The Effects of Lack of Sleep and Poor Sleep During Pregnancy

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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.

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

This article discusses some of the health consequences of a lack of sleep during pregnancy. It offers information about symptoms, diagnosis, and treatment you may wish to discuss with your healthcare provider.

Pregnant woman sleeping
JGI / Jamie Grill / Getty Images

Complications 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 loss of sleep may seem inevitable.

In fact, studies demonstrate that poor sleep quality affects nearly half of all people during pregnancy. A National Sleep Foundation study found 78% of females said their sleep was more disrupted during pregnancy than at any other time in their lives.

Poor sleep can adversely affect health, and it also has a critical impact on pregnant people, potentially leading to maternal health complications such as hypertension and gestational diabetes.

Snoring and obstructive sleep apnea often develop or worsen during pregnancy, especially during the second and third trimesters.

Obstructive sleep apnea affects anywhere from 8% to 32% of pregnant people, with obesity and age influencing the risk of developing the condition. This disruption of breathing during sleep can have serious consequences, including:

High blood pressure in pregnancy is present when blood pressure is measured to be greater than 140/90 millimeters of mercury (mmHg) on repeated occasions after 20 weeks of gestation in people without prior hypertension.

If high blood pressure is accompanied by protein in the urine, preeclampsia may occur. Preeclampsia is associated with potential organ injury in the pregnant person and increases the risk of death for both the pregnant person and child.

A number of findings are associated with preeclampsia. It commonly occurs in the setting of chronic snoring, with about 59% of people with preeclampsia snoring habitually. This may contribute to swelling along the airway, which in turn narrows the passage through which air flows.

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.

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.

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.

With inadequate blood flow to the developing fetus, there can be drops in oxygen levels. This may contribute to growth restriction of the developing fetus, and poor pregnancy outcomes.

Chronic partial sleep loss may also increase the risk of gestational diabetes and excessive weight gain due to changes in glucose (blood sugar) regulation.

With the presence of habitual snoring, there is an increased risk of developing gestational diabetes. Moderate sleep apnea, with at least 15 disruptions to breathing per hour of sleep, as well as long naps, is associated with higher glucose levels.

Poor Sleep Affects Developing Fetus

The developing fetus needs a reliable supply of nutrients, including oxygen. When sleep is disrupted, especially when blood flow to the placenta is compromised, there can be significant consequences.

Insufficient total sleep or fragmentation of deep sleep may reduce the amount of growth hormone released, which can lead to developmental or growth problems in the unborn fetus.

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.

Fortunately, the use of continuous positive airway pressure (CPAP) can improve blood pressure and oxygenation to 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.

Fetal Growth Restriction and Oxygen

Fetal growth restriction (FGR) is a condition associated with serious consequences for a developing fetus, including stillbirth and preterm birth. Lack of oxygen is a contributing factor, associated with a poorly developed (insufficient) placenta and maternal health conditions like preeclampsia. Other factors that may lead to FGR include stress, nutrition, or even high-altitude affects on available oxygen. Maternal sleep quality and position have been linked to FGR.

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.

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.

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 the fragmentation of sleep.

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.

When to See a Healthcare Provider

If you are concerned about whether your sleep difficulties may affect your developing child, speak with your healthcare provider. It can be helpful to review your sleep habits and factors that may contribute to sleep loss.

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.

A Word From Verywell

Early diagnosis and treatment of underlying sleep problems will make your pregnancy more tolerable and lead to better outcomes for your child. This will ultimately lead to a more favorable transition from pregnancy to early parenthood.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.