The Secrets of Sleep, Part 7: Sleep and Pregnancy

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Great news: you're expecting! Not so great news: you're suddenly having trouble sleeping - something you didn't expect to deal with until after bringing home your bundle of joy.

Sleep is an important component of a healthy pregnancy, but as your baby grows, you may find yourself having trouble falling asleep and staying asleep (or, in early pregnancy, having trouble staying awake).

Here's a trimester-by-trimester look at how pregnancy impacts sleep, and what you can do about it. (Stay tuned for a post on the unique sleep challenges facing new moms, when a whole new set of circumstances can come between you and your precious Zzzz.)

First Trimester

Daytime Drowsiness

It should come as no surprise that a woman's body undergoes major changes during pregnancy. Far beyond the growing belly, hormonal and metabolic changes can affect everything from your emotions to your ability to get a good night's sleep. Specifically, increased progesterone production can make you want to fall asleep sitting at your desk.
What you can do: If possible, schedule regular afternoon catnaps. Aim to nap before 4 p.m., as anything later might make it difficult for you to get to sleep at night.

Bathroom Visits

One of the hallmark signs of pregnancy is an increased urge to go. That's because of your uterus presses against your bladder as it grows, leading to frequent urination at all hours of the day (and night).
What you can do: Staying hydrated is important during pregnancy but start tapering off your fluid intake around dinnertime to cut down on midnight bathroom visits.

Nausea: Not Just for Mornings

It's a common joke among pregnant women that morning sickness should be called morning, noon and night sickness, as it can strike at any hour. Almost all pregnant women will experience some first-trimester queasiness, which is even less fun in the middle of the night.
What you can do: Avoid eating large meals late in the evening and keep bland crackers (Saltines are a favorite) nearby to help quell nausea.

Second Trimester


The queasiness that dominated your first trimester has subsided, but it's been rudely replaced by the gnawing pain of heartburn. As your pregnancy progresses, heartburn worsens as the growing uterus puts increased pressure on the stomach, squeezing acid up the esophagus and robbing you of shut-eye.
What you can do: Don't lie down right after eating. When you do go to bed, try propping yourself up slightly or slipping a wedge pillow beneath your regular pillow to keep your upper body elevated. Reduce dinner portions and eat a larger lunch and breakfast. And avoid certain foods that aggravate heartburn, such as spicy, fried and acidic foods.

Crazy Dreams

A common feature of the second and third trimesters, vivid (and often terror-inducing) dreams are brought on by a combination of hormone fluctuations and anxiety - and to be sure, the impending challenges of motherhood are enough to keep anyone up at night.
What you can do: Make evenings about relaxation. Try prenatal yoga or a prenatal massage, meditation or baths (warm, not hot). Physical activity can also help prepare you for sleep, and exercise is important for staying healthy throughout your pregnancy (as long as your doctor says it's safe for you). Morning, afternoon or early-evening workouts are best, as nighttime exercise can actually have the reverse effect and encourage insomnia.

Leg Cramps

Thought to be caused by certain mineral deficiencies, these leg cramps - usually in the calf - can worsen into the third trimester and occur with Restless Leg Syndrome (more on that below) or on their own. Sometimes they're strong enough to jolt even deep sleepers awake.
What you can do: When cramps strike, flexing the foot (rather than pointing your toes) or standing with your foot flat on the ground might bring relief. If you drink carbonated beverages, try cutting back; bubbly drinks contain phosphorus, which decreases the amount of calcium you're able to metabolize, sometimes leading to calcium imbalances and cramping. Load up on calcium-rich foods, such as dark, leafy greens and dairy products.

Third Trimester

Breathing Troubles

Shortness of breath and snoring are two common problems during late pregnancy. That's because vascular congestion and abdominal weight gain can obstruct your airways. A small percentage of pregnant women who snore may also develop obstructive sleep apnea, a condition that is very serious because it deprives you and your baby of oxygen.
What you can do: Sleep on your side (apologies to back and stomach sleepers). If you or your partner have noticed that you stop breathing or gasp for air during sleep, contact your doctor about a sleep study or other solutions for better breathing - and rest.

Restless Leg Syndrome

Is a creeping, crawling, tingling or burning sensation causing you to have an uncontrollable urge to move your legs around at night? You may be one of the approximately 26% of expectant moms to experience Restless Leg Syndrome. This strange sensation may have to do with low levels of iron and folate. Fortunately, Restless Leg Syndrome often subsides after childbirth.
What you can do: Avoid caffeine (it's recommended that women drastically reduce or eliminate their caffeine intake during pregnancy). The same relaxation techniques that ease anxiety may also help relieve Restless Leg Syndrome, including yoga and meditation. Also, avoid lying down or getting into bed until you are just about ready for sleep, as Restless Leg Syndrome worsens the longer you lie still. If an iron and folate deficiency is the culprit, your doctor may recommend a dietary supplement.

Aches and Pains

The final 14-or-so weeks of pregnancy can really wear on your body. Along with achy joints and swelling, lower-back pain and pelvic pain can intensify during late pregnancy, making it woefully difficult to find a comfortable sleeping position.
What you can do: As early as possible in your pregnancy, try to get in the habit of sleeping on your side, particularly your left side (apologies again, back and stomach sleepers). Many pregnant women find it most comfortable with their knees bent and placing a pillow between the knees can also relieve pressure from your pelvis and hips. Sleeping with a pillow beneath your baby bump may also take some pressure off your back.

Frequent Urination

Remember this from your first trimester? As the uterus continues to grow and baby sinks lower in your pelvis, the urge to go makes a reappearance, causing many a mom-to-be to make frequent late-night bathroom runs.
What you can do: Same as before: ease off the liquids in the early evening. Also, eliminate carbonated beverages or drinks containing NutraSweet (commonly found in low-calorie and sugar-free sodas), which can have a diuretic effect.

Research has shown correlations between poor sleep and a more difficult delivery and labor. In fact, a study from the University of California at San Francisco found that pregnant women who got fewer than six hours of sleep per night not only had longer labors but were 4.5 times more likely to have C-sections.

If you're having difficulty "sleeping for two," your AdventHealth medical team is here to help you find the rest and relief you need.

If you'd like to speak to a physician or therapist or are interested in joining a mom-and-baby support group, call us today at Call855-303-DOCS.

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