Obstructive sleep apnea, or OSA, is a condition where breathing repeatedly stops and starts during sleep. These pauses happen when the upper airway becomes blocked or collapses, interrupting rest and lowering blood oxygen levels. Pregnancy introduces unique physiological changes that can trigger the onset of sleep apnea or worsen a pre-existing condition. The prevalence of OSA in pregnancy can range from 3 to 27 percent, with the likelihood increasing in the third trimester.
Causes and Risk Factors During Pregnancy
The physical transformations of pregnancy are a primary driver for the development or worsening of sleep apnea. Hormonal shifts play a direct role; higher levels of progesterone can relax airway muscles, while increased estrogen can cause nasal passages to swell, leading to congestion. These changes can narrow the airway, making breathing more difficult during sleep.
The natural weight gain associated with a healthy pregnancy is also a contributing factor. An increase in body weight, including added breast tissue, can place extra pressure on the chest and throat, constricting the airway. The body also retains more fluid during pregnancy, which can lead to swelling in tissues throughout the body, including those in the upper airway.
As the pregnancy progresses, the growing uterus exerts upward pressure on the diaphragm. This reduces overall lung capacity and alters the way a person breathes, which can contribute to the collapse of the airway during sleep. Pre-existing factors such as a higher body mass index (BMI), a family history of sleep apnea, or having a large neck circumference also heighten the risk.
Recognizing the Symptoms
Identifying the signs of sleep apnea is the first step toward addressing it, and some symptoms can be mistaken for normal pregnancy discomforts. One of the most common indicators is loud and frequent snoring, which a partner often notices first. This snoring may be accompanied by audible gasps, choking sounds, or visible pauses in breathing during sleep.
A pronounced level of daytime sleepiness and fatigue, beyond what is expected during pregnancy, is another symptom. This exhaustion occurs because the repeated interruptions to breathing prevent deep, restorative sleep. Waking up with a morning headache, a dry mouth, or a sore throat are also common experiences for individuals with this condition.
Difficulty concentrating or mood swings may also arise due to fragmented sleep and fluctuating oxygen levels. The persistence and severity of these signs, when viewed together, can signal an underlying issue beyond typical pregnancy-related fatigue.
Potential Complications for Mother and Fetus
Untreated sleep apnea during pregnancy can present several health considerations for both the mother and the developing fetus. The intermittent drops in oxygen and disrupted sleep can place stress on the mother’s body, increasing the likelihood of developing certain pregnancy-related conditions. These include gestational hypertension (high blood pressure) and preeclampsia, a more serious blood pressure disorder.
There is also a documented association between maternal sleep apnea and an increased risk of gestational diabetes. The condition can interfere with the body’s glucose tolerance and insulin resistance. Mothers with untreated OSA may also have a higher probability of requiring an unplanned cesarean section delivery.
For the fetus, the primary concern revolves around the intermittent reductions in maternal oxygen supply. Surges in the mother’s blood pressure can affect blood flow through the placenta, compromising the delivery of oxygen and nutrients to the baby. This may lead to issues such as impaired fetal growth, a lower birth weight, or an increased need for admission to the neonatal intensive care unit (NICU) after birth.
Diagnosis and Management Strategies
If sleep apnea is suspected, the first step is a consultation with a healthcare provider who can assess symptoms and risk factors, as many can overlap with other conditions. A physician may recommend a sleep study, which can be conducted at home or may require an overnight stay in a specialized lab for a test called polysomnography.
The most common and effective treatment for sleep apnea during pregnancy is Continuous Positive Airway Pressure (CPAP) therapy. A CPAP machine delivers a steady stream of air through a mask, preventing the airway from collapsing during sleep. This method is considered safe for both mother and baby and can be adjusted as the pregnancy progresses to accommodate changing needs.
Alongside medical therapies, certain lifestyle and positional adjustments can offer relief. Positional therapy, which involves sleeping on one’s side rather than the back, can help keep the airway open. Elevating the head of the bed may also provide some benefit. Any management strategy must be discussed with and supervised by a healthcare provider to ensure safety and effectiveness.