Virtually no physiological change we can imagine impacts a woman’s life quite like being pregnant. Obviously, there are numerous physical changes that come with carrying a child, but there are other things that change, too, one of which is sleep. Sure, everyone expects a new mom to have sleep issues once the baby arrives, but what many people don’t realize is that the changes a woman’s body experiences during pregnancy also can impact her sleep.
Dr. Jaber Hassan with the Blount Memorial Sleep Health Center says this is due to the many hormonal and anatomical changes women go through when they’re pregnant. “The relationship between sleep and pregnancy typically follows, like any other pregnancy-related changes, the three trimesters,” Hassan said. “Poor sleep and frequent awakenings caused by either bladder irritation from the growing uterus or from newly experienced acid reflux symptoms are very common during the first trimester. Difficulty starting sleep or insomnia also are not uncommon and can potentially be affected by the hormonal surges, combined with the urge to sleep during the day. The pregnancy hormone progesterone is largely responsible for these issues,” he explained. “Although it is called morning sickness, it actually can disrupt the last few hours of sleep and extend throughout the day. This also can result in pregnant women eating closer to bedtime, which is not ideal for quality sleep,” he added.
Hassan says there are some steps you can take to make these issues less disruptive to your sleep. “Adopting good sleep hygiene is essential to sleep in general, particularly during pregnancy,” Hassan said. “Avoiding stimulants such as caffeine and chocolate; eating smaller, more-frequent meals; avoiding eating for couple of hours before bedtime; and raising the head of the bed all can help to control acid reflux. Some over-the-counter medications such as Tums or Maalox are considered safe during pregnancy, as well, but thorough discussion with the obstetrician is a must before starting any of these. Iron deficiencies are expected to occur throughout a pregnancy, particularly if it is not adequately monitored and treated. The direct result of an iron deficiency is restless leg syndrome, which is commonly associated with frequent leg twitching during sleep. Both conditions can affect sleep significantly, with the first one delaying sleep and the second one interrupting sleep or making it less deep,” he explained. “Starting prenatal vitamins with iron even in the pre-pregnancy planning phase can be very helpful. Leg cramps can be very disturbing at nighttime and can be prevented with adequate calcium and vitamin D supplements as directed by the obstetrician,” he added.
“Learning and adopting comfortable and safe sleep positions should start early on during the pregnancy so they will be easy to assume during the third trimester when the blood flow from the legs to the heart can be affected by the weight of the uterus or when the pressure of the uterus is mounting against the diaphragm,” Hassan continued. “Using multiple pillows to support these positions can be helpful. The ideal position in pregnancy is left-side sleep, but sleeping propped up on multiple pillows or in a recliner can be used instead,” he said.
Hassan says pregnant women also are more likely to experience sleep apnea. “The predisposing factor for sleep apnea during pregnancy is the rapid weight gain caused by the accumulation of fat and fluids in the body and the throat area,” he said. “Preexisting sleep apnea can be easily exaggerated during the pregnancy, as well. Snoring is a common result of weight gain, but attention should be paid to other symptoms such as chocking during sleep, morning headaches and worsening daytime sleepiness. Significant sleep apnea usually is associated with a drop in the mother’s oxygen level, which can be harmful to both the mother and the infant. Issues such as preeclampsia, pregnancy related hypertension and diabetes, preterm labor and low infant weight can be prevented if pregnant women pay close attention to sleep apnea symptoms. Referral to a sleep specialist is recommended once sleep apnea is suspected to confirm the diagnosis and to start appropriate therapy early on during the pregnancy,” he explained.
For more information or to schedule an initial appointment, call the Sleep Health Center at 865-980-5120.