From forbes.com
It’s something pregnant people hear over and over again: The first couple of months after a baby is born are not the best for sleep. And that knowledge can make pregnancy insomnia, or disturbed sleep during pregnancy, feel particularly difficult.
If you’re dealing with pregnancy insomnia, you’re not alone. Most common during the third trimester, pregnancy insomnia affects around 64% of pregnant people.
If you’re having trouble sleeping during pregnancy, creating an action plan to manage it is one of the best ways to give yourself relief. Below, we’ve put together a guide to everything you need to know about pregnancy insomnia, from its causes and how long it lasts to how to treat it.
What Is Pregnancy Insomnia?
Whether you’re pregnant now or thinking about getting pregnant, you may be wondering how pregnancy insomnia is actually defined. The short answer is that pregnancy insomnia is very similar to regular insomnia—it’s just insomnia that happens when you’re pregnant.
“Pregnancy insomnia can include having trouble falling asleep, staying asleep or getting quality sleep,” explains Shannon Clark, M.D., an OB-GYN and member of the Clinical Advisory Network at Lansinoh. “This can lead to daytime sleepiness, shorter periods of time sleeping altogether and poor sleep quality.”
What Causes Pregnancy Insomnia?
According to research done on insomnia during pregnancy, the condition is commonly caused by:
- Anxiety disorders
- Mood disorders
- Breathing-related sleep disorders (like sleep apnoea)
- Restless leg syndrome.
- GI symptoms (like reflux, indigestion)
- Urinary frequency
However, there typically isn’t just one cause of insomnia in pregnancy, Diana Kolettis, M.D., a maternal foetal medicine physician at Tufts Medical Center, confirms. “Pregnancy is a physically and mentally stressful time. Mental stress from a pregnancy complication, or simply the anticipation of a new member of the family, can lead to difficulty falling asleep or staying asleep.”
Discomfort, particularly at the end of the pregnancy, can be a big factor too. “As the pregnancy enters the late second and third trimesters, the gravid uterus—or ‘baby bump’—makes finding a comfortable sleeping position very difficult, leading to frequent wake-ups,” says Dr. Kolettis.
Hormonal changes are also thought to be a contributing factor, according to Amy Roskin, M.D., an OB-GYN and chief medical officer at Seven Starling. While more research needs to be done on this topic, studies show that hormonal changes may be to blame for increased risk of restless leg syndrome, a big cause of insomnia in pregnancy.
How Long Does Pregnancy Insomnia Last?
The duration of pregnancy insomnia will vary from person to person, and the answer to this question has a lot to do with what’s actually causing the pregnancy insomnia in the first place.
“Someone in their third trimester, for example, might have sleep difficulties from symptoms like heartburn or pelvic/abdominal pressure from the increased size of the baby,” says Dr. Roskin. “This might be different from first trimester symptoms that might disrupt sleep.”
Additionally, according to Dr. Kolettis, pregnancy insomnia can actually last into the postpartum period. In fact, research shows that postpartum insomnia could affect around 33% of people.
How Do I Manage Pregnancy Insomnia?
There are a number of treatment options available for treating insomnia in pregnancy. While medication is one of them, doctors typically recommend trying behaviour modification methods first.
“Developing a night-time routine is very important,” says Dr. Kolettis. She suggests establishing a bedtime and out-of-bed time each day and sticking to it as much as possible. “Turn off all screens one to two hours before bed, and don’t scroll if you wake up in the middle of the night,” she adds. “Get an old-fashioned clock for your nightstand with a soft glow. Keep your bedroom dark and cool and avoid caffeine.”
There is also some research to support the idea that cognitive behavioural therapy for insomnia, or CBT-I, can help with pregnancy-related insomnia, especially between 18 and 32 weeks.
If your insomnia is later in the pregnancy and related to discomfort, working on changing your sleeping position or location can help. “Many pillows can be helpful in propping up the back or knees, and some women opt to sleep in a recliner chair towards the last few weeks of the pregnancy,” says Dr. Kolettis.
Finally, while you should always talk to your doctor before taking any medication in pregnancy, it is an option. Benadryl is generally considered safe, and some of the most commonly prescribed medications for pregnant people struggling with insomnia are hypnotic benzodiazepine receptor agonists like zaleplon, zolpidem and eszopiclone.
Complications of Pregnancy Insomnia
While not common in otherwise healthy people, there can be some complications associated with pregnancy insomnia.
“It is important to talk about your symptoms with your doctor if you’re experiencing pregnancy insomnia,” says Dr. Kolettis. “Chronic insomnia could be a symptom of other medical conditions such as obstructive sleep apnoea and certain mood disorders like depression and bipolar disease. Moreover, restless sleep can also worsen these conditions, so your doctor will take your specific medical history into consideration when assessing your symptoms.”
Additionally, some research shows that if pregnant people sleep less than six hours a night in the last month of their pregnancy, they may be at risk for longer labour, c-section, preterm delivery and worse labour pain. While some poor sleep during pregnancy probably isn’t anything to worry about, it is important to weigh potential risks with your doctor so they can help you come up with an action plan.
Does Pregnancy Insomnia Hurt My Baby?
In the vast majority of cases, pregnancy insomnia will not cause any complications for the baby. “The foetal sleep cycle is not determined by maternal sleep cycles, thus the foetus will continue to get the rest that they need,” explains Dr. Kolettis.
However, a 2020 study did find that sleep deprivation during pregnancy can occasionally be associated with an increased risk of the baby developing obesity or having high blood pressure, and having a higher BMI as the they grow. It’s important to note that other factors, such as gestational diabetes, could also contribute to these issues, and pregnancy insomnia does not always result in a baby developing weight issues or high blood pressure.
Additional risks of pregnancy insomnia include preterm deliveries and c-section deliveries, as mentioned above.
When to Call the Doctor
You should always stay in touch with your doctor if you’re dealing with pregnancy insomnia. “Tell your doctor at your prenatal care visits that you’re having trouble sleeping,” suggests Dr. Kolettis. “You can prepare for your visit by keeping a sleep diary and bringing it to your appointment. Each morning, write the time you went to sleep and your quality of sleep the night before.”
Having this information can help your doctor assess your symptoms to determine the proper treatment plan, explains Dr. Kolettis. While insomnia in pregnancy usually isn’t something to worry about, it can lower a pregnant person’s quality of life and comes with risks, so it’s important to be open with your health care provider about it.
https://www.forbes.com/health/family/insomnia-during-pregnancy/
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