Sleep in Pregnancy

Up to 75% of pregnant women experience some sort of sleep disruption during pregnancy. The causes for this sleeplessness and insomnia tend to change as the pregnancy progresses and are usually associated with other pregnancy-related symptoms. However sleep patterns may also be influenced by changes in hormones, too.

In the first trimester, sleep may be disrupted by nausea and vomiting or urinary frequency. Anxiety about the changes ahead, or excitement at the recent news, can also keep you lying awake for hours thinking about how different and wonderful your life is about to become!

In the second trimester, common symptoms such as heartburn or reflux, muscle cramps and the increasingly active foetus may contribute to a restless and broken night sleep.

Sleep issues in the third trimester are extremely common. Up to 97% of pregnant women fail to sleep through the night in the last stage of pregnancy. This may be due to general discomfort, an active baby, urinary frequency, back pain, abnormal breathing patterns or restless legs syndrome.

Sleep generally tends to worsen in the first trimester, normalise in the second trimester and worsen again in the third trimester. However this does not happen in all women and it can vary considerably.

But regardless of why you may not be sleeping through the night, the big questions are: what are the effects on you and your baby, and how do you improve your sleep?

More and more evidence is showing that sleep disturbances are associated with certain health conditions. We know that sleep is an active process during which metabolism, tissue restoration, memory, and general equilibrium are maintained. This process is just as, if not more, important in pregnancy, and getting adequate sleep is crucial for you and your baby’s health.

Women with preeclampsia have been shown to have poorer sleep quality than women without preeclampsia, and severely disturbed sleep can increase the risk of emotional disturbances.

Tips to improve sleeping patterns

Firstly, sleeping pills should be avoided in pregnancy and you should always check with your healthcare professional whether specific herbal or natural sleep formulations are safe in pregnancy.

Safe and effective methods for promoting a restful night’s sleep involve engaging in healthy sleep hygiene. This includes:

• Having a regular routine for bedtime.
• Avoiding caffeine and alcohol.
• Engaging in relaxation techniques such as focusing on breathing, taking a warm bath before bed, meditation.
• Limiting fluid intake after 6pm to reduce urinary frequency during the night.
• Ensuring adequate and comfortable pillow support.
• Getting out of bed when you have been awake for a long period of time.
• If you have younger children who are still waking in the night, consider asking your partner if possible to support you in the parenting role and allow you to get some extra sleep.

Addressing underlying conditions in pregnancy will also help. The following are simple suggestions; however, it will always be best if you see a healthcare professional for individual treatment.

• Heartburn: Try sipping on chamomile tea.
• Avoid eating a heavy meal 2-3 hours before bed and avoid chilli and spices.
• Nausea and vomiting:
• Ginger, and sipping on ginger tea.
• Back pain: See a chiropractor, osteopath or physiotherapist.
• Regular massage and reflexology may also benefit.
• Stress and anxiety: Counselling, reflexology and B vitamins.

(Also refer to ‘The Pregnancy Series’ articles for more information on remedies for other common symptoms in pregnancy)
It isn’t always recommended to sleep too much during the day as it increases the risk of further disrupting your nightly sleeping patterns. However, some sleep is better than no sleep, so try to get a couple of hours of sleep during the day if you feel you are having trouble sleeping through the night.