Pregnancy is complicated. For those with obstructive sleep apnea (OSA), sleep disruption and the associated cardiovascular effects of not getting enough oxygen also progresses with your baby. The prevalence of a sleep disorder in pregnant women is actually very high, so it’s only natural for anyone trying to get pregnant to wonder why - and what your risk factors are.
For those who are already pregnant, congratulations! You’re now juggling the biological changes of growing a human and (potentially) OSA. This is doubly true if your OSA diagnosis came first. Don’t worry; Aeroflow Sleep is here to help you understand how important it is to properly identify and treat OSA during pregnancy, because it could save more than one life! OSA is a sleep disorcer that is categorized by temporary pauses in breathing while sleeping.
This Mother’s Day, Aeroflow Sleep will explore the intersection of sleep apnea and pregnancy. Plus, you’ll learn what is happening with your body and why ignoring OSA can seriously harm your health. Most importantly, we encourage you to stay in close communication with your healthcare team in order to have a safer pregnancy with OSA, which is why we brought in an expert. Let’s get started!
Table of Contents
- Does Pregnancy Increase the Risk of Sleep Apnea?
- The Risks of Sleep Apnea During Pregnancy
- Does Sleep Apnea Cause Miscarriage?
- What Are the Signs and Symptoms of Sleep Apnea?
- Does Sleep Apnea Go Away After Pregnancy?
- Can You Be Tested For Sleep Apnea During Pregnancy?
- How Is Sleep Apnea Treated During Pregnancy?
- Aeroflow Can Get Mom-To-Be Treated
Does Pregnancy Increase the Risk of Sleep Apnea?
Dr. Jessica Madden, a board-certified pediatrician and neonatologist of over 15 years and the Medical Director of our parent company’s Breastpumps division, says that,
“Women who are obese when they get pregnant are at the highest risk of having sleep apnea during pregnancy (15-20% of obese women have sleep apnea). Pregnant women are at a higher risk of sleep apnea during pregnancy due to weight gain and also changes in the oropharyngeal region during pregnancy that lead to narrowing of the airway.”
Obesity and pregnancy-related hormonal changes aren’t the only reasons your airways narrow while creating new life. Blood vessels become inflamed, causing upper airway tissues to swell and may reduce lung function. Additionally, lung function can decrease due to crowding as the uterus grows and starts to put pressure on or displace surrounding organs.
Ladies, it’s important to mentally prepare yourself for these situations, and then remember that gestational OSA may not resolve after giving birth. That’s because OSA is even more common immediately postpartum. We’ll revisit this topic later in the blog.
The Risks of Sleep Apnea During Pregnancy
On the flip side, does pregnancy affect sleep apnea? Dr. Madden says yes:
“Yes, pregnant women with sleep apnea are at an increased risk of cardiomyopathy (enlarged heart), congestive heart failure, pulmonary embolism (blood clot in the lungs), and death. Sleep apnea has also been associated with all of the pregnancy complications listed below in various studies:”
- Hypertensive Disorders & Pre-Eclampsia
- Gestational Diabetes
- Preterm Delivery
- Intrauterine Growth Restriction (IUGR)
- Increased Risk of Needing Cesarean Section
- Lower Apgar Scores in Newborns
Additionally, OSA has been associated with concerning birth weights and fetal growth anomalies; including both Small and Large for Gestational Age (SGA & LGA) infants. That said, not all of the studies agree. Dr. Madden explains:
“The scientific evidence showing these associations is conflicting (i.e. for every study that shows sleep apnea and gestational diabetes may be linked, there is another study not showing a relationship between the two).
“There is, by far, the strongest evidence base for sleep apnea during pregnancy increasing the risk of hypertensive disorders and pre-eclampsia. This makes sense since we know that sleep apnea greatly increases the risk of developing high blood pressure in non-pregnant individuals.”
OSA is a well-studied condition with many forms of successful treatment, so it’s always best to follow medical advice from your doctor(s) and take care of yourself before the baby comes. Keeping your blood pressure, oxygen, and sugar levels healthy during pregnancy creates the potential for a far healthier pregnancy, delivery, and neonatal period for both mother and baby.
Does Sleep Apnea Cause Miscarriage?
It’s certainly a question that merits further study, but there is not yet reason to believe sleep apnea causes miscarriage. Dr. Madden assures us that,
“Although there is an association between sleep apnea and pregnancy complications that might increase the risk of miscarriage (i.e. pre-eclampsia), there have not been any studies showing a direct link between sleep apnea and miscarriage.”
