Most women, and even their doctors, dismiss symptoms of excessive daytime sleepiness and fatigue with the rise in progesterone during pregnancy. However, what they seem to overlook is that progesterone continues to rise throughout the pregnancy, yet most women complain about more severe sleep related issues in the first trimester than in the second.
A possible explanation is that between 10 and 20 percent of pregnant women develop obstructive sleep apnea during their first trimester, with an increased risk as the pregnancy continues. Over 40 percent of obese women develop obstructive sleep apnea by the third trimester. While the symptoms are easily dismissed as pregnancy related symptoms, one major indicator that apnea could be the culprit is increased snoring.
The reason for the increased risk of sleep apnea is found in the hormonal changes a woman’s body undergoes during pregnancy. The hormone progesterone causes swelling in the throat tissues, estrogen causes relaxation of the blood vessels, and a hormone only found in pregnancy, known as relaxin, causes the muscles of the body to relax.
While pregnancy related sleep apnea may clear up just fine after birth, there are some serious complications that it can cause during pregnancy, including an increased risk of: high blood pressure, pre-eclampsia, low birth weight and low APGAR scores at birth. Some studies also showed as much as a 65% decrease in fetal movement in mothers with sleep apnea, and treatment with a CPAP machine greatly increased fetal movement. While further research would need to be done, one can assume that the interruption of oxygen could cause a number of risk factors in the unborn child, as well.
If you are pregnant and snore, please talk to your provider at Atlanta ENT about options for testing and treating sleep apnea.
Ramie Tritt, M.D., President, Atlanta ENT