Consequences of Sleeplessness During Pregnancy

 
Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.

 
 
How does Lack of Sleep Affect Pregnancy? | Sleep Disruptions & Their Effect on the Fetus | Can You Improve Sleep When Pregnant? | Is it Important to Manage Sleep when Pregnant?

Overview

Pregnancy is characterized by a rollercoaster of emotional highs and lows for many moms-to-be. 

Despite the overwhelming excitement and joy of bringing a new life into the world, several woes continue to coexist due to the physiological and psychological changes that occur during pregnancy. 

Along with morning sickness, heartburn, and swollen feet, many pregnant women experience variations of sleep restrictions that can significantly impact their overall well-being and quality of life.^[1]

How does Lack of Sleep Affect Pregnancy?

Sleep disturbances occur naturally during the pregnancy cycle. As the body adapts to support the growing fetus, so does the new mom’s mental and physical state. The result? The inevitable disruption in sleep. 

Surveys taking into account the sleep quality of many pregnant women found that sleep deprivation is highly prevalent during these nine months (and beyond), with over 60 percent of participants reporting poorer sleep quality.^[2]

Although a lack of sleep may be a temporary inconvenience for some, for many, however, unhealthy sleeping patterns during pregnancy can lead to several complications for both the mother-to-be and the fetus. 

Various studies assessed the consequences of fatigue and sleep disruption on labor duration and type of delivery. They concluded that pregnant women who averaged less than 6 hours of sleep per night during the final month of pregnancy were more likely to experience longer, more painful labor and were at an increased risk of a cesarean birth than those getting more than 6 hours of sleep.^[3][4]

In addition to the consequences on labor and delivery, lack of sleep during pregnancy can adversely affect health and lead to many other maternal health complications,^[5] such as:

• Prenatal depression
• Hypertension
• Preeclampsia (a complication resultant of hypertension)
• Gestational diabetes

Prenatal depression occurs in up to a quarter of all pregnancies. It’s a significant risk factor for miscarriage and preterm birth.^[6] 

Mothers who exhibit symptoms of depression during pregnancy are more likely to experience sleep disturbances, which inadvertently increase their risk of developing one or more of the sleep-induced complications listed above.^[6]

The association between sleep disturbances in pregnancy and hypertension (high blood pressure) has been studied extensively. 

Hypertension and preeclampsia have variable incidences ranging from 5 to 10 percent of pregnancies and significantly contribute to maternal and prenatal mortality rates.^[7] 

Through mechanisms similar to those in non-pregnant individuals, sleep deprivation in pregnant individuals can disrupt several essential physiological processes that result in increased blood pressure.^[8]

Both hypertension and preeclampsia can commonly occur alongside sleep-disordered breathing, including obstructive sleep apnea and chronic snoring.^[9] 

With obstructive sleep apnea, individuals experience repeated episodes of partial or complete upper airway collapse that cease or reduce airflow for ten or more seconds.^[10]

Aside from disrupting you and your partner’s sleep, it can result in increased blood pressure, preeclampsia, and endocrine or metabolic disturbances that increase the risk of gestational diabetes.^[11]

Sleep Disruptions & Their Effect on the Fetus

On average, adult humans sleep for approximately a third of their life. Thus, a developing fetus is exposed to a mother who is asleep for a third of her gestation.^[12] 

If this sleep period is disrupted, physiological processes associated with providing essential nutrients to the fetus will also be affected.^[13]

Events that occur as a result of disrupted sleep during pregnancy, including obstructive sleep apnea, sleep position, and sleep duration, have been shown to impact the growth of a fetus negatively. For instance, maternal snoring can lead to dysregulation of the fetus’ ability to develop various blood cells, leading to late-onset metabolic disruptions in later life.^[14] 

Moreover, it has been shown that obstructive sleep apnea is associated with fetal growth restriction – a condition during which the developing fetus experiences several consequences, including low birth weight, stillbirth, and preterm birth. 

Repeated episodes of obstructive sleep apnea can result in hypoxemia (lack of oxygen) and activation of inflammatory pathways, coupled with the inadvertent rise in arterial carbon dioxide. These processes can contribute to poor placental oxygen and nutrient exchange, thereby restricting fetal growth.^[15]

Fortunately, treatments are available for women with obstructive sleep apnea who become pregnant. One such treatment is continuous positive airway pressure or CPAP.^[16] 

CPAP is a generally well-tolerated treatment that effectively reduces gestational hypertension and allows the pregnancy to progress under “normal” conditions, promoting the development of a healthy fetus.

Can You Improve Sleep When Pregnant?

Although some pregnant women may develop sleep conditions naturally during their pregnancy, they may be facilitated or aggravated by certain underlying health factors, including obesity, smoking, and following a generally sedentary lifestyle. 

Unfortunately, treating poor sleep quality during pregnancy may prove to be difficult, partially due to the restrictions set out by the Food and Drug Administration (FDA) on using certain medicines in pregnant individuals.^[17]

As a result, more pregnant women are turning to natural and non-pharmacological sleep aids. Exercises such as massage, yoga, and maintaining a more active lifestyle have proved to help reduce back pain and improve sleep.^[18,19,20] 

If anyone is affected by lack of sleep during their pregnancy, they should speak with their healthcare provider so that a tailored “sleep health” regime can be prescribed.

Is it Important to Manage Sleep when Pregnant?

Lack of sleep is highly prevalent among pregnant individuals, particularly those who fall under the high-risk category of being obese, smoking, and having a sedentary lifestyle. As sleep disruptions are widely accepted as pregnancy norms, it’s common to overlook their consequences on the mother-to-be and her unborn child.

Suppose an individual is troubled by their lack of sleep and has found little to no improvements through implementing habitual changes. In that case, a consultation with a healthcare provider can be beneficial. 

