Pregnancy brings many changes to the body, including changes in sleep. While some sleep problems are common and expected, sleep apnea isn’t something to ignore during pregnancy.

Many develop sleep apnea for the first time while pregnant, while others find their existing condition gets worse. Understanding what sleep apnea is, how pregnancy affects it, and why treatment matters can help protect both your and your baby’s health.

What Is Sleep Apnea?

Sleep apnea is a sleep disorder where breathing repeatedly stops and starts during sleep. The most common type is obstructive sleep apnea (OSA), which happens when the muscles of the throat relax too much and block the airway.

These breathing pauses last 10 seconds or longer and may happen dozens or even hundreds of times per night.

Every time breathing stops, oxygen levels in the blood drop. When this happens, the brain briefly wakes the body to restart breathing, although you may not be aware of waking. This leads to poor-quality sleep and can put strain on your heart and blood vessels.

Common signs of sleep apnea include loud snoring, choking or gasping during sleep, unrefreshing sleep, and daytime exhaustion.

Can You Develop Sleep Apnea During Pregnancy?

People who experience sleep apnea in pregnancy usually fall into two groups: those who already had sleep apnea before getting pregnant and find it gets worse, and those who develop it for the first time during pregnancy.

Sleep apnea that develops during pregnancy is called gestational sleep apnea, or gestational obstructive sleep apnea (gestational OSA), if it’s caused by blockages in the throat. Research shows that OSA becomes more common as pregnancy progresses, with the highest rates most often seen in the third trimester.

Pregnancy causes changes that make airflow blockages during sleep more likely. Hormonal changes lead to swelling in the nose and throat, while fluid retention, weight gain, and increased breast size can also increase pressure around the upper airway.

As the baby grows in the uterus, the uterus expands and pushes up on the diaphragm, the main muscle used for breathing. This can leave less room for your lungs to expand, which may make breathing harder.

All of these factors make it easier for the airway to collapse when muscles relax during sleep, potentially triggering sleep apnea events.

Who Is Most at Risk of Developing Sleep Apnea in Pregnancy?

The strongest and most consistent risk factor for gestational sleep apnea is having a higher body mass index (BMI) before or during pregnancy. Extra tissue around the neck and throat can narrow the airway, especially when lying down.

Other risk factors include:

• Older age
• Chronic high blood pressure, also known as hypertension
• Snoring at least three times a week
• A family history of sleep apnea

The risk of developing sleep apnea also tends to grow as pregnancy goes on, since fluid buildup and weight gain increase over time.

How Is Sleep Apnea Diagnosed During Pregnancy?

Sleep apnea is usually diagnosed through a sleep study, also called a polysomnogram or polysomnography. While you sleep, your doctor will monitor your breathing, heart rate, brain waves, and blood oxygen levels with monitors.

An at-home sleep apnea test may also be an option for you. This involves a similar process as a polysomnogram done at a sleep center, but it doesn’t provide data on your brain activity while you sleep.

Is Sleep Apnea Treatment Different During Pregnancy?

One of the most common treatment options for sleep apnea is continuous positive airway pressure therapy, or CPAP therapy. While you sleep, a CPAP machine delivers gentle air pressure through a mask to keep your airway open throughout the night.

CPAP therapy is also a preferred and safe treatment option during pregnancy. Using a CPAP machine can help prevent low blood oxygen levels, which are common in sleep apnea.

Treatment with CPAP therapy during pregnancy is usually similar to treatment for people who aren’t pregnant. However, your healthcare provider or sleep specialist may adjust your care, such as by prescribing a CPAP device that automatically changes air pressure as your breathing patterns change.

Whether you’ve recently developed sleep apnea during your pregnancy or you’ve had it since before getting pregnant, it’s important to have regular check-ins with your doctor. This can help make sure that your treatment remains effective throughout your pregnancy.

Lifestyle changes, such as sleeping on your side, may also help you manage OSA symptoms. Side sleeping is also recommended during pregnancy.

Why Is Treating Sleep Apnea During Pregnancy Important?

Untreated sleep apnea causes repeated drops in blood oxygen levels during sleep. Over time, this can strain the heart and blood vessels. It can also lower oxygen levels in the body, including in the placenta, which may affect how the fetus grows.

Studies have linked sleep apnea in pregnancy with increased risks of:

• Preeclampsia (a life-threatening pregnancy complication that requires early delivery)
• Gestational diabetes
• Gestational hypertension
• Cesarean delivery (C-section)
• Preterm birth (delivery before 37 weeks of pregnancy)

Treating sleep apnea while pregnant may help you sleep better and may lower the risk of some complications.

Studies have found that using a CPAP machine consistently during pregnancy may lower systemic inflammation, stabilize stress hormones, and improve oxygen flow, creating a healthier environment for the fetus.

CPAP therapy may also reduce risks of pre-eclampsia, gestational diabetes, and preterm delivery, and can help regulate hunger hormones, which can help with weight maintenance.

Does Sleep Apnea Go Away After the Baby Is Born?

Sometimes sleep apnea improves or resolves after giving birth, but it’s hard to predict what will happen after pregnancy. One study found that breathing issues caused by sleep disorders improved between 53 percent and 65 percent after pregnancy. After birth, the overall severity of breathing issues also improved.

Everyone’s body is different. For some people, symptoms of sleep apnea may improve after giving birth. For others, sleep apnea may continue after pregnancy. This is sometimes called postpartum sleep apnea.

If you had risk factors for sleep apnea before pregnancy, you may be more likely to still have sleep apnea after giving birth.

Because sleep apnea doesn’t always resolve, repeat testing after pregnancy is often recommended before making changes to your current sleep apnea treatment plan.

Join the Conversation

On MySleepApneaTeam, people share their experiences with sleep apnea, get advice, and find support from others who understand.

What has been the most surprising sleep change you’ve experienced during pregnancy? Let others know in the comments below.