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Compass Guide

Medically reviewed by Varun Halani, MD · August 14, 2026

Sleep Apnea and Pregnancy

Pregnancy can trigger or worsen obstructive sleep apnea. Learn why, how it is safely diagnosed and treated during pregnancy, and why postpartum follow-up matters.

In short

Pregnancy can cause obstructive sleep apnea to develop for the first time or worsen if it already exists, largely because of weight gain, hormonal changes, and swelling of the nasal and upper airway tissues. Untreated sleep apnea in pregnancy has been linked to higher rates of hypertensive complications and other issues, so new or worsening loud snoring, gasping, or unusual daytime sleepiness deserves evaluation. Testing and CPAP treatment are both considered safe during pregnancy.

At a Glance

Why It Happens

Weight gain, hormonal shifts, and fluid redistribution during pregnancy can narrow and swell the upper airway, especially in the third trimester.

Why It Is Easy to Miss

Snoring and fatigue are common in normal pregnancy, which can mask or delay recognition of new sleep apnea.

Why It Matters

Untreated sleep apnea in pregnancy is associated with a higher likelihood of hypertensive disorders of pregnancy and other complications requiring closer monitoring.

How It Is Managed

Home or in-lab sleep testing and CPAP therapy are both considered safe options during pregnancy when coordinated with your obstetric care team.

  • Pregnancy increases the risk of new or worsening obstructive sleep apnea, particularly in the second and third trimesters.
  • Weight gain, hormonal changes, and swelling of the nasal and airway tissues all contribute to a narrower upper airway during pregnancy.
  • Loud snoring, witnessed pauses in breathing, or gasping that develops or worsens during pregnancy is worth mentioning to your obstetric provider, since it is easy to attribute to pregnancy in general.
  • Untreated sleep apnea during pregnancy is associated with a higher likelihood of hypertensive disorders of pregnancy and has been studied in relation to gestational diabetes and other outcomes, though research is still evolving.
  • Both home sleep apnea testing and in-lab polysomnography are considered acceptable and safe ways to evaluate suspected sleep apnea during pregnancy.
  • CPAP is the standard, safe treatment for sleep apnea diagnosed during pregnancy and does not need to wait until after delivery.
  • Sleep apnea that develops or worsens during pregnancy does not automatically resolve after delivery and deserves reassessment rather than assumption.

Pregnancy changes the body in ways that can bring on obstructive sleep apnea for the first time or make existing sleep apnea more pronounced, especially as pregnancy advances. Because fatigue and snoring are both common in pregnancy generally, sleep apnea can be easy to overlook. This guide explains why pregnancy raises the risk, what has been associated with untreated sleep apnea in this setting, and how testing and treatment are approached safely alongside obstetric care.

Why Pregnancy Raises the Risk of Sleep Apnea

Physiological Changes That Contribute

Weight Gain

Weight gained during pregnancy, including around the neck and upper airway, can narrow the space available for airflow during sleep.

Hormonal Changes

Rising estrogen and progesterone levels affect blood vessel tone and can contribute to swelling of the nasal and upper airway tissues.

Fluid Redistribution

When lying down, fluid that has pooled in the legs during the day can shift toward the neck and upper airway, especially later in pregnancy.

Nasal Congestion

Pregnancy-related nasal congestion, sometimes called pregnancy rhinitis, can further narrow the upper airway and worsen snoring.

These changes tend to build gradually, which is why sleep apnea related to pregnancy most often becomes noticeable or worsens in the second and third trimesters rather than early on.

Why It Is Easy to Miss

Overlapping Symptoms

Daytime fatigue, difficulty sleeping comfortably, and even some snoring are common in normal pregnancy, particularly as the body accommodates a growing baby. This overlap can make it difficult to tell whether tiredness or snoring reflects pregnancy itself or a developing sleep-related breathing problem.

