How Sleep Problems can Affect Pregnancy

High Blood Pressure, Diabetes, and Poor Birth Outcomes Can Result

Pregnant woman sleeping
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Sleep can be significantly impacted for women long before the cries of a wailing newborn baby interrupt the night. In fact, sleep problems can begin in pregnancy for many women and this can lead to significant consequences for both mother and child. Learn how sleep disorders such as sleep apnea and inadequate sleep from sleep deprivation contribute to high blood pressure, diabetes, and other undesired outcomes and what can be done to prevent these problems.

The Risk of Sleep Apnea Leading to Preeclampsia and Diabetes

Perhaps the most significant sleep disorder that impacts women and their unborn children in pregnancy is obstructive sleep apnea. Frequent pauses in breathing occur during sleep and lead to sleep fragmentation and drops in the oxygen levels of the blood. This is commonly associated with loud snoring. It may be worsened by weight gain, hormonal changes, and other conditions that occur in pregnancy.

The consequences of sleep apnea in pregnancy can be serious and range from blood pressure problems (leading to gestational hypertension and preeclampsia) to diabetes.

When blood pressure repeatedly is measured higher than 140/90 mm Hg after 20 weeks of pregnancy in women with prior normal blood pressure, this is called pregnancy-induced hypertension. If it leads to a loss of protein from the kidneys into the urine, this is known as preeclampsia and this may lead to an increased risk of death for both mother and child.

Preeclampsia is commonly associated with snoring (with 59% of these women snoring habitually). This is likely due to swelling (edema) along the airway that contributes to both snoring and the airway collapse of sleep apnea. If oxygen levels drop as a result, this is stressful on the developing fetus.

It may contribute to growth restriction, premature delivery, and other complications. Fortunately, the use of continuous positive airway pressure (CPAP) can improve blood pressure, oxygenation, and pregnancy outcomes.

Studies also show that women with preeclampsia experience poor sleep quality. They have less REM sleep and more slow-wave sleep. They more frequently take naps.

Chronic partial sleep loss can also increase the risk of obesity and diabetes. This likely relates to the impaired use of glucose and the improper control of hormones that regulate appetite. Snoring is also associated with an increased risk of gestational diabetes. Sleep apnea that is moderate or severe (with an apnea-hypopnea index >15) and pregnant women who take longer naps are both associated with higher glucose levels.

Inadequate Sleep and the Consequences

Sleep deprivation can have serious health impacts for everyone, and pregnant women are no exception. Inadequate sleep may contribute to fatigue, irritability, and mood disorders including depression.

It may also increase feelings of pain. Attention, concentration, and memory become impaired with sleep loss.

Insufficient or fragmented sleep may also directly affect the development of the unborn baby. Secretion of growth hormone is at its peak during sleep and when it is lost growth restriction may occur.

Too little sleep may also impact the duration and type of delivery. Studies show that women in the third trimester who sleep less than 6 hours had longer labor and 4.5 times the rate of cesarean delivery compared to those who got at least 7 hours of sleep per night. This may be due to the increased perception of pain. Women who snore have an even higher likelihood of emergency cesarean delivery.

What To Do When You Sleep Poorly

Almost all pregnant women, especially those who are overweight or obese, develop sleep problems at some point during pregnancy. It can feel stressful when there is uncertainty about whether the problems are normal or not.

Fortunately, you don’t have to suffer from poor sleep. Speak with your obstetrician about any issues that you are facing. If you need additional support, consider talking with a sleep specialist. There are effective treatments for sleep apnea and insomnia that may provide you with the relief that you need. This assistance may ease your pregnancy and delivery while simultaneously giving your child a healthy start to life. It is possible to have a smooth transition from pregnancy to early motherhood, and there are specialists who can help you to sleep better and succeed.

Sources:

Facco, F.L. et al. “Self-reported short sleep duration and frequent snoring in pregnancy: impact on glucose metabolism.” Am J Obstet Gynecol. 2010;203:143.e1-143.e5.

Franklin, K.A. et al. “Snoring, pregnancy-induced hypertension, and growth retardation of the fetus.” Chest. 2000;117:137-141.

Guilleminault , C. et al. “Normal pregnancy, daytime sleeping, snoring and blood pressure.” Sleep Med. 2000;1:289-297.

Kryger, M.H. et al. "Principles and Practice of Sleep Medicine." ExpertConsult, 5th edition, 2011, pp. 1582-1584.

Lee, K.A. et al. “Sleep in late pregnancy predicts length of labor and type of delivery.” Am J Obstet Gynecol. 2004;191(6):2041-2046.

Sahin, F.K. et al. “Obstructive sleep apnea in pregnancy and fetal outcome.” Int J Gynaecol Obstet. 2008;100(2):141-146.

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