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Pregnancy is an exciting and physically demanding time.
Physical symptoms (body aches, nausea, leg cramps, fetus movements and heart-burn), as well as emotional changes (depression, anxiety, worry) can interfere with sleep.
In the NSF poll, 78% of women reported more disturbed sleep during pregnancy than at other times although some women have few sleep problems.
Sleep related problems also become more prevalent as the pregnancy progresses.
One recent study reported that changes in sleep occur in 13-20% of women in the first trimester and increase to 66-90% by the third trimester.
In general, nausea can be experienced early whereas general discomfort may disrupt sleep later in the pregnancy.
First Trimester (Months 1-3)
Overall, women have lower quality of sleep during the last trimester of pregnancy. High levels of progesterone are produced, increasing feelings of sleepiness. Also, the enlarged uterus can press up against the diaphragm, making it more difficult to breathe.
The number of times a woman wakes up during the night to urinate increases as well. Disturbed sleep patterns may begin. Interrupted sleep can cause daytime sleepiness. Women tend to sleep more during this time than before they were pregnant, or later in pregnancy.
Second Trimester (Months 4-6)
During this trimester, the growing fetus reduces pressure on the bladder by moving above it and decreasing the need for frequent bathroom visits.
Sleep quality is still worse than it was before pregnancy and many women become restless as they search for a comfortable position.
Third Trimester (Months 7-9)
Women experience the most pregnancy-related sleep problems at this time although they may sleep longer and nap more by the end of the pregnancy. They may often feel physically uncomfortable.
Heartburn, leg cramps and sinus congestion are common reasons for disturbed sleep, as is an increased need to go to the bathroom. (The fetus puts pressure on the bladder again.)
One recent study reported, that by the end of pregnancy, 97% of women were waking during the night.
Post-Partum
As might be expected, mothers of newborn babies experience a lot of sleeplessness and daytime sleepiness, which may contribute to the "postnatal blues" experienced by 75-80% of most new mothers.
This is usually a temporary condition, but it can become extremely serious and even put a new mother at risk for suicide. In general, it is treatable with professional help and will improve as the baby develops and establishes regular, nighttime sleep.
Snoring and Severe Daytime Sleepiness
Pregnant women who have never snored before may begin doing so. About 30% of pregnant women snore because of increased swelling in their nasal passages. This may partially block the airways.
Snoring can also lead to high blood pressure, which can put both the mother and fetus at risk. If the blockage is severe, sleep apnea may result, characterized by loud snoring and periods of stopped breathing during sleep.
The lack of oxygen disrupts sleep and may affect the unborn fetus. If loud snoring and severe daytime sleepiness (another symptom of sleep apnea and other sleep disorders) occur, consult your physician.
Secondary Restless Legs in Pregnancy
Up to 15 percent of pregnant women develop Restless Legs Syndrome (RLS) during the third trimester. A contributing cause may be iron and/or folate acid deficiency. In general, RLS is more prevalent in women than men. RLS symptoms make it difficult to fall and stay asleep due to an uncontrollable urge to move the legs in response to unpleasant, restless, creepy feelings in the legs.
These feelings appear when at rest and often disrupt sleep as well. Moving the legs can stop these symptoms temporarily, but the irritation returns when the limb is still. Fortunately, RLS symptoms usually end after delivery of the baby. Medications used to treat RLS may cause harm to the fetus and should be discussed with a doctor.
Sleep Tips for Pregnant Women
1. In the third trimester, sleep on your left side to allow for the best blood flow to the fetus and to your uterus and kidneys. Avoid lying flat on your back for a long period of time.
2. Drink lots of fluids during the day, but cut down before bedtime.
3. To prevent heartburn, do not eat large amounts of spicy, acidic (such as tomato products), or fried foods. If heartburn is a problem, sleep with your head elevated on pillows.
4. Exercise regularly to help you stay healthy, improve your circulation, and reduce leg cramps.
5. Try frequent bland snacks (like crackers) throughout the day. This helps avoid nausea by keeping your stomach full.
6. Special "pregnancy" pillows and mattresses may help you sleep better. Or use regular pillows to support your body.
7. Naps may help. The NSF poll found that 51% of pregnant or recently pregnant women reported at least one weekday nap; 60% reported at least one weekend nap.
8. Learn to relax with relaxation and breathing techniques, which can also help when the contractions begin. A warm bath or shower before bed can be helpful.
9. Talk to your doctor if you develop medical problems and/or insomnia persists.
Once her baby is born, a mother's sleep is frequently interrupted, particularly if she is nursing.
Mothers who nurse and those with babies that wake frequently during the night should try to nap when their babies do.
Sharing baby care to the extent possible, especially during the night, is important for the mother's health, safety, performance and vitality.
