When my son turned one we celebrated his first birthday with friends, family, and chocolate cake smeared all over his face. Smiling and laughing from his high chair, anyone could see he was thriving. I, on the other hand, was a mess.
Although my child had been sleeping through the night for months, most days I felt as tired and haggard as I’d been during the newborn phase. It wasn’t that I couldn’t sleep–my eyes closed the minute I hit the pillow and I had to pry them open when my alarm went off in the morning. It was that I couldn’t sleep enough.
From the moment my day began, I was consumed with thinking about when I could go back to bed. At work, I fantasized about sneaking off to empty conference rooms and napping on the floor. At home, I organized my life around going to bed as early as I could, even if it meant curtailing my social life or time with my husband. None of my efforts, however, made a dent in my exhaustion.
My husband, finally weary of my sleep-deprived crankiness, suggested I get checked for sleep apnea. I’d started snoring during pregnancy and had never stopped, and he was convinced this was the problem. However, my doctor informed me I didn’t fit the profile for sleep apnea (i.e., male, middle-aged, and overweight.) Instead, he gave me a vitamin D supplement and sent me on my way.
What to Know About Sleep Apnea During Pregnancy
Getting Diagnosed With Obstructive Sleep Apnea (OSA)
Fast forward six years and one more child, and I’ve been officially diagnosed with obstructive sleep apnea (OSA). OSA is a serious condition where you stop breathing multiple times a night. This impacts your sleep because your brain realizes you can’t breathe and briefly wakes you up to reopen your airway. This all happens so quickly that you don’t usually remember it, but the impacts can be lasting and severe.
The data from my sleep study showed I stopped breathing on average ten times per hour. Meaning that if I slept for eight hours, I was waking up to restart my breathing eighty times every night!
No wonder I was exhausted.
With my diagnosis came a flood of emotions. First, I was relieved that something was actually wrong with me; that I hadn’t just transformed into a perpetually tired and cranky person for no reason. Then I became anxious–OSA left untreated can be a serious health risk and at this point mine had been going on for years. Finally, I grew angry with myself for going so long without getting fully checked out, and with the doctor who’d brushed off my original inquiry about sleep apnea because of his own misconceptions about OSA.
What is Pregnancy-Induced OSA?
My OSA is specifically pregnancy-induced, which happens to about 20% of pregnant women. The physical changes women undergo during pregnancy, such as weight gain, throat anatomy limitations, and brain or hormonal changes, put them at higher risk for OSA. Because OSA symptoms may overlap with other common pregnancy symptoms, like heartburn, headaches, and emotional changes, many women go undiagnosed with sleep apnea during pregnancy or have their sleep concerns dismissed.
This dismissal is both frustrating and dangerous, as the negative impacts of sleep deprivation are well documented. According to Dr. Julie Grant, an Atlanta-based sleep psychologist, the short-term effects include poor concentration, feelings of depression and anxiety, negative impacts on social life, nausea, and headaches. In the long run, not sleeping well can elevate your risk for cancer, stroke, heart problems, diabetes, and kidney disease.
In addition, OSA during pregnancy can cause complications like preeclampsia, gestational diabetes, or premature delivery. It also increases the risk of needing a cesarean section (C-section) delivery, having complications with anesthesia, and enduring a longer labor.
Signs of OSA (or another sleep disorder)
It can be difficult for moms to tell whether feelings of tiredness are due to the general demands of motherhood, or whether it’s something more. To discern whether something more serious is going on, Dr. Grant suggests monitoring your sleep patterns to see how much sleep you’re actually getting. If, after assessing your patterns, you find you’re getting consistent and sufficient sleep (i.e., at least seven hours most nights) but that your daytime functioning is still impaired, then it’s time to seek professional help.
With OSA specifically, symptoms to watch for include snoring, waking up in the night gasping or choking, or waking in the morning with a dry mouth or sore throat.
Editor’s Note: Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical or mental health condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.
Where to Start
Grant suggests educating yourself first, starting with reputable websites like The Sleep Foundation, The Cleveland Clinic, and Johns Hopkins Sleep Medicine, which offer good information on sleep hygiene and various sleep disorders. If you think you have a breathing or movement disorder, like OSA, then a sleep study may be necessary. Your family doctor or a behavioral sleep medicine specialist can screen you and refer you to a sleep clinic for this.
While some sleep studies take place overnight in a lab, mine was a home study and was surprisingly straightforward. I received a pulse oximeter in the mail and wore it overnight. (Some home sleep studies also include a nasal device to measure breath but mine didn’t.) In the morning I synced the device with an app that shared the data back with the sleep clinic.
Most importantly, if you initially find your concerns about sleep dismissed (as I did), find another doctor. According to Dr. Grant, OSA is frequently seen in women who are at a healthy weight, and pregnancy and menopause can push women into sleep apnea. “There is also a strong genetic component to it,” she says, “so bringing awareness to women about OSA is important!”
OSA Treatment Options
Treatment options for OSA vary according to severity. Sometimes it can be as simple as learning to sleep in a new position that doesn’t worsen breathing issues. Other patients choose to wear an oral appliance that helps correct the issue. And some, like me, opt for a continuous positive airway pressure (CPAP) machine.
A CPAP machine delivers a steady flow of air to a mask that’s worn over your nose or mouth. As you sleep the stream of air keeps your airways open so you don’t stop breathing and wake up repeatedly. And while a CPAP may not be the most attractive bedtime gear, I quickly set my ego aside once I experienced how effective it was.
For me, the results have been life-changing. I’m no longer dragging myself out of bed in the morning or cutting back on my evening activities so I can get to bed. I’m not as short-tempered with my kids, and my husband has commented (perhaps more often than necessary) about how much more fun I am to be around.
As moms, we often hold the world on our shoulders. We’re expected to work, take care of our kids, run the day-to-day logistics of our families, and show up for our communities. All of this feels daunting on a good day, let alone trying to do it if we’re sleeping poorly. If you think you might have a sleep disorder I urge you to contact your doctor. It’s time we un-normalized being tired all the time and started getting the help we need.