Pregnancy. A time of joy

For most women, pregnancy is a time of great joy, excitement and anticipation. Unfortunately, for many it can also be a time of serious sleep disturbance, even for women who have never had problems sleeping. In fact, according to the National Sleep Foundation's 1998 Women and Sleep poll, 78 percent of women report more disturbed sleep during pregnancy than at other times. Many women also report feeling extremely fatigued during pregnancy, especially during the first and third trimesters. Considering the physical and emotional demands of pregnancy and the prevalence of sleep disorders among pregnant women, it's no wonder that expectant mothers become so tired.

Why pregnant women experience sleep disorders

One of the reasons for fatigue and sleep problems during pregnancy is changing hormone levels. For example, rising progesterone levels may partly explain excessive daytime sleepiness, especially in the first trimester. Hormonal changes may also have an inhibitory effect on muscles, which may result in snoring, and in obese women may increase the risk of developing sleep apnea and may be partly responsible for the frequent trips to the bathroom during the night.

These interruptions, as well as those caused by nausea and other pregnancy-related discomforts, can result in significant loss of sleep. Many women experience insomnia due to emotions and anxiety about labour and delivery, balancing motherhood and work, or their changing relationship with their partner. This is especially true of first-time mothers. For most women, getting a full night's sleep becomes even harder once the baby is born.

Several sleep disorders can be caused or made worse by pregnancy, including:

Restless Legs Syndrome. In a study of over 600 pregnant women, 26% reported symptoms of restless legs syndrome, a condition characterized by unpleasant feelings in the legs that worsen at night and that are relieved by movement.

Gastroesophageal Reflux Disease (GERD, also known as heartburn). One recent study found that 30-50 percent of pregnant women experience this condition almost constantly during pregnancy.

Sleep Apnea. This disorder, in which breathing is repeatedly interrupted during sleep, is one that pregnant women are at risk for developing. If developed, complications during pregnancy can occur. In fact, researchers recently found that women who slept fewer than 6 hours per night had longer labours and were 4.5 times more likely to have caesarean deliveries.

Based on these findings, researchers recommend that doctors and their pregnant patients discuss both sleep quantity and sleep quality as part of basic prenatal care and stress the importance of "sleeping for two."

Tips for Pregnancy Sleep

In addition to working closely with your doctor, take a look at this list of nine tips we’ve compiled to help with some common pregnancy-related sleep issues:

  • 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 products) or fried foods. 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.
  • Try frequent bland snacks (e.g., 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. The NSF poll found that 51 percent of pregnant or recently pregnant women reported at least one weekday nap; 60 percent reported at least one weekend nap.
  • 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.
  • Talk to your doctor if you develop medical problems and/or insomnia persists.