Sleep apnea during pregnancy | VivaRespire

Sleep Apnea During Pregnancy: Everything You Need to Know

Pregnancy involves profound physiological changes that can promote or worsen sleep apnea. This condition is often under-diagnosed in pregnant women, despite potentially serious consequences for mother and baby.

Why does pregnancy increase the risk of sleep apnea?

Weight gain: gestational weight gain narrows the upper airway.
Nasal congestion: hormonal rhinitis of pregnancy is very common and promotes mouth breathing, which worsens apnea.
Hormonal changes: progesterone stimulates breathing, but nasal congestion and anatomical changes counterbalance this protective effect.
Gastroesophageal reflux: common in pregnancy, can aggravate airway inflammation.
Sleep position: supine position, difficult to avoid especially late in pregnancy, worsens apnea.
Increased blood volume: can cause mucosal edema of the upper airway.

Studies estimate that sleep apnea affects 10 to 26% of pregnant women, with prevalence significantly higher in the third trimester. In obese women or those with pre-eclampsia, prevalence may exceed 50%.

Consequences of untreated apnea during pregnancy

For the mother:

Gestational hypertension and pre-eclampsia (strongly associated)
Gestational diabetes (nocturnal hypoxia increases insulin resistance)
Extreme fatigue and perinatal depression
Increased cardiovascular risk

For the baby:

Fetal growth restriction (repeated nocturnal hypoxia)
Premature birth risk increased
Low birth weight
Higher cesarean section rate

If you have been snoring loudly since the start of pregnancy or your partner observes breathing pauses at night, inform your gynecologist or midwife immediately. Sleep apnea during pregnancy is treatable and treatment benefits are well established.

CPAP therapy during pregnancy

CPAP is the reference treatment for obstructive sleep apnea and is safe throughout pregnancy. Benefits include: reduced nocturnal hypoxia episodes (direct benefit for fetal oxygenation), better control of gestational blood pressure, improved sleep quality and daytime fatigue.

During pregnancy, the required CPAP pressure may increase over the trimesters due to weight gain and anatomical changes. Regular follow-up with your sleep physician is recommended.

Sleep positioning and apnea

Sleep on the left side: optimizes uteroplacental blood circulation and reduces apnea. Preferred over right side to avoid inferior vena cava compression by the liver.
Pregnancy pillow: C-shaped or U-shaped pillows help maintain lateral position throughout the night.

After delivery

Pregnancy-related apnea may improve significantly after delivery. However, women with pre-existing apnea should continue treatment. A reassessment (polygraphy or PSG) is recommended 3-6 months postpartum to determine if CPAP remains necessary. Breastfeeding is not a contraindication to CPAP.

Browse our Auto CPAP devices. For convention details: CPAP reimbursement in Belgium.