Snoring during pregnancy: risks and what to do

Pregnancy brings many physiological and hormonal changes that can affect sleep. One of the most common symptoms is snoring, which, although often considered harmless, can be a sign of a more serious sleep disorder during gestation, such as obstructive sleep apnea (OSA) [3].

Why does snoring increase during pregnancy?

During pregnancy, the body undergoes a series of transformations that can predispose women to snoring and to developing sleep-disordered breathing [3]. Hormonal changes, such as increased estrogen and progesterone, can cause swelling of the nasal and throat mucous membranes, narrowing the airways.

Additionally, weight gain and the growing uterus put pressure on the diaphragm, affecting respiratory mechanics [3]. These combined factors make pregnant women more susceptible to snoring and sleep apnea.

Risks of snoring during pregnancy

Occasional and mild snoring is usually not a cause for concern. However, habitual snoring or the presence of sleep apnea during pregnancy is associated with various risks for both the mother and the baby [1, 3].

Maternal complications

Sleep disorders, including snoring, have been linked to an increased risk of several serious complications for the mother:

• Preeclampsia: A 2022 meta-analysis found that sleep disturbances increase the risk of preeclampsia by almost three times (aOR: 2.77) [1]. Another 2026 study also confirms that sleep disorders, especially obstructive sleep apnea, are associated with an elevated risk of preeclampsia (OR: 1.83) and other hypertensive disorders of pregnancy [2].
• Gestational diabetes: There is an association with an almost twofold increased risk of developing gestational diabetes (aOR: 1.96) [1].
• Cesarean delivery: Women with sleep disorders have double the risk of needing a cesarean delivery (aOR: 1.99) [1].
• Gestational hypertension: Sleep disorders are associated with an increased risk of gestational hypertension (OR: 1.50) [2].
• Depression: The risk of depression is also significantly increased (aOR: 3.98) [1].

Fetal and neonatal complications

Sleep-disordered breathing can also affect the fetus and newborn [3]:

• Preterm birth: Sleep disorders are associated with an almost twofold increased risk of preterm birth (aOR: 1.95) [1].
• Altered fetal growth: There may be an impact on the baby's growth trajectories [3].
• Congenital anomalies: The relationship with certain congenital anomalies has been investigated [3].
• Epigenetic changes: Evidence of epigenetic changes has even been observed in offspring exposed to disordered breathing during sleep [3].

Identifying and treating sleep disorders during pregnancy is an essential measure for the safety of both mother and baby.

When should I be concerned about snoring?

Not all snoring during pregnancy indicates a serious problem. However, it is important to pay attention to certain signs that might suggest the presence of obstructive sleep apnea:

• Habitual and loud snoring: If snoring is constant and very loud.
• Breathing pauses: If your partner observes that you stop breathing for short periods during sleep.
• Waking up with a choking sensation or gasping for air.
• Excessive daytime sleepiness: Feeling very sleepy during the day, even after getting enough sleep.
• Morning headaches.
• Chronic fatigue and difficulty concentrating.

What can be done?

If a sleep disorder is suspected, the doctor may recommend a more detailed evaluation. Treatment for sleep apnea during pregnancy may include:

• Sleep hygiene measures: Adopting healthy habits such as maintaining a regular sleep schedule, sleeping on your side, and avoiding caffeine or heavy meals before bedtime [1].
• Lifestyle changes: Maintaining healthy weight gain and engaging in moderate physical activity, if approved by your doctor.
• Continuous positive airway pressure (CPAP) devices: In cases of moderate to severe sleep apnea, CPAP is an effective treatment that helps keep the airways open during sleep.
• Mandibular advancement devices: In some cases, these may be an option, always under medical supervision.

It is important to remember that this information is general and does not replace the assessment and advice of a medical professional. Each pregnancy is unique, and recommendations should be personalized.