What are the signs to look for? chance of developing preeclampsia, gestational hypertension, and gestational diabetes. These Are there other common sleep Sleep apnea, when the upper airway closes conditions can be dangerous for a developing during sleep, is unlikely to wake you, but it is baby. One study found that expectant moth- problems that may occur during likely that your bed partner will notice loud ers with apnea were up to three times more pregnancy? snoring and sudden gasps for air. You may no- likely to require a cesarean delivery, while their tice that you feel excessively sleepy during the newborns were more likely to require treat- Insomnia – symptoms of insomnia include dif- day. Falling asleep while reading, watching TV, ment in the neonatal intensive care unit, often ficulty falling asleep, staying asleep, or waking working, or sitting in traffic, are signs of exces- for breathing problems. It is very important to up too early or feeling unrefreshed upon awak- sive daytime sleepiness. You may also notice diagnose sleep apnea and take appropriate ening. Insomnia related to stress or anxiety that you’re especially irritable, impatient, and steps to treat it. about labor, delivery and/or balancing work forgetful. If you experience some or most of and motherhood may result in significant sleep these symptoms, it’s time to talk to your health Is there treatment for OSA during loss. Further, some of the discomforts of preg- care provider about possible causes for your nancy (nausea, back pain and fetal movements) fatigue. People with apnea often wake up with pregnancy? may also disrupt sleep. headaches too, so if you find this to be the Treatment for mild sleep apnea usually starts case, mention this to your health care provider Restless legs syndrome (RLS) - symptoms of RLS with lifestyle changes. Your doctor may advise as well. include unpleasant feelings in the legs, some- you to sleep on your side to improve the flow times described as creepy, tingly or achy. These of blood and nutrients to your fetus and to Am I at risk for OSA? feelings are worse at night or in the evening your uterus and kidneys. You may be given a hours before bed, and are temporarily relieved special mouth guard to wear at night to keep by movement or stretching. If you’re overweight or obese, you are already your airway open. If you are overweight or at a higher risk for sleep apnea because the obese, work with your health care provider Gastroesophageal reflux (GERD)– GERD, also extra weight in your neck puts pressure on your to find a healthy weight management plan, known as heartburn, is considered a normal airway. Further, if you gain too much weight since being at a healthy weight is a very ef- part of pregnancy. However, nighttime symp- during pregnancy (>35 pounds if you were fective treatment for sleep apnea. If you are toms of GERD can disrupt sleep during preg- a normal weight before pregnancy, or >20 having significant nasal congestion, you can nancy. pounds if you were obese), you are at an even try adhesive breathing strips, which open up higher risk. One study found that 15 percent your nostrils, or nasal saline spray. Talk to your Frequent nighttime urination – the frequent of obese pregnant women suffer from apnea. health care provider about nasal corticosteroid need to urinate at night is a common feature Expectant moms with gestational diabetes are sprays and/or other treatments for nasal allergy of pregnancy and can result in loss of sleep. also at higher risk of having apnea. In fact, symptoms. all pregnant women have an increased risk of developing OSA. Higher levels of estrogen and For persistent or more severe apnea, you may increased amounts of blood can change blood need CPAP (continuous positive airway pres- vessels and cause the mucous membranes lining sure) therapy. A CPAP machine uses a mask that the airway to swell, constricting airflow. fits over your nose and/or mouth and connects to a small pump that provides a gentle flow of How does OSA affect pregnancy? air to keep your airway open. Most people with sleep apnea find almost immediate relief with a CPAP machine, though it can take a little time Over time, sleep apnea lowers your blood- to get used to. oxygen levels (the less air you breathe in each night, the less oxygen your body gets), increas- ing your risk of high blood pressure, heart at- tack, stroke, obesity, diabetes, depression, and heart failure. In pregnancy, OSA increases the Women’s Center For Obstructive Sleep Neurological Care Apnea in Pregnancy If you are having difficulty sleeping during Recently the number of women of reproduc- pregnancy, or are concerned you may have tive age with obesity has increased. Various sleep apnea or one of the above conditions, obesity-related conditions that may complicate pregnancy, such as obstructive sleep apnea it is a good idea to discuss your concerns and (OSA), have also increased. symptoms with your health care provider.

OSA is a condition in which the upper air- way closes during sleep, temporarily blocking airflow and causing brief periods of shallow breathing, lasting about 10 seconds each. Peo- ple with OSA often have heavy snoring. Usu- ally, people with apnea do not wake up and do Strong Sleep Disorders Center not remember episodes, though it disturbs the 2337 South Clinton Avenue quality of their sleep. Rochester, NY 14618 Phone: (585) 341-7575 Other physiologic and hormonal changes that Fax: (585) 341-7595 occur during pregnancy may play a role in the frequency and severity of OSA among preg- nant women. Some of the hormonal changes that occur in pregnancy may weaken muscle tone, which may result in snoring and in obese women, increase the risk of developing sleep apnea. The development of OSA in pregnancy may be partly responsible for frequent trips to the bathroom, nightime heartburn, and increased daytime sleepiness.

urmc.rochester.edu/sleep-center