The Effects of Lack of Sleep and Poor Sleep During Pregnancy

Being pregnant can be stressful. It is a time of great change within the body when expectant people often strive to make healthy decisions to give their unborn child the best chance to grow and develop normally. There may be diet changes, and sleep is inevitably given careful consideration.

Pregnant woman sleeping
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What are the consequences of lack of sleep during pregnancy? Learn about the effects of poor sleep on an expectant parent, the pregnancy itself, and the developing fetus.

Complications of Lack of Sleep

Poor sleep can adversely affect health, and it also has a critical impact on pregnant women, potentially leading to maternal complications such as hypertension and gestational diabetes. What contributes to this relationship?

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

It's estimated that sleep apnea affects 10 percent of pregnant people, and this disruption of breathing during sleep can have serious consequences, including:

  • Hypertension (high blood pressure)
  • Preeclampsia
  • Gestational diabetes
  • Pulmonary hypertension

High blood pressure in pregnancy is present when blood pressure is measured to be greater than 140/90 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 must flow.

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 baby, 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 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 baby.

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.

Blood flow to the fetus is at its peak during sleep, and oxygen levels that drop during sleep as a result of sleep apnea will have a major impact.

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.

Studies show people in the third trimester of pregnancy who sleep fewer than six hours per night experienced longer labors and had 4.5 times higher rates of cesarean section compared to those who slept at least seven hours a night.

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 undermine the pregnant person's daytime function and mood, possibly resulting in problems with attention, concentration, and memory. Higher incidences of depression may also result. These issues may affect communication and 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.

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.

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 further, leading to normal birth weight and improving outcomes for the infant at delivery.

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.

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

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

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Article Sources
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Additional Reading
  • Kryger MH, et al. Principles and Practice of Sleep Medicine. ExpertConsult, 5th Edition. 2011. pp. 1582-4.

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