by Dr. Michele Brown, OB/GYN
As the morning sunlight streams in your bedroom window, you open your eyes and stretch your arms toward the light with happiness. You are pregnant!
Your next thought is of the wonderful man lying next to you who made this all possible. You turn to admire his handsome, sleeping face but… where the heck is he?
You find him on the living room sofa, covered with his own clothes, fast asleep. As he wakes, he smiles and fibs to you. "No honey, you were not snoring. I just couldn't sleep and didn't want to wake you." But the truth is in his eyes. You were snoring. Again.
In our society, snoring is either a dark, embarrassing secret, the subject of jokes on late night TV, or both.
Causes of Snoring in Pregnancy
But, as far as I'm concerned, snoring is not funny nor should it be taken lightly, especially in pregnancy. Why? Because snoring could easily be indicative of something not right with your pregnancy, and perhaps something that could, and should, be easily remedied.
Sleep complaints are common in pregnancy. Many anatomical, physiological, and hormonal changes occur during these nine months that can contribute to these sleep difficulties and snoring is one of the most common, and often the most annoying, problem.
Pregnancy snoring is caused by factors that lead to upper airway obstruction causing audible sounds. The elevated hormonal increases of estrogen and progesterone can cause congestion and edema leading to nasal obstruction which manifests as snoring. The upper displacement of the diaphragm by the gravid (pregnant) abdomen is one reason. Increases in fluid volume can cause swollen nasal passages, adding to breathing difficulty at night.
About one quarter of all pregnant women snore, especially during the second and third trimester of pregnancy. It is estimated that only 4% of these women snored before becoming pregnant. Habitual snoring is defined as snoring at least, but often more than 3 nights per week.
Tell Your Provider About Snoring
Studies have found that habitual snoring is associated with other health related complications in pregnancy. Listed among the complications are:
- Pregnancy induced hypertension
- Toxemia (elevated blood pressure, protein in the urine and swelling in the third trimester only)
- Gestational diabetes
- Sleep apnea -- complete cessation of airflow associated with lack of oxygen and arousal from sleep
- Metabolic syndrome
- Intrauterine growth retardation
- Apgar scores below 7 at birth
- Edema of face, hands, legs, and feet
Factors That Predispose a Pregnant Woman to Snoring
Large weight gain during pregnancy, obesity prior to the pregnancy and/or history of asthma, are all predisposing factors for developing snoring in pregnancy.
Remedies for Snoring
Several suggestions that can relieve snoring include:
- Elevate the head of the bed slightly
- Sleep in the lateral position
- Humidifier use to moisten the nasal passages
- Carefully control weight gain
- Lose weight prior to becoming pregnant
- If sleep apnea exists, consider nasal continuous positive airway pressure, special dental prosthesis, or overnight supplemental oxygen therapy
Caregivers should ask pregnant women during their routine prenatal visits about their sleep and snoring patterns. Pregnant women who habitually snore should be considered higher risk pregnancies and carefully monitored for complications. Recommended glucose evaluations, ultrasounds, Doppler flow studies, non-stress testing, and fetal kick counts, allow the clinician to detect many of the associated complications.
If sleep apnea is suspected, referral to a sleep center for evaluation is warranted. Pulse oximetry and overnight polysomnography are testing that can be performed to detect sleep apnea. Because of the association of snoring and sleep apnea with hypertension and metabolic syndrome, patients should be followed after delivery for evidence of arterial hypertension and coronary artery disease later on in life.
In Other Words
Most people don't know that they snore and many people won't tell their spouses the truth. Make sure your spouse tells you even if it hurts. The ramifications for your baby could be serious. Don't let his well intentioned fib, or your feminine ego, get in the way of your baby's health. Tell your health care provider if you snore.
Dr. Brown, founder of Beauté de Maman, is a board-certified member of the American College of Obstetrics and Gynecology, a member of the American Medical Association, the Fairfield County Medical Association, Yale Obstetrical and Gynecological Society and the Women's Medical Association of Fairfield County. She is a magna cum laude graduate of Tufts University, completed her medical training at George Washington University Medical Center and completed her internship and residency in obstetrics and gynecology at Yale-New Haven Hospital. Dr. Brown has a busy obstetrical practice in Stamford, Connecticut and, as a clinical attending, actively teaches residents from Stamford Hospital and medical students from Columbia Presbyterian Hospital in New York.
Copyright © Michele Brown. Permission to republish granted to Pregnancy.org, LLC.