleep on your left side or with your upper body slightly elevated
- Treat nasal congestion naturally (e.g., humidifier, saline sprays)
- Avoid smoking, alcohol, and caffeine before bed
- Maintain a healthy weight as advised by your doctor
2. Continuous Positive Airway Pressure (CPAP)
CPAP therapy, delivering gentle air pressure through a mask to keep airways open, is safe and highly effective in pregnancy. Studies show it can improve oxygen levels, stabilize blood pressure, and even enhance fetal well-being.
3. Postpartum Reassessment
The good news: for many women, sleep apnea improves after delivery as swelling subsides and body weight normalizes. However, if symptoms persist, a follow-up sleep study is important to reassess treatment needs.
Why Early Diagnosis Matters
Sleep-disordered breathing in pregnancy is often underdiagnosed, mistaken for normal tiredness. But identifying it early can dramatically improve outcomes, reducing complications like preeclampsia, gestational diabetes, and premature birth.
If you’re experiencing persistent fatigue, snoring, or disturbed sleep during pregnancy, talk to your healthcare provider or a sleep specialist. A simple test could protect both your health and your baby’s.
Key Takeaway
Pregnancy naturally changes your breathing and sleep patterns, but sleep apnea is not something to ignore. Understanding the signs, getting tested, and seeking proper care can help ensure a safer, healthier pregnancy for both mother and baby.
