The Dangers of Snoring During Pregnancy
Is snoring killing you in your sleep? If you are pregnant, is snoring also starving the fetal heart of oxygen? We often think of snoring as an annoying habit our significant other or family members do or you might be the one snoring. Even so, is snoring normal?
During pregnancy, gestational diabetes can tend to be the physicians focus. However, sleep health should be discussed especially in relation to gestational sleep apnea. Snoring is NOT normal. Yet, over 3/4 of pregnant women experience more sleep disturbance than before conceiving. While being a tired mom is socially considered normal, less typical is obstructive sleep apnea which is a condition that presents more often during pregnancy and causes your breathing to start and stop during sleep.
Sleep apnea is deprives your body of oxygen and can be serious for both the expectant mother and the baby. It is a chronic condition that occurs when the airways collapse during sleep temporarily blocking airflow and causing involuntary moments of breathlessness or shallow breathing. Temporary pauses of breathing called apnea can last anywhere from ten seconds to a minute or more. The level of apnea you have is determined by the number of times you stop breathing in your sleep. People with mild sleep apnea typically have 5-14 pauses of breathing an hour. Those with moderate apnea have 15-29 pauses and people with severe apnea experience more than 30 episodes an hour. All pregnant women have an increased risk of obstructive sleep apnea because higher levels of estrogen can cause the mucus membranes in ones nose to swell leading to nasal congestion. Working harder to breathe can also cause the lining of airway to swell which restricts the airway and increases the difficulty to breath. This chain of events can make sleep apnea somewhat more common during pregnancy. About 8% of pregnant women enrolled in a study developed symptoms at mid-pregnancy. If expectant mother is overweight, obese, or gain too much weight during pregnancy, she is particularly at risk. Extra tissue in her neck can block the airway making it harder to breath at night. Mothers to be with gestational diabetes are also at higher risk. Other reasons ones airway might be blocked during sleep include congestion caused by allergies or illness along with certain physical attributes such as: receding chin, enlarged adenoids, large tongue, deviated septum, or above average neck circumference.
What happens when the snoring starves the fetal heart of oxygen? As the child grows and the lungs and respiratory systems are cramped breathing compensation means there is a higher chance for increased pressure and snoring during sleep. Less oxygen to the fetus increases the risk of pregnancy complications and neonatal morbidity such as intrauterine growth restriction, organ development and neurobehavioral disorders and neonates. Fetal hypoxia exposure is known to impair fetal cardiovascular systems.
When it comes to sleep apnea and pregnancy, recognition and treatment of sleep apnea can be beneficial to a healthy pregnancy. Physicians are encouraging consistent sleep schedules, sufficient sleep durations (usually about 7-9 hours a night), and treating problems with insomnia or sleep apnea are recommended. Pregnant women need to maintain the same bedtime and waketime each day, limit caffeine consumption especially after 1pm, and limit screen-time before bed to reduce the chances of developing sleep apnea. Also, making sure not to over nap during the day. Finding a good sleeping position such as lying on ones side with knees bent is likely to be the most comfortable position. Sleeping in this position allows the heart to carry blood back to the heart from the legs and feet more easily as it decreases the amount of pressure that the baby applies to the inferior vena cava. The most effective treatment for sleep apnea is continuous positive air pressure of a CPAP machine. It is a device worn at night that keeps the throat from collapsing.
The risk for preclampsia and gestational diabetes is higher in pregnant women with sleep apnea. At this time, universal screening for mild or moderate sleep apnea during pregnancy is not the standard of care. If a woman comes into pregnancy with an already established diagnosis of sleep apnea and a prescription for CPAP she should be encouraged to continue therapy under the supervision of a sleep specialist. In addition, women presenting to their OB with severe sleep complaints during pregnancy should be referred to a sleep specialist for evaluation.
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