Pregnancy insomnia: Why you're not sleeping

Having trouble sleeping, mum-to-be? Learn what causes this difficulty and how to treat pregnancy insomnia here.

''Asleep at 1am and awake at 5am for no apparent reason. Welcome to pregnancy insomnia,” said one mum on social media. 

Pregnancy sleep can be frustrating and uncomfortable. Most of the time, you find yourself tossing and turning all night.

Trying to get comfortable is a struggle.

You’re pregnant, and all of a sudden you’re not sleeping anymore. It’s not surprising because you have plenty to get used to.

You can’t sleep because of cramps and other discomforts caused by the hormones.

You want to get a good night’s sleep, but the changes your body is going through are preventing you from snoozing.

Expecting mothers don’t realise that there’s this type of sleeplessness that they’re experiencing. It’s called pregnancy insomnia.

What is pregnancy insomnia?

You may have heard of pregnancy insomnia, but what exactly is it?

Pregnancy insomnia causes you to have trouble sleeping during your pregnancy.

You may find that you’re having issues falling asleep or waking up in the middle of the night.

Many women experience pregnancy insomnia at some point during their pregnancy.

It’s a type of insomnia that can occur during the first and third trimesters of pregnancy.

Importance of sleep during pregnancy

But before we dive into the topic of pregnancy insomnia, let’s discuss why it’s essential for mums-to-be to have a good night’s sleep.

• Restful nights: Pregnancy can bring discomfort like a growing belly, aches, pains, heartburn, and hormonal changes that affect sleep patterns. Getting a good night’s sleep helps pregnant women rest and rejuvenate their bodies for the challenges of pregnancy and childbirth.

• Reduced pregnancy complications: Sufficient sleep during pregnancy is associated with lower risks of developing pregnancy complications such as preeclampsia (high blood pressure) and gestational diabetes.

• Labour and delivery benefits: Adequate sleep during pregnancy has been linked to shorter labours and lower rates of caesarean sections. Research suggests that pregnant women who get fewer than six hours of sleep in a 24-hour period may have an increased likelihood of experiencing longer labour and requiring caesarean deliveries.

• Restless Legs Syndrome (RLS) management: RLS, a common cause of sleeplessness during pregnancy, can be alleviated by getting sufficient rest. 

• Stress reduction: Pregnancy can bring about various stressors, including hormonal changes and the anticipation of future responsibilities. Prioritising good sleep helps in reducing stress levels, ensuring better overall well-being for expectant parents.

• Preparation for postpartum challenges: Getting enough sleep during pregnancy is essential because once the baby arrives, sleep patterns are likely to be disrupted. By prioritising sleep during pregnancy, expectant parents can build up their energy reserves, as the initial months after childbirth can be demanding.

What is early pregnancy insomnia?

Pregnancy is a time of excitement, exhaustion and sometimes even fear. But one thing that many women don’t expect is the impact it can have on their sleep.

If in the middle of the night, you wake up feeling restless and unable to go back to sleep, you’re not alone. Many women experience insomnia early in their pregnancy.

Insomnia is a common symptom in the first trimester, affecting up to 80 per cent of women.

Hormonal changes during pregnancy often cause early pregnancy insomnia. The increased anxiety and irritability make it difficult to fall asleep and stay asleep. 

In some cases, nausea and vomiting can also trigger pregnancy insomnia. 

It’s common to feel exhausted during pregnancy, especially in the first trimester. Yet, some women find that they have difficulty sleeping, even when they’re tired.

Causes of pregnancy insomnia per trimester

There are a lot of reasons why you might be having trouble sleeping during your pregnancy. Let’s break it down to the common causes of sleep deprivation in each stage of pregnancy:

First trimester

• Hormonal changes: Fluctuations in hormones, particularly an increase in progesterone, can lead to disrupted sleep patterns and increased drowsiness during the day.
• Frequent urination: The growing uterus and increased blood flow to the pelvic area can result in increased pressure on the bladder, leading to more frequent trips to the bathroom at night.
• Nausea and vomiting: Morning sickness or nausea during the first trimester can disturb sleep and make it difficult to find a comfortable position.

