Pregnancy and Sleep-Disordered Breathing, A Practical Guide for Expecting Parents
Growing a baby reshapes nearly every system in your body, and sleep is no exception. Beyond the usual nausea and fatigue, some pregnant people develop changes in nighttime breathing. Sleep-disordered breathing (SDB), including obstructive sleep apnea (OSA), can influence both maternal health and fetal development if it goes unrecognized.
What Counts as Sleep-Disordered Breathing?
SDB describes repeated pauses or shallow breaths during sleep. In obstructive sleep apnea, the upper airway narrows or collapses, which limits airflow and disrupts oxygen levels.
During pregnancy, shifts in hormones, fluid balance, and body weight can crowd the airway and make smooth, quiet breathing harder to maintain overnight.
Why Pregnancy Raises the Likelihood
Several pregnancy related changes can tip the scales toward SDB:
- Fluid shifts and healthy weight gain that reduce upper airway space
- Hormonal effects, especially higher estrogen, that contribute to nasal stuffiness
- Less room for the lungs as the uterus grows, which alters breathing mechanics
- More fragmented sleep from discomfort, bathroom trips, or fetal movement
Snoring that is new or noticeably louder often appears in the second or third trimester, even in people who never snored before pregnancy.
Signs That Deserve Attention
Because tiredness is common in pregnancy, SDB can hide in plain sight. Watch for patterns like these:
- Loud, frequent snoring
- Breathing pauses reported by a bed partner
- Gasping or choking episodes during sleep
- Waking with a dry mouth or headache
- Daytime sleepiness or mental fog
- Irritability, mood swings, or low mood
If several of these apply to you, consider discussing a sleep evaluation rather than writing them off as normal pregnancy changes.
Potential Effects on Parent and Baby
Untreated SDB is more than a snoring issue. It is linked with health concerns that can affect pregnancy outcomes.
Maternal Considerations
- Hypertensive disorders of pregnancy, including preeclampsia
- Gestational diabetes mellitus
- Higher chance of cesarean delivery
- Cardiovascular strain and unstable oxygen levels overnight
Fetal Considerations
- Low birth weight
- Preterm birth
- Lower Apgar scores at delivery
- Possible growth concerns related to fluctuating oxygen levels
Research suggests that OSA in pregnancy can roughly double the odds of preeclampsia and may triple the risk of gestational diabetes compared with pregnancies without SDB.
How Diagnosis Works
The most accurate test for SDB is an overnight, attended sleep study called polysomnography. Home tests may be used in selected cases, but they can underestimate severity during pregnancy.
Your clinician may recommend screening or a sleep study if you:
- Have chronic high blood pressure or obesity
- Are 35 or older
- Are carrying twins or higher order multiples
- Have a history of preeclampsia or gestational diabetes
- Snore regularly or have other persistent symptoms
Safe, Pregnancy Friendly Treatment Choices
Treatment aims to restore steady breathing, improve sleep quality, and lower pregnancy risks.
1. Lifestyle and Positioning
- Sleep on the left side or elevate the upper body with pillows
- Ease nasal congestion with a humidifier or saline sprays, as advised by your clinician
- Avoid smoking, alcohol, and late caffeine
- Follow weight gain guidance from your prenatal care team
2. Continuous Positive Airway Pressure (CPAP)
CPAP uses gentle airflow through a mask to keep the airway open. It is considered safe in pregnancy and can improve oxygen levels, help stabilize blood pressure, and support fetal well-being.
3. Recheck After Delivery
Many people see improvement postpartum as swelling decreases and weight normalizes. If symptoms continue, a follow-up evaluation helps refine or discontinue therapy as appropriate.
Why Acting Early Helps
SDB in pregnancy is often overlooked because fatigue feels routine. Identifying and treating it can reduce the chance of complications such as hypertensive disorders, gestational diabetes, and premature birth.
If you notice persistent snoring, unrefreshing sleep, or breathing pauses, speak with your prenatal provider or a sleep specialist. A simple assessment can protect your health and your baby’s health.
Bottom Line
Pregnancy changes how you breathe and how you sleep, but significant snoring or witnessed breathing pauses should not be ignored. Recognizing symptoms, getting tested when appropriate, and starting effective treatment can make pregnancy safer and more comfortable for both parent and baby.