Alaska Sleep Education Center

Pregnancy and Sleep Apnea: OSA and Increasing Weight Gain

Posted by Jennifer Hines

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on Dec 23, 2015 8:00:00 AM


Like most moms-to-be, you are probably suffering from uncomfortable restless nights and sleep deprivation and you haven’t even had the baby yet!   As if nausea, chronic back pain, fetal movement, and frequent trips to the bathroom weren't discomforting enough, many women even develop sleep disorders while pregnant including insomnia, restless leg syndrome, nocturnal gastroesophageal reflux disease (GERD), and excessive daytime sleepiness.

According to a study conducted, 75% of pregnant women experience sleep issues at some point during their pregnancy.  Most of these sleep disturbances are considered fairly normal during the course of pregnancy.  However, the less typical sleep disorder, obstructive sleep apnea (OSA), is often the most problematical for the health of you and your baby.

The exact prevalence of OSA among pregnant women is unknown however the prevalence of OSA is estimated to be 5 - 6% among women of reproductive age.

Obesity and Pregnancy

The occurrence of obesity in reproductive-aged women has increased in recent years. As a result, the prevalence of obesity-related comorbid conditions complicating pregnancy is also increasing, such as OSA.  In fact one study found that 15 % of obese pregnant women suffer from OSA.  Women who are already overweight are more likely to develop OSA as a result of an excess build up of fatty tissues in the throat due to the added weight gain experienced during pregnancy.  Moms-to-be with gestational diabetes are also at a higher increase of being diagnosed with OSA. 

Pregnancy is associated with many physiologic and hormonal adjustments.  In addition to obesity and pregnancy weight gain as a risk factor of OSA, an increase in estrogen during pregnancy can cause the mucus membranes lining the airway to swell and constrict airflow.  The third trimester of pregnancy can show an increase in the restriction of upper airway dimensions due to weight gain.

Dangers of Sleep Apnea and Pregnancy

The combination of OSA and pregnancy can be potentially harmful to the fetus given the low oxygen reserves during pregnancy.  Untreated OSA in pregnant women can lead to complications during pregnancy including high blood pressure, enlarged heart, pulmonary blood clots, more frequent preeclampsia, neonatal intensive care unit admissions, and cesarean delivery.

One study also found that expectant moms with OSA were up to three times more likely to require a cesarean delivery, while their newborns were more likely to require treatment in the neonatal intensive care unit, often for breathing problems. That’s why it’s so important to diagnose OSA and take steps to treat it.

Pregnancy Sleep Techniques and Tips

Treatment for mild sleep apnea usually starts with lifestyle changes such as practicing some of the proper sleep hygiene techniques listed below:  

  1. Maintain a regular sleep/wake cycle.Prioritizing sleep is key in getting  Making sure that you're going to bed and waking up at the same time every day (including weekends) goes a long way in feeling more awake and alert during the day.
  2. Exercise regularly.Unless your doctor advises against it, regular exercise should be done at least 30 minutes a day. Getting out any pent up energy through exercise will increase circulation, improve mood, and help you fall asleep easier at night. However, no vigorous exercise should be done too close to bedtime. If you prefer to workout later in the day, some light exercises such as yoga are recommended.
  3. Cutback on fluids at night.It's very important to stay hydrated during pregnancy, but to help reduce late night trips to the bathroom avoid drinking large amounts in the hours leading up to bedtime.
  4. Avoid Spicy Foods and heavy meals before bedtime. Eating spicy foods before bedtime can increase the chances and severity of heartburn at night. Eating heavy meals before bedtime makes the body work harder during sleep to digest your food, distracting it from working on the repairs your body needs for the next day's activities. If you're feeling hungry close to bedtime, try eating a light snack such as a banana, crackers and cheese, or a small bowl of cereal. For more information on foods and sleep click here.
  5. Sleep on your left side.During the third trimester of sleep it is recommended that expecting mothers sleep on their left side. This increases the flow of blood and nutrients to the fetus, uterus, and kidneys. Also, try to avoid sleeping on your back for extended periods of time.
  6. Use pillows. Special pregnancy pillows can go a long way towards nighttime comfort. Another pillow tip to reduce back pain is to lay on your left side with hips and knees bent and place pillows between your knees, under your abdomen, and behind your back.
  7. When having trouble sleeping get out of bed.If sleep is alluding you, don't lie in bed willing it to come. Get out of bed and do another relaxing activity such as reading, writing, take a warm bath, or any other relaxing activity before returning to bed.
  8. Take short naps during the day.For the most part, naps are usually advised against as they tend to disrupt regular sleep cycles making going to sleep at night more difficult. However, studies have shown that napping while pregnant can prove beneficial. A poll by the National Sleep Foundation found that 51% of women reported at least one midweek nap and 60% reported napping on the weekends. However, if you choose to nap make sure they're no more than 20-30 minutes long, and don't nap too close to bedtime.

While the diagnosis and management of OSA are similar in pregnant and non-pregnant women, some aspects of the disorder are unique to pregnancy.   If you're following these tips and still are having troubles with sleeping try talking with your doctor about other alternatives. If sleep apnea is causing you sleep troubles you may need to have a sleep study performed. 

At the Alaska Sleep Clinic we help diagnose and treat a variety of sleep disorders in all people. If you live in Alaska and believe you may be suffering from a sleep disorder give the trusted sleep experts of the state a call for a free 10-minute phone consultation.  Don't let your sleep troubles get in the way of the joys of pregnancy, contact us today!

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Topics: sleep apnea, obstructive sleep apnea

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