Pregnant women who are diagnosed with sleep disorders such as sleep apnea and insomnia appear to be at risk of delivering their babies before reaching full term

The study found the prevalence of preterm birth -- defined as delivery before 37 weeks' gestation -- was 14.6 percent for women diagnosed with a sleep disorder during pregnancy, compared to 10.9 percent for women who were not. The odds of early preterm birth -- before 34 weeks -- was more than double for women with sleep apnea and nearly double for women with insomnia. Complications are more severe among early preterm births, which makes this latter finding particularly important, the authors said.

In contrast to the normal sleep changes that typically occur during pregnancy, the new study focused on major disruptions likely to result in impairment. The true prevalence of these disorders is unknown because pregnant women often go undiagnosed. Treating sleep disorders during pregnancy could be a way to reduce the preterm rate, which is about 10 percent in the United States, more than most other highly developed countries.

The study, published Aug. 8, 2017 in Obstetrics & Gynecology, is the first to examine the effects of insomnia during pregnancy. Because of a large sample size, the authors were able to examine the relationship between different types of sleep disorders and subtypes of preterm birth (for example, early vs. late preterm birth, or spontaneous preterm labor vs. early deliveries that were initiated by providers due to mothers' health issues).

To separate the effects of poor sleep from other factors that also contribute to a risk of preterm birth, the researchers used a case-control design: 2,265 women with a sleep disorder diagnosis during pregnancy were matched to controls who did not have such a diagnosis, but had identical maternal risk factors for preterm birth, such as a previous preterm birth, smoking during pregnancy, or hypertension.

"This gave us more confidence that our finding of an earlier delivery among women with disordered sleep was truly attributable to the sleep disorder, and not to other differences between women with and without these disorders," said Jennifer Felder, PhD, a postdoctoral fellow in the UCSF Department of Psychiatry and the lead author of the study.

The researchers were surprised by how few women in the dataset -- well below 1 percent -- had a sleep disorder diagnosis, and suspect that only the most serious cases were identified.

"The women who had a diagnosis of a sleep disorder recorded in their medical record most likely had more severe presentations," said Aric Prather, PhD, assistant professor of psychiatry at UCSF and senior author of the study. "It's likely that the prevalence would be much higher if more women were screened for sleep disorders during pregnancy."

Cognitive behavioral therapy has been shown to be effective in the general population and does not require taking medications that many pregnant women prefer to avoid. To find out if this therapy is effective among pregnant women with insomnia, and ultimately whether it may improve birth outcomes, Felder and colleagues are recruiting participants for the UCSF Research on Expecting Moms and Sleep Therapy (REST) Study.

"What's so exciting about this study is that a sleep disorder is a potentially modifiable risk factor," said Felder, who was trained in clinical psychology.

Story Source:

Materials provided by University of California - San Francisco. Original written by Laura Kurtzman. Note: Content may be edited for style and length.

Journal Reference:

  1. Jennifer N. Felder, Rebecca J. Baer, Larry Rand, Laura L. Jelliffe-Pawlowski, Aric A. Prather. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm BirthObstetrics & Gynecology, 2017; 1 DOI: 10.1097/AOG.0000000000002132

Cite This Page:

University of California - San Francisco. "Sleep disorders linked to preterm birth in large California study: Insomnia, sleep apnea nearly double the risk of a preterm delivery before 34 weeks." ScienceDaily. ScienceDaily, 8 August 2017. <>.

Women and Obstructive Sleep Apnea

The bed partners of snorers sleep an average of 62 minutes less per night.

                          Beninati W et al. The Effect of Snoring and Obstructive Sleep Apnea on the Sleep Quality of Bed Partners Mayo Clin Proc 1999 Oct. 74 (10) 955-8.

Although Obstructive Sleep Apnea Syndrome is more common in men it is not unusual for women to also have Obstructive Sleep Apnea. For every 2 to 3 men diagnosed with OSA, 1 woman will be diagnosed with this condition. The ratio increases for woman in the stages of menopause to be equal to the number of men who are diagnosed with OSA. 

Poor sleeping habits are more dangerous for woman than they are for men. This is not to say that it is not an issue for men, but woman who suffer from lack of sleep often experience feelings of anger, depression, and display higher levels of distress and hostility, whereas men do not.

Often women with Obstructive Sleep Apnea are misdiagnosed, as the symptoms for OSA often appear differently in women. The typical model for patients with this syndrome has been overweight, middle-aged males.  Your average woman may just as likely have Obstructive Sleep Apnea and display more psychological symptoms such as depression, insomnia, mood disturbances, etc.

Women with polycystic ovarian syndrom are 30x more likely to have sleep disordered breathing than control subjects.  

Alexandros N.Vgontzas. et Al,  Polycystic Ovary Syndrome Is Associated with Obstructive Sleep Apnea and Daytime Sleepiness: Role of Insulin Resistance, Journal of Clinical Endocrinology and Metabolism 2001 Feb 86 (2): 517


Pregnancy and Snoring:

An estimated 30% of all pregnant women snore. Snoring is caused by a partial obstruction of the airway as the air passes over the soft tissues in its path. If you are concerned that your snoring has become significant during pregnancy, please discuss it with your doctor.

Women who snore on a regular basis deliver developmentally -retarded babies 7% of the time, versus women who snore occasionally, who deliver developmentally-retarded babies 2.3% of the time.

                                                                                                                                                                Franklin, K. Chest 2000; 117 137-141

Michele Okun, PhD assistant professor of psychiatry and psychology and a psychoneuroimmunologist at the the University of Pittsburgh is studying the impact of sleep disturbances on women, in particular, weeks ten to twenty of pregnancy. This essential time period is when the placenta is formed. Dr. Okun described that the immune system is in a delicate balance. If there is too little inflammation the blastocyst can't implant and if there is too much immune response later the fetus may be rejected. Placental development is critical, as is the level of cytokines present. Elevated cytokine levels are associated with very dangerous outcomes in pregnancy such as pre-eclampsia, low birth weight, and preterm birth. One common reason for elevated cytokine levels during pregnancy is sleep loss.        E. Vitone, Pittmed, Summer 2012


It is important for women to be educated on all of the information related to snoring and symptoms of Obstructive Sleep Apnea Syndrome to improve discussions with their physicians.