Sleep and Pregnancy

Getting Enough Sleep During Pregnancy

The amount of sleep you get while you’re pregnant not only affects you and your baby, but could impact your labor and delivery, as well. Lack of sleep during pregnancy has been tied to a number of complications, including preeclampsia (a serious condition that affects your blood pressure and kidneys and could result in pre-term birth). Now is the time to take sleep seriously.

When you become pregnant, one of the first symptoms you may notice is being overwhelmingly tired, even exhausted. Sleep will be irresistible to you. You can most likely blame your changing hormones for this, especially the extra progesterone that comes with being pregnant. In the beginning, pregnancy also lowers your blood pressure and blood sugar, which can make you feel tired.

Shortly after the first trimester, your energy should return. Then, sometime during the third trimester, you’ll begin to feel tired again. Some of this feeling can be blamed on the sheer physical exhaustion that comes from growing a baby and the stress that it puts on your body. Mostly, though, your weariness during this time is in direct relation to your inability to get a good night’s sleep.

Even if you’ve never had trouble sleeping before, you may find it much more difficult while you’re pregnant.

Path to improved health

Sleep should never be seen as a luxury. It’s a necessity — especially when you’re pregnant.

In fact, women who are pregnant need a few more hours of sleep each night or should supplement nighttime sleep with naps during the day, according to the National Institutes of Health.

For many pregnant women, though, getting 8 to 10 hours of sleep each night becomes more and more difficult the farther along they are in their pregnancy. There are many physical and emotional obstacles to sleep in this stage. Anxiety about being a mom or about adding to your family can keep you awake. Fear of the unknown or about the delivery can cause insomnia. Plus, there is the getting up every few hours to go to the bathroom. It also can be difficult to find a comfortable position in bed, especially if you are a former stomach sleeper.

If any of the following is keeping you awake at night, try these strategies for getting a good night’s sleep.

Heartburn

At some point in their pregnancy, most pregnant women suffer from heartburn, which is a form of indigestion that feels like burning in your chest and throat. Heartburn can wake you up in the middle of the night and ruin a good sleep. Minimize the chance for this by avoiding spicy foods. Also, cut down on rich foods for dinner.

Restless leg syndrome

Few things are more distracting than restless legs syndrome (RLS), especially when you are trying to go to sleep. While you can’t take traditional RLS medicines when you are pregnant, you can try to reduce the feelings of RLS with a good prenatal vitamin that includes folate and iron.

Morning sickness — at bedtime

Despite the name, morning sickness can occur any time and is often worse later in the day. Try eating a few crackers at bedtime and keep a stash in your nightstand in case a wave of nausea hits as you are trying to go to sleep.

Insomnia

There are many ways insomnia can creep in and compromise your sleep time. Often, it’s just about being able to shut down your brain. Most medicines for insomnia should not be taken while you are pregnant. Instead, try journaling some of the things you are anxious about. Write down what is stressing you and try to let it go as you go to sleep. Also, stop drinking caffeine by early afternoon. Try not to take long naps during the day. Doing any — or all — of these things can help ease you back into sleep at a reasonable bedtime.

Leg cramps

Not many things can wake you as quickly and painfully as a leg cramp. Sometimes called a charley horse, these cramps are usually a contraction of your calf muscle. Less frequently, they can occur in your thigh or your foot. These can plague you in pregnancy because of a lack of minerals, especially calcium and magnesium. They also are more common if you are dehydrated. To guard against leg cramps, make sure that you continue to take your prenatal vitamin and drink plenty of water and other fluids during the day.

Finding a comfortable position

As your body grows, sleep becomes a little harder to come by, especially in the third trimester. It’s difficult to get comfortable. It’s harder to move around and shift positions in bed. If you’ve been a stomach or back sleeper, it can be hard to adjust to sleeping on your side. The best position to sleep in when you’re pregnant is on your left side. This improves blood flow and, therefore, nutrient flow to your baby. Try lying on your left side, knees bent with a pillow between your knees. It also helps to tuck a pillow under your stomach, as well, for extra support.

Frequent bathroom breaks

With baby pushing down on your bladder, you likely can’t make it all night without waking at least once to go to the bathroom. You can help minimize nighttime bathroom trips by cutting down on how much you drink in the evenings. Just be sure to get adequate hydration during the day. Bright lights can make it harder for you to fall back asleep, so use nightlights so that you will not need to turn on the lights when you get up to go to the bathroom.

In addition to minimizing the common obstacles to getting a good night’s sleep, there are also ways to encourage good sleep habits, also called good sleep hygiene.

  • Be consistent with your sleep schedule. Go to bed and wake up at the same time every day.
  • Prioritize sleep. It’s one of the healthiest things you can do for your body.
  • Exercise, but do not exercise at bedtime.
  • Keep daytime naps short.
  • Stick to a bedtime routine that relaxes you, and don’t vary from it.
  • Make your bedroom inviting. Do not keep a TV, computer, or other distracting tech gadgets in your bedroom.
  • Do not eat at bedtime. Finish eating two to three hours before going to bed.

Things to consider

Sleep is essential to health. Lack of sleep is associated with many chronic diseases, including type 2 diabetes, obesity, depression, and even heart disease. If you’re pregnant, not getting an adequate amount of sleep can put you at risk for some serious conditions. Lack of sleep can also complicate your delivery.

In one research study, pregnant women who slept less than six hours at night late in pregnancy had longer labors and were more likely to have cesarean deliveries.

Another study reports that the sleep you get in your first trimester can affect your health in the third trimester. Women who don’t get enough sleep (less than five hours per night) in the first trimester are nearly 10 times more likely to develop preeclampsia late in pregnancy. Preeclampsia is a condition associated with pregnancy-related high blood pressure, swelling of hands and feet, and protein in urine. It can lead to serious and sometimes even fatal complications during pregnancy for mother and for child.

Too much sleep during the first trimester (more than 10 hours a night) can also increase your risk for developing preeclampsia, making you twice as likely to have it.

If you’ve ever had a sleep disorder, it could be made worse by pregnancy. If you’ve had sleep apnea in the past, your snoring may get worse during pregnancy. This is especially true if you were already overweight when you became pregnant. Expect that RLS will worsen during this time. Heartburn will intensify, too.

When to see a doctor

If insomnia, sleep apnea, or any other condition is interfering with your sleep, tell your doctor. Lack of sleep during pregnancy has been liked to high blood pressure (hypertension), preeclampsia, pre-term birth, and other pregnancy-related complications.

Many times, there are no symptoms that alert you when your blood pressure is elevated. Your doctor will check your blood pressure at your prenatal visits, but if you have a severe headache or swelling of your hands, ankles, and feet, contact your doctor.

Symptoms of preeclampsia include:

  • Severe headache
  • Changes in vision, including blurred vision
  • Nausea or vomiting
  • Not urinating as frequently
  • Shortness of breath
  • Pain in your upper abdomen on the right side

Questions for your doctor

  • How can I get through my day when I’m tired all the time?
  • Is there anything I can take for heartburn?
  • Is sleeping on my back unsafe for my baby?
  • Does exercise improve sleep quality?
  • Is it normal to snore during pregnancy?
  • Are there over-the-counter sleep medications or supplements that are OK to use during pregnancy?
  • Are there foods I should or should not eat that will help my sleeping?

Resources

National Institutes of Health: Eunice Kennedy Shriver National Institute of Child Health and Human Development, How much sleep do I need?