Check out our site pages for natural herbal remedies as a sleep aid.Note: Although generally safe, clary sage and chamomile oils should be avoided during pregnancy. If in doubt about any essential oils, consult a medical practitioner.
Women’s Sleep Habits
Sleep loss in women has reached epidemic proportions. Unfortunately, many women are unaware of the negative impact sleep problems can have on their health and performance. Identifying the unique complications that contribute to sleep problems in women is an important step in achieving better sleep.
Almost three out of four women do not get eight or more hours of sleep per night during the workweek. On average, women sleep approximately 6.5 hours per night during the workweek.
While many women experience difficulty sleeping, only 4% of adults currently see a physician regarding their sleep problems.2
Hormones Affect Sleep
Sleep is disturbed 2.5 days on average during the menstrual cycle. More women complain of sleep problems during menstruation (71%), when hormone levels are at their lowest, than during the premenstrual week (43%).
A majority (79%) of women report an increase in sleep problems during pregnancy.
Forty percent of menopausal women suffer from sleep problems, which are usually related to hot flashes. A majority of menopausal/postmenopausal women report frequent insomnia.
Medical Conditions
Depression and anxiety, conditions associated with sleep loss, are twice as common in women as they are in men.
More women than men suffer from nighttime pain, including pain due to arthritis, which may make it more difficult to get a good night’s sleep.
Maternal Responsibilities
Most moms develop a high sensitivity to the sounds of their children and awaken more easily than women without children. This heightened sensitivity may continue long after their children sleep through the night.
Consequences of Sleep Loss
Middle-aged women who sleep an average of five hours or less nightly may be more likely to have heart disease than women who sleep eight hours nightly.
Sleep loss may increase hunger and affect the body’s metabolism, which may make it more difficult to maintain or lose weight.
A majority of women surveyed say that sleep problems hinder their ability to perform daily activities at least a few days per month.
Of those women who report that their sleep problems hinder their daily activities, forty-six percent report that sleep problems interfere with household duties, and nearly two thirds say sleep problems interfere with their relationship with either their spouse or their children.
How Women Can Achieve Better Sleep
Avoid alcohol as well as foods or beverages high in caffeine (eg, coffee, colas, tea, chocolate), sugar (including honey), and salt.
Exercise regularly, but do so at least three hours before bedtime.
Try warming up your feet if you’re having trouble sleeping. Inadequate vasodilation (opening of blood vessels to increase blood flow) may cause sleep problems.
If you can’t fall asleep, participate in a quiet, relaxing activity in a dimly lit room.
Sleep Loss Affects Health and Performance
The amount of sleep a woman gets may directly affect her health. Studies published in the Journal of the American Medical Association and the Lancet suggest that sleep loss may increase hunger and affect the body’s metabolism, which may make it more difficult to maintain or lose weight.
Sleep loss may also interfere with the body’s ability to metabolize carbohydrates and cause high blood levels of glucose, a basic sugar. Excess glucose promotes the overproduction of insulin, and can also lead to insulin resistance, a critical feature of adult-onset diabetes.
In addition, research shows that short-term sleep deprivation may increase blood pressure. In fact, a recent study published in the Archives of Internal Medicine demonstrated that chronic sleep loss is associated with an increased risk of heart disease.
Women between the ages of 45 and 65 who slept an average of five hours or less per night were 39% more likely to have heart problems than women who slept eight hours per night.
Sleep loss can also hinder a woman’s ability to perform daily responsibilities and may also impact her relationships. According to the National Sleep Foundation’s Women and Sleep Poll, a majority of women (51%) say that their sleep problems hinder their ability to perform daily activities at least a few days per month.
Of those women, 46% report interference with carrying out household duties, 27% report interference with job performance, and nearly two thirds say that lack of sleep causes problems with their relationship with either their spouse or their children.
Sleep aid tips for Mothers
Avoid alcohol as well as foods or beverages high in caffeine (eg, coffee, colas, tea, chocolate), sugar (including honey), and salt.
Exercise regularly, but finish your workout at least three hours before bedtime. Exercise may relieve some PMS symptoms and promotes a good night’s sleep.
If you are having trouble falling asleep, try warming up your feet. Inadequate vasodilation (opening of blood vessels to increase blood flow) may cause sleep problems. This remedy might be especially helpful to older women with poor circulation in their extremities.
If you can’t fall asleep in bed after a reasonable period, get up, go into a darkened or dimly lit room, and participate in a quiet activity such as reading, knitting, or listening to soothing music. Do not use this time to catch up on laundry or paperwork.
If you experience sleep disturbances for more than a few weeks, see your doctor. In addition to behavioral and lifestyle modifications, there are prescription sleep medications that may help individuals fall asleep quickly and increase their total sleep time with minimal next-day effects.
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