Pregnancy and Sleep Disordered Breathing

Sleep disordered breathing comprise many disorders such as snoring, upper airway resistance syndrome, obstructive sleep apnea (OSA), and obesity–hypoventilation syndrome. The incidence of sleep disordered breathing in non-pregnant women has been reported up to 8%, and in obese non-pregnant women approximately 37 %. Pregnant women, and especially obese pregnant women, are found to be susceptible to sleep disordered breathing. Studies have found compared to approximately 4 % of non-pregnant women, 14–52 % of pregnant women snore by the third trimester. The incidence of snoring in women with pre-eclampsia has been reportedly up to 85 %. There are various factors that can increase the risk of sleep disordered breathing in pregnancy such as weight gain, upper airway changes, diaphragm elevation, decreased lung volumes, hyperventilation and an increase in non-REM sleep.

Symptoms of obstructive sleep apnea tend to differ in women compared with men. Women often present with symptoms of fatigue, insomnia, morning headaches and depression. Pregnant women are less likely to have witnessed apneas and their most common presenting complaint is snoring. OSA in pregnancy is likely underestimated given that the presenting symptoms may not be classic for OSA and may be mistaken as physical, mental or emotional manifestations of changes occurring during pregnancy. OSA, if left untreated, often worsens during pregnancy. Treatment of sleep disordered breathing during pregnancy is important for healthy maternal and fetal outcomes.