Sleep Apnea & Pregnancy
Sep. 11, 2015Did you know that not treating Sleep Apnea during pregnancy could put your infant at risk? Did you know during pregnancy the majority of women experience alterations in sleep? Do you know that you might need to alter your sleep or CPAP therapy during pregnancy?
The physiologic and biochemical change of pregnancy may place women at risk for developing specific sleep disorders such as obstructive sleep apnea and restless legs syndrome. Pregnant women’s sleep pattern and duration also changes due to hormonal changes mainly during the first trimester. Overall studies show mean increase in sleep duration of 0.7 hours is common; however, due to fatigue or nausea and vomiting, sleep is more disturbed. During the third trimester the REM (deepest stage of sleep) is shorter and the majority of women start taking mid-day naps. Other physiological changes such as edema of the nasal mucosa can lead to increased airflow resistance and airway narrowing which exacerbates sleep apnea.
Sleep apnea is a risk factor for pregnancy-induced hypertension which can increase the risk of premature delivery, feral growth retardation and maternal mortality. Studies shows apnea episodes causes fetal heart rate to decelerate.
Women may experience severe persistent insomnia which could fail to respond to sleep hygiene measures or targeted therapies. However trial of behavioral therapies is strongly recommended.
Sleeping on your side is strongly suggested to reduced severity of sleep apnea as well as it avoids uterine compression of the inferior vena cava and potential compromise of cardiac output. To get assistance in sleeping on your side you could obtain bumper belt from CanSleep services which has stuffed pockets that prevents you from sleeping on your back.
Some women diagnosed with OSA require higher therapeutic pressure (about 1-2 cmH2O higher). Talk to your therapist at CanSleep to perform overnight oximetry to check for desaturation and need of CPAP titration.
By Bahareh Ezzati (BSc, CPhT, RRT)