Pregnancy

Pregnancy is a time of joyful expectation for the family. However, sleep disturbance makes this period difficult and challenging. As your pregnancy progresses, you may start to experience all sorts of sleep issues including daytimes sleepiness and insomnia. Sleep problems tend to occur during the first and the third trimesters; less so during the second trimester.

Common sleep problems in pregnancy

  1. Excessive daytime sleepiness: Due to poor sleep quality and the increase in progesterone. It becomes more difficult to find a comfortable position.
  2. Insomnia: Due to hormonal changes, frequent urination, nausea, back pain, movements of the fetus and stress (anticipation of labor and delivery) and possible sleep apnea and restless leg.
  3. Restless legs syndrome: this is an unpleasant urge or twitch to move the legs during rest but improves with movements.
  4. Sleep apnea and snoring: Caused by hormonal changes and weight gain.  It carries a risk of low birth weight and pre-eclampsia
  5. Nighttime gastroesophageal reflux (GERD) or heartburn
  6. Pain and discomfort with finding a good position.

Tips on managing sleep issues during pregnancy

  1. Make sleep a priority.
  2. Naps: Schedule a daily nap during the day if you are not getting a good night sleep.
  3. Medications: Avoid sleeping pills for insomnia since many of them carry risks for the fetus. Restless legs medications are also not indicated during pregnancy because of the potential harm on the fetus.
  4. Restless legs: If you suffer from restless legs, get evaluated for anemia and low folate levels during pregnancy.  Prenatal vitamins should help. Avoid coffee.
  5. Routine: Maintain a routine sleep and wake schedule.
  6. Exercise: Get daily gentle exercise as permitted by your doctor. Along with drinking plenty of water during the day, it improves circulation and reduces leg cramps at night.
  7. Comfortable position: Sleep on your left side to allow the best blood flow to the fetus. Avoid sleeping on your back for too long. Use a pillow under you knee and perhaps another under your abdomen. You can use regular pillows or purchase special pregnancy pillow.
  8. Sleep apnea: If you have pauses in breathing or your snoring is severe, talk to your doctor to get tested with a sleep study. Particular attention should be paid to overweight women who gained more weight during pregnancy or those who developed swelling in their feet or hypertension (pre-eclampsia) since they are at higher risk for sleep apnea. Treatment is with CPAP therapy which involves the use of face mask connected to a devise that delivers pressurized room air to maintain an open airway. It is a safe treatment of sleep apnea for pregnant women.
  9. Reflux: Avoid heavy meals close to bedtime to decrease the chance for getting heartburn at night. Avoid fluids close to bedtime. However, drink plenty of water during the day. If heartburn continues to be a problem use a couple of pillows to elevate your head. Avoid food that is spicy, acidic or fried.
  10. Stress: Reduce any stress through talking to a friend or a professional but also through gentle exercise and meditation.
  11. Pre-bedtime habits: Adopt a relaxing pre-bedtime habit to allow you a stress-less evening as night approaches. Take a warm bath or shower, read a book and listen to soft music.