Is sleep apnoea during pregnancy dangerous for the baby?

If untreated, moderate to severe apnoea may reduce oxygen flow to the placenta. Research links it to higher risks of preeclampsia, growth restriction, and early delivery.

Can nasal congestion alone cause poor sleep in pregnancy?

Yes. Hormonal rhinitis is common and can trigger dry mouth, restlessness, or light sleep, especially if mouth breathing becomes frequent.

Do all pregnant people need a sleep study if they snore?

Not always. Occasional snoring is common. But if it’s loud, constant, or paired with poor sleep quality, daytime fatigue, or hypertension, testing should be considered.

Nasal Congestion and Sleep Apnoea in Pregnancy: Why Breathing Feels Different Now

If you're pregnant and waking up gasping, struggling with nasal stuffiness, or feeling exhausted despite sleeping through the night, your breathing might be trying to tell you something.

Pregnancy reshapes how you breathe. Hormonal changes cause the lining of your nose to swell. Your diaphragm has less room to expand. And as your weight increases, so does pressure around your throat. For many pregnant people, this leads to nasal congestion. For others, especially in the second and third trimesters, it may lead to sleep apnoea, a condition where breathing repeatedly stops and starts during sleep.

Let’s break down what’s happening, why it matters, and what you can do about it, especially if your nights no longer feel restful.

What Is Sleep Apnoea and How Is It Different from Nasal Congestion?

Sleep apnoea in pregnancy often goes unrecognised because it can be mistaken for simple snoring or fatigue.

Sleep apnoea is a sleep disorder where your breathing momentarily stops or becomes very shallow multiple times per hour. These pauses reduce oxygen flow to your brain and body and can disrupt deep sleep cycles.
Nasal congestion, on the other hand, is more localised: it’s caused by swollen nasal passages and increased blood flow in your mucous membranes due to high oestrogen and progesterone levels.

While nasal congestion can aggravate sleep apnoea, the two aren’t the same. However, many pregnant people experience both at the same time.

Why These Breathing Changes Matter in Pregnancy

These conditions can affect your energy, your oxygen levels, and your baby’s development.

Reduced oxygen flow: Untreated sleep apnoea can lower the oxygen your baby receives through the placenta.
Exhaustion despite sleeping: Apnoea disrupts REM sleep and may lead to daytime sleepiness, irritability, and even depression.
Higher risk of complications: Some studies link sleep apnoea in pregnancy with elevated risks of preeclampsia, gestational diabetes, and preterm birth.
Blood pressure issues: Apnoea may exacerbate existing hypertension or trigger spikes overnight.
Worsening nasal symptoms: Congestion can lead to mouth breathing, dry throat, and disrupted sleep rhythms.

Why It Happens: Hormonal, Mechanical, and Metabolic Triggers

Several overlapping factors make pregnant people vulnerable to both nasal congestion and sleep apnoea:

Hormonal shifts: Rising oestrogen levels cause vascular congestion in nasal tissues, often leading to a “pregnancy rhinitis” that mimics allergy symptoms.
Fluid retention: Progesterone and general water retention can cause swelling in the soft tissues of the upper airway.
Weight gain: Even modest gestational weight gain can increase soft tissue mass around the neck and tongue, narrowing the airway.
Lung compression: As the uterus grows, your diaphragm has less space to expand, reducing your lung volume at night.
Sleep position: Lying flat, especially on your back, can allow the tongue and soft palate to fall backward, partially blocking airflow.

How Sleep Apnoea is Diagnosed in Pregnancy

Many cases go undiagnosed because the symptoms overlap with typical pregnancy fatigue. If you or your partner notice:

Loud snoring
Witnessed pauses in breathing during sleep
Daytime sleepiness or morning headaches
Dry mouth upon waking
High blood pressure or frequent urination at night

…a sleep evaluation may be needed.

Diagnosis usually involves a polysomnography test (overnight sleep study) or a home sleep apnoea test. Your doctor will assess your apnoea-hypopnea index (AHI), which measures the number of breathing interruptions per hour.

Treatment and Support: Medical, Practical, and Lifestyle

CPAP machines (Continuous Positive Airway Pressure): If diagnosed with moderate to severe sleep apnoea, your doctor may recommend CPAP therapy. It's safe during pregnancy and improves oxygen delivery.
Elevating your head while sleeping: Use a wedge pillow or elevate the bedhead slightly to open the airway.
Avoid back sleeping: Side-sleeping (especially on the left) reduces pressure on the airway and improves circulation.
Control nasal swelling: Use saline nasal sprays, warm compresses, or steam inhalation.
Gentle exercise: Regular walking or prenatal yoga improves fluid circulation and may reduce airway swelling.
Weight monitoring: Gain within ICMR-recommended limits for your BMI range to reduce metabolic and structural risks.

Avoid decongestant nasal sprays unless advised by your doctor. Many contain vasoconstrictors not recommended in pregnancy.

Emotional and Practical Support

Breathing difficulties chip away at your rest, mental clarity, and confidence. Here’s what can help:

Track your sleep quality: If you wake up feeling unrested, write down symptoms to share with your doctor.
Communicate with your partner: They may notice symptoms you don’t, like snoring or gasping.
Seek support early: Apnoea during pregnancy isn’t rare or shameful. Many people silently suffer through it, thinking it’s “just pregnancy stuff.”
Create a calm sleep environment: Cool room temperature, light-blocking curtains, and a predictable bedtime can help you fall asleep faster, even with congestion.

Feeling breathless or blocked at night during pregnancy could be a sign of something deeper, like sleep apnoea. Understanding how your body changes across trimesters, knowing what symptoms to watch for, and exploring both medical and traditional remedies can help you sleep safer and breathe easier. There’s help, and it starts with listening to your breath.

FAQs on Nasal Congestion and Sleep Apnoea in Pregnancy: Why Breathing Feels Different Now

Is sleep apnoea during pregnancy dangerous for the baby?
If untreated, moderate to severe apnoea may reduce oxygen flow to the placenta. Research links it to higher risks of preeclampsia, growth restriction, and early delivery.
Can nasal congestion alone cause poor sleep in pregnancy?
Yes. Hormonal rhinitis is common and can trigger dry mouth, restlessness, or light sleep, especially if mouth breathing becomes frequent.
Do all pregnant people need a sleep study if they snore?
Not always. Occasional snoring is common. But if it’s loud, constant, or paired with poor sleep quality, daytime fatigue, or hypertension, testing should be considered.