A wake-up call for expectant mothers: The link between sleep apnea and fetal health

Sleep plays a crucial role in overall health, and this is particularly true during pregnancy when the body undergoes significant changes. However, for some expectant mothers, a condition known as sleep apnea is known to disrupt this essential aspect of rest.

Sleep apnea during pregnancy is a serious concern that can have implications for both the mother and the developing baby. As researchers delve deeper into the complexities of maternal health, understanding the relationship between sleep apnea and pregnancy becomes increasingly vital.

In an interaction with Midday.com, Dr Sibasish Dey, Head of Medical Affairs, South Asia, ResMed, provided insights into the connection between sleep apnea and pregnancy. Dr Dey's expertise sheds light on the potential risks and challenges faced by expectant mothers who experience sleep apnea, as well as the implications for their prenatal care and overall well-being.

Here are the edited excerpts from the interview:

What are the potential risks and complications associated with sleep apnea during pregnancy?

Dey: Pregnancy, while a joyous time, often disrupts sleep due to physiological changes which can pose significant risks and complications. Sleep plays a vital role for both the mother and the developing foetus. However, hormonal and anatomical shifts can lead to discomfort, making rest elusive, especially in the later stages which can lead to several major consequences.

The chance of having obstructive sleep apnea (OSA) increases with pregnancy, and even after the gestational period, OSA is linked to a number of unfavourable pregnancy outcomes and maternal morbidities.

Sleep apnea during pregnancy can lead to long-term health complications, such as the increased risk of gestational diabetes, preeclampsia etc. Moreover, it may even affect foetal health, contributing to intrauterine growth retardation and preterm birth. Hence, prioritising sleep hygiene is crucial for both maternal and foetal well-being during pregnancy.

Can untreated sleep apnea during pregnancy lead to long term health issues for both the mother and the child?

Dey: Sleep apnea may significantly impact maternal and foetal health outcomes due to oxygen deprivation during sleep. It heightens risks of gestational diabetes, hypertension, preeclampsia and preterm birth in mothers, while also potentially leading to low birth weight and developmental issues in babies. Apnea-induced oxygen fluctuations can impair placental function, limiting oxygen supply to the foetus, and maternal sleep disturbances also affect foetal development.

Furthermore, untreated sleep apnea during pregnancy can have long term health consequences for both the mother and child, including increased risks of chronic conditions and developmental delays. Hence, early detection and intervention are essential to mitigate these risks.

Are there any specific challenges or considerations in diagnosing and treating sleep apnea in pregnant women?

Dey: Diagnosing and treating sleep apnea in pregnant women can be challenging as the overall awareness around OSA is low. Sleep apnea impacts women differently owing to hormonal variances during pregnancy. Differentiating between pregnancy-related symptoms such as snoring and fatigue and those indicative of sleep apnea can be complex.

The treatment decisions must carefully balance the benefits of improving maternal sleep and health outcomes with minimising potential risks to the developing foetus. Close collaboration between obstetricians, sleep specialists, and other healthcare providers is essential in navigating these challenges effectively.

What strategies or treatments are available for managing sleep apnea in pregnant women, and how do they impact pregnancy outcomes?

Dey: There are several strategies to lessen pregnancy-related difficulties with sleep. The primary strategies are to modify the sleeping posture like sleeping left lateral and practising good sleep hygiene. In cases where OSA is symptomatic and troublesome, physicians may recommend Continuous Positive Airway Pressure (CPAP) machines, oral appliances.

Continuous positive airway pressure (CPAP) therapy may be used with caution during pregnancy to enhance oxygen levels and relieve discomfort. Women's symptoms differ from men's symptoms, hence PAP therapy for them requires a tailored algorithm. ResMed has introduced AutoSet For Her (AfH), a women-specific therapy that addresses and adapts to the unique breathing patterns of women.

The key to better sleep during pregnancy is managing pregnancy-related sleep problems in addition to practising good sleep hygiene. The mother's and the child's outcomes can be optimised with routine prenatal care and cooperation between obstetricians and sleep medicine specialists.

How does sleep apnea impact pregnancy-related conditions such as gestational diabetes and hypertension?

Dey: Sleep apnea can worsen pregnancy-related conditions like gestational diabetes and hypertension by disrupting breathing during sleep, leading to oxygen deprivation and stress. This stress can induce insulin resistance, heightening the risk of gestational diabetes. Moreover, interrupted breathing can elevate blood pressure, worsening hypertension.

What measures can be taken to raise awareness and improve screening for sleep apnea among pregnant women in India?

Dey: It is essential to promote awareness of women's specific sleep apnea symptoms so that more people and their loved ones are aware of the warning indicators. According to our ResMed Sleep Survey 2023 respondents, only 21 per cent of males and 24 per cent of females have been tested for sleep apnea, highlighting the lack of awareness of sleep-related conditions.

Regular screening for sleep apnea should be a component of an annual physical checkup for women, especially pregnant women, as the condition is often underdiagnosed. This would not only be consistent with the progressive trend of the healthcare sector, but it would also increase pregnant women's access to these vital treatments.