Sleep Apnea and Pregnancy: How They are Connected

If you are expecting and have trouble sleeping, you might wonder if you are experiencing undiagnosed sleep apnea with your pregnancy. Sleep apnea is a condition that causes pauses in breathing during sleep. It can affect anyone, but it is more common in people who are overweight, have a large neck, or have nasal congestion. Sleep apnea can also affect pregnant women, especially in the third trimester. In this article, we will explain how sleep apnea and pregnancy are connected, what are the risks and complications, and how to treat and prevent sleep apnea during pregnancy.

What is sleep apnea?

Sleep apnea is a serious sleep disorder that affects about 5% of pregnant women. It occurs when the muscles in the back of the throat relax and block the airway, causing snoring and breathing interruptions. These interruptions can last from a few seconds to more than a minute and can happen hundreds of times per night. When this happens, the brain and the body do not get enough oxygen, which can lead to various health problems.

There are two main types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). OSA is the most common type, and it happens when the airway is physically blocked by the soft tissues of the throat. CSA is less common, and it happens when the brain does not send the right signals to the muscles that control breathing. Some people may have both types of sleep apnea, which is called mixed or complex sleep apnea.

Sleep apnea can affect anyone, but some factors can increase the risk of developing it. These include:

• Being overweight or obese

• Having a large neck circumference

• Having a family history of sleep apnea

• Having a deviated septum or nasal polyps

• Smoking or drinking alcohol

• Having allergies or sinus problems

• Taking certain medications that relax the muscles

• Having a history of stroke, heart disease, or diabetes

Pregnancy can also increase the risk of sleep apnea, especially in the third trimester. This is because pregnancy causes hormonal changes that can affect the muscles and tissues of the throat. Pregnancy also causes weight gain, fluid retention, and swelling of the nasal passages, which can narrow the airway. Additionally, pregnancy can increase the blood volume and oxygen demand of the body, which can make sleep apnea more severe.

Sleep apnea and pregnancy complications

Sleep apnea can have negative effects on both the mother and the baby during pregnancy. Some of these effects are:

• Poor quality of sleep: Sleep apnea can cause frequent awakenings, difficulty falling asleep, and daytime sleepiness. This can affect the mother's mood, energy, concentration, and memory. Poor sleep quality can also increase the risk of depression and anxiety during pregnancy.

• High blood pressure: Sleep apnea can cause spikes in blood pressure during the night, which can lead to chronic hypertension. High blood pressure can increase the risk of preeclampsia, a serious condition that causes swelling, protein in the urine, and seizures. Preeclampsia can also affect the placenta and reduce the blood flow to the baby.

• Gestational diabetes: Sleep apnea can affect the body's ability to regulate blood sugar levels. This can lead to gestational diabetes, a type of diabetes that develops during pregnancy. Gestational diabetes can cause high blood sugar levels for both the mother and the baby, which can increase the risk of complications such as macrosomia (large baby), birth injuries, cesarean delivery, and neonatal hypoglycemia (low blood sugar in the baby).

• Low birth weight: Sleep apnea can reduce the oxygen supply to the baby during pregnancy. This can affect the baby's growth and development, and lead to low birth weight. Low birth weight babies may have more health problems such as respiratory distress syndrome, jaundice, infections, and bleeding in the brain.

• Preterm birth: Sleep apnea can increase the risk of preterm labor and delivery. Preterm birth is defined as giving birth before 37 weeks of gestation. Preterm babies may have more difficulties with breathing, feeding, temperature regulation, and infections. They may also have long-term problems such as cerebral palsy, learning disabilities, and behavioral issues.

How to Diagnose Sleep Apnea During Pregnancy?

If you suspect that you have sleep apnea during pregnancy, you should talk to your doctor as soon as possible. Your doctor may ask you about your symptoms, medical history, family history, and lifestyle habits. Your doctor may also examine your mouth, nose, throat, neck, and chest for any signs of obstruction or inflammation.

The most reliable way to diagnose sleep apnea is by doing a sleep study. A sleep study is a test that measures:

• breathing patterns,
• heart rate,
• blood pressure,
• oxygen levels,
• brain activity.

A sleep study can be done in a sleep lab or at home, depending on your condition and preference. A sleep study can help your doctor determine the type, severity, and frequency of your sleep apnea episodes.