What Deserves Attention

Signs worth mentioning to your obstetric provider include snoring that becomes noticeably louder or more frequent, witnessed pauses in breathing or gasping during sleep, and daytime sleepiness that feels out of proportion to your sleep schedule. None of these findings confirm sleep apnea on their own, but they are reasonable prompts for a conversation about whether evaluation makes sense.

What Has Been Associated With Untreated Sleep Apnea in Pregnancy

Research on obstructive sleep apnea during pregnancy is still evolving, and much of the available evidence is considered lower certainty than research in other areas of sleep medicine. With that caveat, studies have found associations between untreated sleep apnea in pregnancy and a higher likelihood of several outcomes:

  • Hypertensive disorders of pregnancy, a category that includes gestational hypertension and preeclampsia
  • Gestational diabetes, in some study populations
  • Certain fetal growth and delivery-related outcomes, an area where research continues to develop

These are associations observed across groups of patients in research studies, not predictions about any individual pregnancy. They are also part of why sleep apnea in pregnancy is generally taken seriously enough to evaluate rather than dismissed as an inevitable part of pregnancy discomfort. Your obstetric provider remains the right source for how any of this applies to your specific pregnancy and its monitoring.

How Sleep Apnea Is Diagnosed During Pregnancy

Evaluating Suspected Sleep Apnea in Pregnancy

  1. 01Discuss SymptomsSnoring, witnessed breathing pauses, or unusual daytime sleepiness are discussed with your obstetric provider or a sleep medicine physician.
  2. 02Consider Risk FactorsFactors such as pre-pregnancy weight, chronic or pregnancy-related hypertension, and family history help inform whether testing is appropriate.
  3. 03Sleep TestingA home sleep apnea test or in-lab polysomnography is used to evaluate breathing during sleep; both are considered safe during pregnancy.
  4. 04InterpretationResults are interpreted by a sleep medicine physician, who may recommend in-lab testing if a home test result does not match the level of clinical suspicion.

A home sleep apnea test is a reasonable and generally safe first option for many pregnant patients with suspected sleep apnea, since it can be completed in familiar surroundings. It can, however, underestimate severity in some cases, so an in-lab sleep study may still be recommended if symptoms are significant despite a reassuring home test, or if the clinical picture calls for a more detailed evaluation.

CPAP: The Standard Treatment During Pregnancy

CPAP is considered the standard, safe treatment for obstructive sleep apnea diagnosed during pregnancy and is not something patients need to defer until after delivery. For sleep apnea that is clearly more than mild, treatment is generally recommended regardless of how bothersome symptoms feel day to day, since the goal is to keep the airway open and breathing regular throughout the night. For milder cases, the decision to start treatment during pregnancy is weighed alongside symptoms and any other pregnancy-related health considerations.

Because the upper airway and overall fluid status can continue to shift as pregnancy progresses, some patients benefit from periodic reassessment of their CPAP settings during pregnancy rather than assuming an initial setting will remain ideal throughout. This is a conversation to have with the sleep medicine physician managing your treatment.

Postpartum: Reassessment, Not Assumption

Because pregnancy-related weight gain and hormonal changes contribute to sleep apnea risk, some patients do find their sleep apnea improves after delivery as those factors resolve. This improvement is not guaranteed, and sleep apnea that developed or continued through pregnancy should be reassessed after delivery rather than assumed to have gone away on its own. If you were diagnosed with or treated for sleep apnea during pregnancy, plan to revisit the topic with your sleep medicine physician in the postpartum period to determine whether continued treatment, retesting, or simply monitoring makes sense for you.

When to Seek Evaluation

Consider bringing up sleep apnea with your obstetric provider if you notice loud or worsening snoring, witnessed pauses in breathing or gasping during sleep, or daytime sleepiness that feels out of proportion to your circumstances, particularly if you also have risk factors such as elevated pre-pregnancy weight, high blood pressure, or a family history of sleep apnea. Your obstetric provider can help decide whether referral to a sleep medicine physician for a sleep evaluation is a reasonable next step for you.

