Sleep breathing problems during pregnancy


Problem Sleep

Helpful advice for those who don’t breathe easy overnight.

By the end of your pregnancy, getting a good night’s sleep is nothing more than a pipe dream. Between the back pain, leg cramps, baby kicks, and squashed bladder, you’re in and out of bed so much, it feels like a revolving door. Yet for many pregnant women, sleeping poorly isn’t just an annoyance, but a sign of something more serious.Recent studies published in The Journal of the American Medical Association (JAMA) have shown that sleep apnea, which affects about 18 million Americans, is more likely to develop in pregnancy but less likely to be diagnosed, because fitful sleep is such a standard complaint for expectant mothers.

In sleep apnea, the muscles of the upper airway collapse on themselves, causing breathing pauses during sleep.Sleep apnea is common in pregnancy because of the swelling your high estrogen level causes and the change in lung function influenced by a growing uterus. Left untreated, sleep apnea can impact the health of mom and baby, too.

Fortunately, if you discover your sleep troubles do go beyond what you’d expect when you’re expecting, there’s a simple treatment to get you back to catching Z’s—and keeping them. So, what’s the difference between normal pregnancy sleep disturbance and the symptoms of sleep apnea?

Suddenly Snoring

Julie Carnett of Johnston, RI, never snored. That is, until she was about five months pregnant, when her sawing logs began to keep her husband up at night.As a registered nurse with 15 years’ experience, Carnett knew enough to be concerned. “I told my doctor that I was snoring loudly, drooling a lot, and feeling poorly rested,” she remembers. The doctor sent Carnett in for a sleep study, called a polysomnogram, in which electrodes recorded data on her sleep. “Sure enough, they diagnosed me with obstructive sleep apnea,” she says.

Roughly 25 percent of all pregnant women report that they snore, as opposed to just 4 percent of women in general, according to JAMA— and although snoring is a red flag for sleep apnea, it doesn’t necessarily mean you have the disorder.But, says Grace Pien, M.D., assistant professor of sleep medicine at University of Pennsylvania School of Medicine, if you or your partner notice that you’re experiencing breathing pauses that last 10 to 15 seconds and end with a snort, choke, or gasp, or if you feel so sleepy during the day that you can’t function, you should talk to your doctor. These are all signs of sleep apnea, also known as obstructive sleep apnea (OSA).Overweight women are at a greater risk of developing sleep apnea, and the extra weight gained in pregnancy may increase their chances.

Why Should You Worry?

“With pregnant women, we’re concerned that not enough oxygen is getting to the placenta, which can lead to problems for the baby,” Pien explains.According to JAMA, these problems include increased risk of pre-eclampsia and small-for- gestational-age infants; not to mention the risks to mom.

These include risks that sleep apnea has been associated with in the general population: everything from severe car crashes to type 2 diabetes, as reported by the American Thoracic Society.

What Can You Do?

The good news is that sleep apnea most often improves after the baby’s birth. And there’s an effective treatment that is not only easy, but also safe for pregnant women. Sufferers use a device called continuous positive airway pressure (CPAP), which delivers air through a tube that goes over the mouth and rests against the nose. It might take a little getting used to, but Carnett says CPAP has radically improved her quality of life, especially since her sleep apnea didn’t disappear after delivery.

“When I found out I had sleep apnea, I was actually really relieved because it meant there was something I could do to fix the problem,” Carnett explains. “It may sound scary, but it’s a manageable thing, and I feel so much better now because I just have much more energy.” And, with a 10-month-old daughter to chase around, energy is a handy thing to have.


Sleep’s greatest enemy is a restless mind, which may be why 78 percent of moms-tobe say they experience insomnia, according to the American Pregnancy Association.“In pregnancy, there’s often an underlying anxiety about the big life changes in the works, and this anxiety often hits in the middle of night, when women are waking frequently anyway,” says Nancy Krauss, a certified nurse- midwife in New York City.

The first step to send insomnia packing is making yourself as comfortable as you can. Don’t drink too much water before bed, use a body pillow for support, and crank up the mind-clearing white noise.And above all else, let yourself off the hook, Krauss says. “Reassure yourself that your body is resting even if you’re not sleeping, and use the opportunity to practice relaxation techniques for labor,” she explains. The extra training couldn’t hurt and, chances are, as soon as you stop trying to sleep, you’ll drift off.

— Nicole Caccavo Kear

 Nicole Caccavo Kear is a freelance writer who lives in New York City with her husband, her two-year-old son, and new baby girl.


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