Sleep And Pregnancy
How Does Pregnancy Affect
Pregnancy is very demanding for any woman and is
a time of great sleep disruption. Many factors contribute to this:
hormone changes, the growing fetus, bodily discomfort (vomiting,
heartburn, cramp, pressure on the bladder), mood changes, and
anxiety related to delivery. The postnatal (post-birth) period comes
with interrupted sleep pattern in the period when the new baby’s
demands take precedence. Some women develop sleep disorders, such as
restless legs syndrome and sleep apnea, for the first time.
Do Women Snore More During
About 30 percent of women will snore during
pregnancy, 15-20 percent of them the first time. If this is severe
enough, it may be associated with higher blood pressure during
pregnancy, and 10 percent of pregnant snorers develop pre-eclampsia
(high blood pressure, fluid retention, and protein in urine during
pregnancy). Significant snoring during pregnancy should be assessed
by a doctor.
Can Women Develop Sleep Apnea
Obese women who are pregnant and women who gains
excessive weight while pregnant are at a high risk of developing
sleep apnea. A drop in blood oxygen levels at night is associated
with potential complication for the baby. It is important that any
overweight woman or woman who gains a lot of weight during pregnancy
should be assessed by a a doctor evidence of sleep apnea.
Do Women Experience Restless
Leg Syndrome (RLS) During pregnancy?
The other major sleep disorder that can occur
during pregnancy is restless legs syndrome (RLS) and leg cramp.
About 15-25 percent of women develop RLS during pregnancy in
association with iron deficiency, and women with low folate levels
are also at risk. Although RLS will resolve after delivery, it is an
additional stressor during pregnancy and can disrupt sleep, so make
sure that you have adequate iron and vitamin B12 levels
in your blood before and during pregnancy.
How Does Sleep Change After
About 35-80 percent of women experience “baby
blue” 3 to 5 days after delivery. The blues generally don’t last
longer that about 2 weeks, but 20 percent of women develop postnatal
depression. Postnatal depression can occur any time within 6 months
of delivery and like any mood disorder, it can result in severe
Sleep Patterns During
Sleep patterns change throughout pregnancy,
largely as a result of the enormous physical changes that take place
as the fetus grows, but also partly due to hormonal changes that
Sleep During The First
The first trimester is the period from conception
to 3 months. During this time, there are high levels of progesterone
in body, which have a sleep-inducing and sedating effect on the
Progesterone also increases the need to urine due
to the effect it has on the smooth muscle in the bladder. Women
often experience more sleep difficulty during the night due to an
increased need to go to the bathroom.
Many women often experience daytime sleepiness
and fatigue during this time. Nausea and vomiting is not just
limited to “morning sickness” but can also occur in the evening.
There is a greater tendency to sleep longer than prior to pregnancy,
but there is less slow wave sleep during this time.
Sleep During The Second
second trimester of pregnancy is the period from the fourth to the
sixth month. Progesterone levels continue to rise during this period
but more slowly.
Many women experience a great improvement in
their sleep quality and quantity during this period and report more
The growing fetus moves above the bladder and the
need to urinate decreases. However, many women start to snore at
this stage, probably because of the effects of oestrogen on blood
vessels, resulting in nasal congestion. During this time, there is
an increased risk of developing sleep apnea and also high blood
pressure, so you must be carefully monitored by your doctor. There
is less slow wave sleep than prior to pregnancy and more time is
spent awake during the night.
Sleep During The Third
third trimester is the period from the seventh to the ninth month.
Progesterone levels are at their peak during this time. Omen report
the most sleep difficulties during this stage of pregnancy.
Sleep disturbances are very common and are caused
by a wide variety of factors including leg cramps, heartburn, nasal
congestion, and an increased need to urinate. The baby’s movements
can also disturb sleep. The baby’s movements can also disturb sleep.
In the last few weeks of pregnancy, many women find achieving a
comfortable sleeping position difficult.
This can lead to increased daytime fatigue and
sleepiness. Breast tenderness, shortness of breath, and irregular
uterine contractions can also affect sleep adversely. Overall, more
time is spent awake and there is less slow wave sleep.
Improving Sleep During
Ensure a high intake of folate, iron, and
vitamin B12 before during pregnancy.
Exercise regularly and control weight.
Keep fluid intake high, but try and cut down
before bedtime to ease the stress on your bladder.
If the heartburn is a problem, sleep with the
head of your bed elevated, or use a few pillows.
Eating small meals during the day and
avoiding spicy or fried meals may reduce reflex and help with
nausea, especially during the first trimester.
Schedule naps during the day, to help with
daytime fatigue and tiredness.
As your pregnancy progresses, adjust your
bedding accordingly. Special pregnancy pillows and support
pillows may make sleeping more comfortable.
In the third trimester, try and sleep on your
left side (rather than your back to allow for improved blood
flow to the fetus, uterus, and kidneys.
Early Stage of
What sorts of sleep disruption
occur after pregnancy?
Unsurprisingly, women experience more awakenings
at night after delivery (for feeding of the baby), although this
tends to settle after the first month. Many mothers find daytime
naps are a good way to compensate for this disruption in sleep
during the night. For first time mothers, the first 3-6 weeks after
delivery are very tiring and fatigue levels remain high for 3 months
(higher than prior to pregnancy). There is a high proportion of slow
wave sleep after pregnancy related largely to the production of the
hormone prolactin responsible for “letting down milk”.
How Can I Ensure I have Enough
Sleep In The Early Stages of Looking After My Baby?
Initially, it will be difficult for you to have
unbroken sleep during the night. But the good news is that once your
baby has regular sleep wake pattern (by about 6 months) things will
start to return to normal. To combat fatigue, make sure you eat
well. Iron levels are low after pregnancy and this can make you feel
more tired. Scheduling a nap when the baby is napping during the day
helps, as does having a partner or family member who can assist with
Should I Worry if I’m Not
Getting Enough Sleep?
Don’t be hard on yourself – pregnancy and the
first 6 months with a new baby is extremely demanding physically and
emotionally, and just getting through the day is an achievement in
itself. If you feel your “baby blues” are not lifting or if feel
depressed, seek professional advice. Depression can negatively
affect infant mother bonding besides your own state of well being.
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