The Effects of Lack of Sleep and Poor Sleep During Pregnancy

Poor sleep quality during pregnancy is a common complaint as your body changes over time. Both physical and emotional health changes, including the stress of being pregnant, can disrupt sleep.

Studies demonstrate that nearly half of pregnant persons experience poor sleep quality.

For many pregnant people, the lack of sleep may seem a temporary inconvenience. However, unhealthy sleep patterns, like sleep apnea, can contribute to complications with pregnancy. The quality of your sleep can also affect the developing fetus.

This article discusses how sleep disturbances during pregnancy may be linked to certain health consequences. It offers information about symptoms, diagnosis, and treatment you may wish to discuss with your healthcare provider.

Causes of Lack of Sleep

Pregnancy is a time of great changes in your diet, fitness plans, and sleep patterns. As your body changes, so does your mental and physical preparation for the future. The following are common causes of lack of sleep during pregnancy.

General Discomfort

Common discomforts during pregnancy can negatively affect sleep quality and quantity. They can make it difficult to fall asleep and stay asleep.

They may include pregnancy symptoms like:

• Back pain
• Frequent urination at night
• Heartburn
• Leg cramps
• Restless leg syndrome
• Nausea and vomiting

Breathing Problems

Due to hormonal changes, weight gain, and increased blood flow during pregnancy, you may experience breathing difficulties during sleep.

Snoring and obstructive sleep apnea often develop or worsen during pregnancy, especially during the second and third trimesters. Obstructive sleep apnea, a chronic sleep condition where a person’s breathing slows or stops during sleep, affects anywhere from 8% to 32% of pregnant people, with obesity and age influencing the risk of developing the condition.

People who gain too much weight or who have a large neck circumference may be at additional risk. These factors contribute to the collapse of the airway and to difficulty breathing during sleep.

Symptoms of sleep-disordered breathing may include:

• Heavy snoring
• Reduced airflow
• Complete cessation of breathing (apnea)
• Waking during the night and gasping or choking
• Excessive daytime sleepiness

Complications Relating to Lack of Sleep

Poor sleep, and problems breathing while sleeping, can adversely affect your health and the health of your developing fetus.

Excessive Weight Gain

Studies suggest that poor sleep quality may be associated with excessive gestational weight gain during pregnancy. Gaining more than the recommended amount of weight is linked to:

• Having a large baby (which can lead to delivery complications)
• An increase in the amount of weight you hold on to after pregnancy (which can lead to obesity)

Gestational Diabetes

One 2017 meta-analysis published in Sleep Medicine Reviews found that short sleep duration in pregnancy (less than six-and-a-quarter hours per night) may be associated with hyperglycemia and an increased risk of gestational diabetes.

Gestational diabetes occurs when a pregnant person can’t create enough insulin, a hormone that controls blood sugar (glucose).

Having gestational diabetes can increase your risk of:

• High blood pressure during pregnancy
• Having a large baby that needs to be delivered by cesarian section (C-section)
  

High Blood Pressure

Research shows that sleep disorders, particularly ones that affect breathing, are strongly associated with the development of gestational hypertension (high blood pressure during pregnancy) and preeclampsia.

If high blood pressure is accompanied by protein in the urine, preeclampsia may occur (a dangerous condition that can lead to seizures). It commonly occurs in the setting of chronic snoring.

Studies have shown people with preeclampsia have poor sleep quality with an increase in slow-wave sleep and a decrease in rapid eye movement (REM) sleep. In addition, they take naps more frequently.

Preeclampsia is associated with potential organ injury in the pregnant person and increases the risk of death for both the pregnant person and child.

Obstructive Sleep Apnea

The developing fetus needs a reliable supply of nutrients, including oxygen. When breathing is disrupted during sleep, blood flow to the placenta is compromised, leading to potentially significant consequences.

Pauses in breathing (apnea), may be associated with surges in blood pressure. These surges can lead to changes in the blood vessels and increase overall blood pressure. This may reduce the blood volume pumped by the heart, a reduction in cardiac output. As a result, blood flow to the fetus via the placenta can be compromised.

It is well-understood that even minor declines in the oxygen levels of the mother may endanger the fetus. When the mother’s blood oxygen falls, the fetus reacts with decelerations of the heart rhythm and acidosis.

For pregnant persons with OSA, continuous positive airway pressure (CPAP) can improve blood pressure and oxygenation in the fetus. This may allow the pregnancy to progress under improved conditions, leading to normal birth weight and improving outcomes for the infant at delivery.

Delivery and Post Delivery Complications

Some studies of people experiencing sleep quality disruptions in the second and third trimesters of pregnancy find higher rates of cesarean section delivery in pregnant people who report insomnia.

Other complications may include:

• Increased pain during labor
• Longer labor

Role of Interventions

Clearly, snoring and sleep apnea will increase the risk of problems during pregnancy. Additional health problems, such as obesity, diabetes, asthma, and smoking, will make these difficulties worse.

As a result, there is an increased risk of premature delivery, growth restriction, and potential for health problems in, or death of, the newborn infant.

There may be a higher perception of pain in those who sleep less. Sleep deprivation may also interfere with the normal progression of labor.

Inadequate quality or quantity of sleep may affect a pregnant person's daytime function and mood, with possible impacts including:

• Attention span
• Ability to concentrate
• Memory difficulties
• Depression
• Communication issues
• Challenges with social interactions

For many people, these issues may persist into the first few weeks after delivery, especially because the child’s nighttime feedings may continue sleep fragmentation.

Almost all people, especially those who are overweight or obese, have sleep problems at some point during pregnancy. Most of the stress is related to uncertainty about whether the problems are normal or not.

Summary

Poor sleep quality is common during pregnancy, especially as you advance into the third and second trimester. While easily overlooked, the lack of sleep has impacts on a pregnant person's health as well as that of a developing fetus.

There are ways to improve your sleep habits, such as limiting screen time before bed or practicing mindfulness to reduce stress. However, poor sleep quality in pregnant people can contribute to serious health conditions, like preeclampsia, that require medical attention. Speak to your healthcare provider about concerning symptoms as soon as possible.