There are a variety of ways in which a sleep-deprived pregnant individual can improve their sleep habits without compromising their pregnancy. 

Consult with a medical professional as soon as possible if symptoms are becoming a concern.

References:

1. Chang, J. J., Pien, G. W., Duntley, S. P., & MAcones, G. A. (2010, April 14). Sleep Deprivation during Pregnancy and Maternal and Fetal Outcomes: Is There a Relationship? Sleep Med Rev., 107–114. https://doi.org/10.1016/2Fj.smrv.2009.05.001
2. Facco, F. L., Kramer, J., Ho, K. H., Zee, P. C., & Grobman, W. A. (2010, January). Sleep Disturbances in Pregnancy. Obstetrics &Amp; Gynecology, 115(1), 77–83. https://doi.org/10.1097/aog.0b013e3181c4f8ec
3. Lee, K. A., & Gay, C. L. (2004, December). Sleep in late pregnancy predicts length of labor and type of delivery. American Journal of Obstetrics and Gynecology, 191(6), 2041–2046. https://doi.org/10.1016/j.ajog.2004.05.086
4. Beebe, K. R., & Lee, K. A. (2007, April). Sleep Disturbance in Late Pregnancy and Early Labor. Journal of Perinatal &Amp; Neonatal Nursing, 21(2), 103–108. https://doi.org/10.1097/01.jpn.0000270626.66369.26
5. Palagini, L., Gemignani, A., Banti, S., Manconi, M., Mauri, M., & Riemann, D. (2014, August). Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep Medicine, 15(8), 853–859. https://doi.org/10.1016/j.sleep.2014.02.013
6. FIELD, T., DIEGO, M., HERNANDEZ-REIF, M., FIGUEIREDO, B., SCHANBERG, S., KUHN, C., DEEDS, O., CONTOGEORGOS, J., & ASCENCIO, A. (2008, January). CHRONIC PRENATAL DEPRESSION AND NEONATAL OUTCOME. International Journal of Neuroscience, 118(1), 95–103. https://doi.org/10.1080/00207450601042144
7. Gao, M., Hu, J., Yang, L. et al. (2019, July)Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China. BMC Pregnancy Childbirth19, 444. https://doi.org/10.1186/s12884-019-2583-1 
8. von Dadelszen P, Menzies JM, Payne B, Magee LA. (2009, Feb).PIERS (Pre-eclampsia Integrated Estimate of Risk) Study Group. Predicting adverse outcomes in women with severe preeclampsia. Semin Perinatol. Jun;33(3):152-7. https://doi:10.1053/j.semperi.2009.02.009   
9. Haney A, Buysse DJ, Okun M. (2013, Dec) Sleep and pregnancy-induced hypertension: a possible target for intervention?J Clin Sleep Med 15;9(12):1349-56. https://doi:10.5664/jcsm.3290   
10. Peppard PE, Young T, Palta M, Skatrud J. (2000, May)Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med. 11;342(19):1378-84. https://doi:10.1056/NEJM200005113421901  
11. Luque-Fernandez, M. A., Bain, P. A., Gelaye, B., Redline, S., & Williams, M. A. (2013, September 14). Sleep-Disordered Breathing and Gestational Diabetes Mellitus. Diabetes Care, 36(10), 3353–3360. https://doi.org/10.2337/dc13-0778
12. Warland, J., Dorrian, J., Morrison, J. L., & O’Brien, L. M. (2018, October). Maternal sleep during pregnancy and poor fetal outcomes: A scoping review of the literature with meta-analysis. Sleep Medicine Reviews, 41, 197–219. https://doi.org/10.1016/j.smrv.2018.03.004
13. Reichner CA.(2015, May). Insomnia and sleep deficiency in pregnancy. Obstet Med. 2015;8(4):168–171. https://doi:10.1177/1753495X15600572 
14. Silvestri R, Aricò I. (2019, July). Sleep disorders in pregnancy. Sleep Sci. 12(3):232-239. https://doi:10.5935/1984-0063.20190098 
15. Kneitel AW, Treadwell MC, O’Brien LM. (2018, May) Effects of maternal obstructive sleep apnea on fetal growth: a case-control study. J Perinatol;38(8):982-988. https://doi:10.1038/s41372-018-0127-6 
16. Dominguez JE, Street L, Louis J.(2018, June). Management of Obstructive Sleep Apnea in Pregnancy. Obstet Gynecol Clin North Am;45(2):233-247. https://doi:10.1016/j.ogc.2018.01.001 
17. Cooper, W. O., Hickson, G. B., & Ray, W. A. (2004, March). Prescriptions for contraindicated category X drugs in pregnancy among women enrolled in TennCare. Paediatric and Perinatal Epidemiology, 18(2), 106–111. https://doi.org/10.1111/j.1365-3016.2003.00542.x
18. Wang, S. M., Dezinno, P., Maranets, I., Berman, M. R., Caldwell-Andrews, A. A., & Kain, Z. N. (2004, July). Low Back Pain During Pregnancy. Obstetrics &Amp; Gynecology, 104(1), 65–70. https://doi.org/10.1097/01.aog.0000129403.54061.0e
19. STERNFELD, BARBARA; QUESENBERRY, CHARLES P. JR; ESKENAZI, BRENDA; NEWMAN, LAWRENCE A (1995, May). Exercise during pregnancy and pregnancy outcome.Medicine & Science in Sports & Exercise: Volume 27 – Issue 5 – p 634-640
20. Field, T., Hemandez-Reif, M., Hart, S., Theakston, H., Schanberg, S., & Kuhn, C. (1999, January). Pregnant women benefit from massage therapy. Journal of Psychosomatic Obstetrics &Amp; Gynecology, 20(1), 31–38. https://doi.org/10.3109/01674829909075574