Sleep apnea during pregnancy is manageable, and identifying it does not need to be a source of alarm. The combination of your obstetric team and a sleep medicine physician working together gives you the best foundation for a plan tailored to your pregnancy.

Can pregnancy actually cause sleep apnea, or does it just make existing sleep apnea worse?

Both can happen. Some people develop obstructive sleep apnea for the first time during pregnancy, particularly in the second and third trimesters, while others who already have mild sleep apnea find it becomes more pronounced as pregnancy progresses. Weight gain, hormonal changes, and swelling of the nasal and upper airway tissues all play a role.

Why is sleep apnea harder to notice during pregnancy?

Fatigue and snoring are both common in normal pregnancy, which can make new or worsening sleep apnea easy to overlook or attribute to pregnancy in general. This is one reason it is worth mentioning loud snoring, witnessed breathing pauses, gasping, or unusual daytime sleepiness to your obstetric provider rather than assuming it is simply expected.

Is it safe to have a sleep study while pregnant?

Yes. Both home sleep apnea testing and in-lab polysomnography are considered safe during pregnancy. Home sleep apnea testing is often more convenient, though it can sometimes underestimate the severity of sleep apnea, and an in-lab study may be recommended if clinical suspicion remains high despite a reassuring home test.

Is CPAP safe to use during pregnancy?

Yes. CPAP is considered the standard, safe treatment for sleep apnea diagnosed during pregnancy. It does not need to be delayed until after delivery, and many patients are managed with CPAP throughout the remainder of their pregnancy.

Does sleep apnea during pregnancy increase the risk of preeclampsia or high blood pressure?

Research has found an association between obstructive sleep apnea in pregnancy and a higher likelihood of hypertensive disorders of pregnancy, which includes conditions such as gestational hypertension and preeclampsia. This is an association observed in studies, not a guarantee of what will happen in any individual pregnancy, and your obstetric team is best positioned to monitor your blood pressure and overall risk.

Does sleep apnea during pregnancy affect the baby?

Some studies have found associations between untreated sleep apnea in pregnancy and outcomes such as gestational diabetes and certain fetal growth or delivery considerations. The overall evidence is still developing, and any specific concerns about your baby's growth or well-being should be directed to your obstetric provider, who has the full picture of your pregnancy.

Will my sleep apnea go away after I give birth?

It might improve, since weight and hormonal changes related to pregnancy can partially reverse after delivery, but improvement is not guaranteed and should not simply be assumed. Sleep apnea that develops or continues after pregnancy deserves its own reassessment rather than an assumption that it has resolved on its own.

Should every pregnant person be screened for sleep apnea?

Not necessarily every pregnant person, but screening is often considered for those with risk factors such as obesity, chronic or pregnancy-related hypertension, diabetes, or a family history of sleep apnea. Your obstetric provider can help determine whether screening or referral for testing makes sense for your specific situation.

Who should I talk to first if I am worried about sleep apnea during pregnancy?

Start with your obstetric provider, since they are coordinating your overall pregnancy care and can help decide whether referral for a sleep evaluation is appropriate. From there, a sleep medicine physician can arrange testing and, if needed, treatment in coordination with your obstetric team.

Guidelines and Professional Societies

  1. CHEST · 2026American College of Chest Physicians clinical practice guideline on obstructive sleep apnea in pregnancy, addressing screening, diagnostic testing, and positive airway pressure treatment.
  2. AASMAmerican Academy of Sleep Medicine, Journal of Clinical Sleep Medicine — clinical guidance on the dynamic changes in sleep apnea risk during pregnancy related to hormonal and physiological shifts.
  3. Society of Anesthesia and Sleep Medicine and the Society for Obstetric Anesthesia and Perinatology consensus guideline on the screening, diagnosis, and treatment of obstructive sleep apnea in pregnancy, published in Obstetrics & Gynecology.

Key Evidence

  1. NIHNational Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development — research on risk factors for sleep apnea during pregnancy.