It’s no secret that when you’re pregnant, sleep can be more difficult. Early pregnancy insomnia, difficulties getting comfortable, and the frequent late-night pee stops can all make it difficult to get enough rest, even when you really need it.

As your pregnancy progresses, you might also find that you start snoring.

But it turns out there is one more thing that makes getting enough quality rest tough too: sleep apnea, a condition that researchers estimate may affect as many as 26 percent of all pregnancies.

Obstructive sleep apnea is a condition where your breathing stops repeatedly while you sleep, disrupting your sleep.

It occurs when your upper airway — including the base of your tongue and soft palate — gets either partially or completed blocked or collapses during the night, pausing your breathing for 10 seconds or longer.

This occurs hundreds of times throughout the night. When your breathing restarts, you might snore loudly or even gasp or choke in your sleep.

Hormonal changes can lead to sleep apnea during pregnancy.

Higher levels of hormones, for example, can cause the mucus membranes in your nose to swell, making you feel more congested than usual — which in turn, can lead to snoring and sleep apnea.

Higher levels of progesterone, another hormone, also activate muscles, which can relax your airway and contribute to sleep apnea.

In addition, as you gain weight during your pregnancy, it can put more pressure on your airways, making it more difficult to breathe at night.

Your developing uterus and baby also put pressure on your lungs, reducing your air volume and increasing your breathing rate.

You are also less likely to sleep on your back as your pregnancy progresses, but that too increases the risk of sleep apnea.

Obstructive sleep apnea is a sleep disorder because it disrupts the quality of your sleep. As a result, if you have sleep apnea, you likely feel extra fatigued and groggy the next day. This is because each time your breathing pauses, you will partially wake up to make yourself breathe again — meaning you don’t sleep as deeply.

For you

In general, when left untreated, sleep apnea starts to take a toll on your overall health because when your breathing pauses, the oxygen level in your blood drops, and your heart rate increases.

That’s why the condition, even when you’re not pregnant, can raise your risk for or contribute to several other health conditions, including:

But during pregnancy specifically, sleep apnea can raise y

our risk of gestational hypertension (high blood pressure) and gestational diabetes.

Research has also shown that it could lead to:

For baby

Because pauses in breathing with sleep apnea can cause surges in blood pressure, it can cause changes in your blood vessels, reducing the volume of blood pumped by your heart. This can compromise the blood flow to your baby via the placenta, leading to drops in the baby’s oxygen levels too.

This can cause your baby’s heart rate to drop or acidosis. It can also contribute to fetal growth restriction, a condition where your baby doesn’t grow in-utero as expected, leading them to be smaller than their gestational age.

When your sleep is disrupted during pregnancy, it can also lower the amount of growth hormone released, leading to not only growth problems but also developmental issues. It can also increase the risk of preterm birth, as well as health problems or even the death of your newborn baby.

Any pregnant person can develop obstructive sleep apnea.

However, the risk is higher if you have obesity, gain weight too quickly during pregnancy, or have gestational diabetes. You are also more likely to develop it if you have a deviated septum or a wider neck.

Sleep apnea will generally make you feel more tired, groggy, or irritable in the morning.

Other symptoms you might notice include:

Your partner or anyone who sees you sleep might also notice you’re snoring more loudly, may witness you gagging or choking in your sleep, or may even notice that you stop breathing for 10 seconds or more at a time.

If you or a loved one think you have sleep apnea during your pregnancy, it’s important to mention it to your OB-GYN or healthcare professional.

Your doctor will ask you about your symptoms, then likely evaluate your mouth, nose, and throat.

They might also refer you to a sleep specialist, who can run a sleep study — or polysomnography — to measure things like your airflow, breathing patterns, and blood oxygen levels while you sleep.

This will help them determine the severity of your sleep apnea and develop a treatment plan that will work for you.

Treatment will depend on the severity of your sleep apnea and your symptoms.

Your doctor will likely recommend you start with adhesive breathing strips, which help open up your nostrils to help you breathe while you sleep.

They might also recommend tips to help reduce any nasal congestion you’re having, including:

  • saline sprays
  • saline rinses
  • humidifiers in the room where you sleep

In some cases, they might also recommend an over-the-counter decongestant that is safe to take during pregnancy — but be sure not to take any medication by yourself without running it by your doctor.

They might also recommend some dietary changes to help you gain weight at a healthy rate throughout your pregnancy.

In more serious cases of sleep apnea, they might prescribe:

CPAP machines are generally covered by insurance and are machines that require that you wear a mask over your nose and mouth while you sleep. This mask provides you with a gentle, continuous flow of air to help keep your airways open so you can breathe without disruption.

If your sleep apnea isn’t severe, your doctor will probably recommend some tips for you to try at home to reduce your sleep apnea before prescribing something like a CPAP machine.

These can include:

Sleep positions

Sleeping on your back can make sleep apnea worse. That’s why your doctor will recommend you sleep on your left side during your pregnancy.

If this isn’t your usual sleeping position — or you keep waking up to find that you’ve rolled on your back in your sleep — consider getting a body pillow or pillow wedge to help you feel more comfortable on your side.

You can also try putting something behind your back — like a tennis ball taped to your back or a hard book next to you in bed — to try to remind yourself not to roll into the wrong position.

Healthy eating choices

Gaining weight at a doctor-recommended pace can help reduce your risk of developing sleep apnea, which is why it’s important to focus on nutritious foods that keep you full — rather than snacks — while you’re pregnant.

If you’re gaining weight too quickly or feeling unsure about what you can and can’t eat during pregnancy, talk with your doctor. They’ll be able to help make some recommendations.

Wear nasal strips

As mentioned, over-the-counter nasal strips can be very effective at keeping your airways open and clear while you sleep, reducing your sleep apnea and snoring.

In general, with treatment, sleep apnea can be improved, which will reduce your risk for longer-term health complications.

Does it go away after pregnancy?

It depends.

Research suggests that sleep apnea improves or resolves completely after pregnancy — especially if you didn’t have it before you got pregnant.

Sleep apnea tends to improve with weight loss in general, so as your uterus shrinks back down to its typical size and you lose some of the extra weight of pregnancy, you may see improvement.

If you don’t, let your doctor know and they can go over long-term treatment options with you.

Does it affect the baby?

It’s unclear what the long-term effects of sleep apnea might be on babies after they’re born, but some smaller studies have suggested that there might be some longer-term consequences.

For example, one older study found a correlation between kids born to moms with sleep apnea and lower social development scores, while another found shorter telomere lengths in their DNA, which can sometimes lead to age-related disease.

However, further research is needed before we’ll know for sure what long-term effects there might be on the baby.

Sleep apnea can develop in pregnancy, especially as your baby grows in your uterus and puts pressure on your lungs and you gain baby weight. Your hormones, too, can increase your risk of developing sleep apnea.

This can put you at risk for a number of health complications, including gestational diabetes, preeclampsia, preterm birth, prolonged labor, or an unplanned c-section. It can also put your baby at risk of not growing and hitting gestational milestones.

The good news is that there are treatments you can try, including nasal strips and CPAP machines. The condition might also improve after your baby arrives.

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