How to Treat Sleep Apnea During Pregnancy?

The treatment of sleep apnea during pregnancy depends on the type, severity, and cause of your condition. Some of the possible treatments are:

Lifestyle changes: Some lifestyle changes that can help improve your sleep apnea symptoms are not always possible in pregnancy, such as losing weight. Other things that can help when pregnant include sleeping on your side, elevating your head, and using pregnancy-safe nasal sprays or strips to clear your congestion.

Continuous positive airway pressure (CPAP) therapy: CPAP is the most common and effective treatment for sleep apnea. It involves wearing a mask that delivers pressurized air to your nose or mouth, keeping your airway open while you sleep. CPAP can reduce your snoring, improve your oxygen levels, lower your blood pressure, and improve your quality of sleep. CPAP is safe and recommended for pregnant women with moderate to severe sleep apnea.

Oral appliances: Oral appliances are devices that fit in your mouth and adjust your jaw position, opening up your airway while you sleep. Oral appliances can be an alternative to CPAP for mild to moderate sleep apnea. They are custom-made by a dentist or an orthodontist, and they require regular adjustments and follow-ups.

Surgery: Surgery is usually the last resort for treating sleep apnea. It involves removing or modifying the tissues that block your airway, such as the tonsils, adenoids, uvula, soft palate, or tongue. Surgery can be effective for some cases of sleep apnea, but it also carries risks and complications such as bleeding, infection, pain, and scarring. Surgery is not recommended for pregnant women unless it is absolutely necessary.

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How to Prevent Sleep Apnea During Pregnancy?

Some of the ways to prevent or reduce the risk of developing sleep apnea during pregnancy are:

1. Maintaining a healthy weight: Gaining too much weight during pregnancy can increase the risk of sleep apnea. You should follow your doctor's advice on how much weight you should gain based on your pre-pregnancy weight and body mass index (BMI). You should also eat a balanced diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats. You should avoid foods that are high in calories, sugar, salt, and fat.

2. Exercising regularly: Physical activity can help you maintain a healthy weight, improve your blood circulation, strengthen your muscles, and reduce stress. You should aim for at least 30 minutes of moderate exercise most days of the week. You should choose activities that are safe and comfortable for you and your baby, such as walking, swimming, yoga, or pilates. You should avoid activities that involve high impact, jumping, twisting, or lying on your back.

3. Sleeping well when you can: Getting enough sleep is important for your health and well-being during pregnancy. You should try to get at least seven to nine hours of sleep every night. You should also follow good sleep hygiene practices such as having a regular bedtime routine, keeping your bedroom dark, quiet, and cool, avoiding caffeine before bed, and limiting naps during the day.

Understanding the connection between pregnancy and sleep apnea is vital for a healthy journey. If you suspect you have sleep apnea during pregnancy, don't hesitate to seek medical guidance. With the right support and treatment, you can enjoy a safe and comfortable pregnancy.

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FAQs

Q: Can I use CPAP while pregnant?
Yes, CPAP therapy is safe and recommended for pregnant women with moderate to severe sleep apnea. CPAP can improve your oxygen levels, lower your blood pressure, and reduce the risk of complications for you and your baby. You should consult with your doctor before starting CPAP therapy, and follow their instructions on how to use it properly.

Q: Can I take medication for sleep apnea while pregnant?
No, there is no medication that can treat sleep apnea directly. Some medications that are used to treat other conditions such as allergies, Asthma or depression may have side effects that can worsen sleep apnea symptoms. You should always check with your doctor before taking any medication while pregnant, and inform them if you have sleep apnea.

Q: Can I have surgery for sleep apnea while pregnant?
No, surgery is not recommended for treating sleep apnea while pregnant unless it is absolutely necessary. Surgery can have risks and complications such as bleeding, infection, pain, and scarring. Surgery can also affect the development of the baby's face and mouth. You should only consider surgery for sleep apnea after you have delivered your baby, and after consulting with your doctor.

Q: How can I cope with sleep apnea during pregnancy?
Having sleep apnea during pregnancy can be challenging and stressful. You may feel tired, irritable, anxious, or depressed. You may also worry about the health of your baby. It is important to seek help and support from your doctor, your partner, your family, and your friends. You should also try to relax and enjoy your pregnancy as much as possible.

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