Pregnancy: Sleeping for Two

By:
iVillage Health & Well-Being Staff Writer

Pregnancy is an exciting and physically demanding time. Physical symptoms (body aches, nausea, leg cramps, fetus movements and heartburn), as well as emotional changes (depression, anxiety, worry) can interfere with sleep. In the 1998 Women and Sleep Poll (WSP), 78% of women reported more disturbed sleep during pregnancy than at other times.

First Trimester (Months 1-3)
High levels of progesterone are produced, increasing sleepiness. Also, the number of times a woman wakes up during the night to urinate increases. 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)
Progesterone levels still rise, but slowly. This allows for better sleep than during the first trimester. The growing fetus reduces pressure on the bladder by moving above it, decreasing the need for frequent bathroom visits. Sleep quality is still worse than it was before pregnancy.

Third Trimester (Months 7-9)
Many women complain of sleep problems during this phase. 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.)

Snoring and Severe Daytime Sleepiness
Pregnant women who have never snored before may begin doing so because of increased swelling in their nasal passages. This may partially block the airways. 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.

Restless Legs and Poor Sleep
More women (28%) than men (21%) reported restless legs syndrome (RLS) symptoms in the National Sleep Foundation's (NSF) 1998 Omnibus Sleep in America Poll. Up to 15 percent of pregnant women develop RLS during the third trimester. RLS symptoms - crawling or moving feelings inside the foot, calf or upper leg - temporarily disrupt sleep. Moving the legs can stop these symptoms temporarily, but symptoms return when the limb is still. Fortunately, symptoms usually end after delivery of the baby. Women who are not pregnant can also suffer from RLS.

Drugs used to treat RLS may cause harm to the fetus and should be discussed with a doctor.

Sleep Tips for Pregnant Women

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.
Drink lots of fluids during the day, but cut down before bedtime.
To prevent heartburn, do not eat large amounts of spicy, acidic (such as tomato and citrus products) or fried foods. Also avoid chocolate and foods containing mint. If heartburn is a problem, sleep with your head elevated on pillows.
Exercise regularly to help you stay healthy, improve your circulation, and reduce leg cramps. (Be sure to discuss your exercise routine with a physician.)
Try frequent bland snacks (like crackers) throughout the day. This helps avoid nausea by keeping your stomach full.
Special "pregnancy" pillows and mattresses may help you sleep better. Or use regular pillows to support your body.
Naps may help. (In the 1998 WSP, 51% of pregnant or recently pregnant women reported at least one weekday nap; 60% reported at least one weekend nap.)
Talk to your doctor if insomnia persists.

Once her baby is born, a mother's sleep is frequently interrupted. Mothers should try to nap when their babies do. After-birth blues (postpartum depression) may also be related to sleep problems. This is a temporary condition treatable with professional help.