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Jennifer L.W. Fink
Registered Nurse

Sleep Apnea During Pregnancy

Worried you could have sleep apnea? Here’s how to spot it, and what to do about it.

What is sleep apnea?

Sleep apnea is a sleep disorder where there are pauses in breathing. Instead of breathing in and out normally, a woman with sleep apnea will stop breathing for a brief period and then start back up spontaneously. These pauses can happen many times in a night.

What are the signs of sleep apnea during pregnancy?

Loud snoring is the number one sign of sleep apnea. Not everyone who snores has sleep apnea, but a lot of snorers do. Sometimes, a partner will also say they saw or heard the other partner “choking,” or coughing and sputtering after a breathless pause.

Extreme daytime sleepiness is another symptom of sleep apnea. It can be hard to tell the difference between normal pregnancy exhaustion and tiredness caused by sleep apnea, but if you just can’t stay awake in the afternoons, or are dozing off while driving, tell your doctor. He can order some tests to see if sleep apnea is causing your tiredness.

Other symptoms include waking with a headache and/or dry mouth, nighttime heartburn and frequent nighttime urination. (Of course, heartburn, waking up at night and having to pee are all common symptoms during pregnancy too, so they’re not surefire signs.)

Are there any tests for sleep apnea?

A sleep study is the definitive test for sleep apnea. Using specialized equipment and monitors, healthcare professionals can assess your breathing, oxygen levels, sleep stage, body movement and heart, lung and brain function while you sleep. A sleep study will reveal if you stop breathing during the night, and if so, how often and to what degree. It allows a doctor to determine if your snoring or brief pauses in breath are no big deal, or if they interfere with the supply of oxygen to your body.

Sleep studies used to be performed exclusively at hospitals and sleep center, but today, they are sometimes performed at home.

A doctor may also send you to an ear, nose and throat specialist for an examination of your upper airway. A thorough exam can reveal structural problems, such as a deviated septum or enlarged tongue, which might contribute to sleep apnea. 

All tests for sleep apnea are non-invasive and won’t affect your pregnancy.

How common is sleep apnea in pregnancy?

The incidence of sleep apnea in women of childbearing age is somewhere between one to 10 percent. (It’s hard to come up with an accurate number, since many people have sleep apnea without knowing it.)

Women are more likely to develop sleep apnea during pregnancy and after menopause. But while restless sleep and shortness of breath are common in pregnancy (especially in later pregnancy), sleep apnea is rare in healthy pregnant women with uncomplicated pregnancies. It’s more common in women with high blood pressure, preeclampsia or gestational diabetes.

How did I get sleep apnea?

That’s a tough question, because there are a lot of causes of sleep apnea. Obstructive sleep apnea happens when something blocks the flow of air through the airway, and some people are simply more likely to develop sleep apnea because of the shape of their upper airway. Genetics plays a role — if someone else in your family has sleep apnea, you’re more likely to have it too, the same way you can inherit your dad’s eye color or your mom’s dimples.

Obesity is commonly linked to obstructive sleep apnea, because excess tissue in the airway (and excess pressure from extra weight) can obstruct the airway during sleep.

During pregnancy, the physical changes you experience may contribute to the development of sleep apnea. Pregnancy hormones can congest the mucous membranes of the upper airway; that congestion can increase the likelihood of sleep apnea.

Sleep apnea is more common in pregnant women with high blood pressure and/or gestational diabetes, but high blood pressure and gestational diabetes don’t seem to_ cause _sleep apnea.

How will my sleep apnea affect my baby?

Sleep apnea during pregnancy has been linked with gestational diabetes, preeclampsia, preterm delivery and low birth weight. The good news is that appropriate treatment greatly increases your chances of having a healthy baby.

What’s the best way to treat sleep apnea during pregnancy?

That depends on the cause and severity of your sleep apnea. The most common treatment options are:

• Continuous positive airway pressure (CPAP). A CPAP machine uses air pressure to keep your airway open while you sleep. A person using a CPAP machine wears a mask over her nose or nose and mouth while sleeping; a tube connects the mask to a machine at the bedside and delivers positive air pressure. CPAP treatment is highly effective for obstructive sleep apnea, but some people find the machine and mask cumbersome. If you need CPAP, but are uncomfortable with the machine, let your physician know; don’t just stop using it. CPAP only works if you use it.

• Oral appliances.  Specially-made oral appliances can keep the airway open while you sleep. To be effective, they must be custom-made for you; there’s no such thing as an over-the-counter, one-size-fits-all oral appliance for sleep apnea.

• Surgery. Although surgery is not usually done on pregnant women unless absolutely necessary, it can be performed before or after pregnancy if a structural defect if found to cause your sleep apnea.

What can I do to prevent sleep apnea?

Keeping your weight in check may help. Sleep apnea is more common in obese women (and men), so watch your pregnancy weight gain. Most women should gain between 25 and 35 pounds during pregnancy. Obese women are advised to keep their weight gain between 11 and 20 pounds.

What do other pregnant moms do when they have sleep apnea?

“Find a doctor that will take you seriously. When I told my doctor about my symptoms, they ordered a sleep study and within a few weeks I had my results and started on my CPAP machine. I have never felt so amazing and well rested in my life.”

“I have sleep apnea. I had it before I was pregnant so I already have my CPAP machine and wear the mask every night. But it got worse with pregnancy. I also use a non-water Vicks vaporizer. It is about 10 bucks at Walgreens or Target (that is where I found it) and you get these little Vicks cartridges to put in it. It helps.”

Are there any other resources for sleep apnea in pregnancy?

The Bump expert: Matthew D. Mingrone, MD,  lead physician for EOS Sleep California centers.

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