What Are the Signs and Symptoms of Sleep Apnea?
The following list details the signs and symptoms of sleep apnea. Be on the lookout for any and all, especially in combination. And don’t be afraid to ask your primary care physician, obstetrics team, or gynecology experts for more information. They may refer you to a sleep specialist or ENT who can help you determine the best next steps. Here’s that list:
- Loud snoring
- Daytime sleepiness
- Headache, dry mouth, or sore throat upon waking
- Gasping or choking during the night
- Gestational hypertension (high blood pressure)
- Weight gain or obesity
- Irritability or mood swings
We know these last two can be hard to differentiate as symptoms during pregnancy. Nevertheless, mention them to your doctor
A healthy metabolic rate should be maintained, even while pregnant. Therefore, excess weight gain can still be harmful. According to a medical review in WhatToExpect, “If you gain 3 lbs. in a week during the second trimester or 2 lbs. in a week during the third trimester, it could be a sign of preeclampsia.”
Your degree of mood disruption is also of note if you are severely sleep or oxygen deprived.
Does Sleep Apnea Go Away After Pregnancy?
As your body heals postpartum, be sure to treat your gestational OSA like it has not gone away. Sleep apnea may become less noticeable, but it is important to continue treatment until you and your doctor decide together on next steps. After all, we mentioned earlier how gestational OSA may not resolve after giving birth.
The ways your doctor may suggest to resolve it are based on two major factors: weight loss and changing hormone levels. Progesterone regulates your menstrual cycle, and as that returns, these resolutions sometimes can as well. If not, you may need hormonal supplements provided by your doctor to get things going again.
Keep in mind that sleep becomes even more elusive and more important to address after birth too! Always talk to your doctor about any health concerns regarding sleeping or breathing. You require as much rest as you can get, because your health is very important to your baby’s health.
Can You Be Tested For Sleep Apnea During Pregnancy?
Yes, you should absolutely get tested if there’s any indication of sleep apnea. A polysomnography sleep study can be done in the lab, overseen by a sleep specialist. This is the most comprehensive and accurate type of testing and is safe during pregnancy.
If you prefer, home sleep testing could also be arranged in the comfort of your own bed; however, this is typically unattended by a physician and does not always provide as accurate of results.
In either case, testing is non-invasive and monitors a lot; like your overnight airflow, oxygen levels, and AHI, or Apnea-Hypopnea Index. This is the measurement that helps doctors determine if obstructive sleep apnea treatment is necessary, and to what degree.
How Is Sleep Apnea Treated During Pregnancy?
Luckily, if you are diagnosed with sleep apnea, you have a number of treatment options available during pregnancy. Your doctor may recommend:
- Positional therapy, wherein you support or train your body to achieve certain sleep positions for maximum airflow.
- Over-the-counter decongestants to reduce swelling and open up airways.
- Weight management to keep weight gain from getting out of control. Albeit normal during pregnancy is normal, obesity in all body types leads to a high risk of developing or worsening OSA. This pertains to obese pregnant women too.
Most importantly, CPAP treatment will likely be prescribed in combination with the options listed above. Dr. Madden confirms that,
“CPAP is a safe treatment for sleep apnea during pregnancy, and is actually the treatment of choice for sleep apnea during pregnancy.”
CPAP stands for continuous positive airway pressure, and it is a completely non-invasive nightly breathing treatment. This form of sleep medicine is provided through a CPAP machine, which produces air pressure that keeps your airways from collapsing. Ever-improving technology makes CPAP machines more and more comfortable too, helping you get a better night’s sleep while avoiding oxygen desaturation, cardiovascular disease, and a whole host of pregnancy-related complications.
Aeroflow Can Get Mom-To-Be Treated
None of this needs to be stressful. Aeroflow Sleep takes the headache out of healthcare and gets you set up with PAP supplies through insurance. We are in network with most primary and secondary insurance providers and are even accredited by Medicare and Medicaid. All you have to do is fill out a simple questionnaire to check your eligibility and tell us which (if any) PAP supplies you currently use. It’s as simple as that!
Nearing your due date? Aeroflow Breastpumps can help with that side of things! From breast pumps to maternity compression and postpartum recovery, discover the motherhood essentials covered. Just provide your insurance information here too.
No matter what you need at this time, breathe, sleep, and dream deeply, Mama. You’ve got this!