Second trimester

• Increased size and discomfort: As the baby grows, the uterus expands and can cause physical discomfort, making it challenging to find a comfortable sleeping position.
• Back pain: The added weight of the baby and changes in posture can contribute to back pain, which can disrupt sleep.
• Restless legs syndrome: RLS can be more prevalent during the second trimester, affecting sleep quality.

Third trimester

• Frequent urination: The pressure of the baby on the bladder is most pronounced during the third trimester, leading to more frequent trips to the bathroom at night.
• Heartburn and indigestion: Hormonal changes and the growing uterus can cause acid reflux, resulting in heartburn and discomfort during sleep.
• Anxiety and discomfort: As the due date approaches, expectant mothers may experience increased anxiety about the fear of childbirth and being a parent, and at the same time, anticipation for what lies ahead. They may also have physical discomfort, making it challenging to relax and fall asleep.

Pregnancy insomnia effect on mum and baby

Effect on mum

When you’re pregnant, sleep is one of the most important things you can do for your health. It will make you feel a lot better and it’s also essential to your baby’s development. 

But what happens when insomnia strikes? And how does it affect your pregnancy? It can have some significant effects including:

• Weight gain
• Depression and anxiety (which can lead to postpartum depression)
• High blood pressure
• Lower quality of sleep
• Lowered energy levels during the day
• Increased risk for depression and anxiety
• Increased risk for preterm labour and low birth weight babies

Is insomnia harmful to your unborn baby’s health?

Getting enough quality rest can help keep both you and your unborn child healthy. Insomnia during pregnancy can be harmful to your baby’s health.

If you don’t get enough sleep, it can make you feel more stressed. This can have a negative effect on your blood pressure, heart rate and other bodily functions.

Pregnancy insomnia can increase the risk of heart disease in both mother and child. It’s also linked to an increased risk for gestational diabetes.

Not getting enough sleep can make you very tired. This might make you and your baby more likely to have a miscarriage or a baby that is not growing well.

How to deal with pregnancy insomnia?

There are a few things you can do to help ease pregnancy insomnia. This will help you get some much needed shut-eye.

Here are some tips that will help you deal with insomnia during pregnancy:

• Cognitive Behavioral Therapy for insomnia (CBT-I)

According to the Sleep Foundation, working with a therapist may help the pregnant woman address her anxious thoughts, discuss realistic goals for sleeping a certain number of hours and suggest relaxation techniques such as meditation and progressive muscle relaxation. 

Moreover, studies have found that CBT-I is effective in easing insomnia symptoms and improving sleep for pregnant people.

If you do not have easy access to in-person appointments, you can receive CBT-I treatment over the phone or online.

• Sleep hygiene tips

General sleep hygiene recommendations from healthcare professionals can be beneficial in managing pregnancy insomnia.

These may include maintaining a consistent sleep schedule, creating a comfortable sleep environment, avoiding stimulating activities close to bedtime, and practising relaxation techniques.

• Mindfulness-based interventions

Mindfulness techniques can help pregnant individuals cope with sleep disturbances caused by discomfort, pain, or an active mind.

Mindfulness practices promote relaxation, stress reduction, and improved sleep quality.

• Addressing related causes

Another way to overcome pregnancy insomnia is to directly address the common culprits like heartburn and RLS.

Adopting healthy eating habits like avoiding greasy or spicy foods and leaving time after a meal before lying down can help ease heartburn while performing leg stretches and sleeping with a pillow wedged between your legs can alleviate RLS.

Can you use sleep aids like melatonin during pregnancy?

Experts do not recommend the use of sleeping medications like melatonin supplements for pregnant women. It is because they already produce high levels of melatonin in the third trimester.

Doctors worry that taking melatonin supplements may deliver too much melatonin to the baby and potentially interfere with the development of the sleep-wake cycle.

If you are struggling with sleep problems during pregnancy, consult with your doctor first before using melatonin supplements or other medications. 

How to get better sleep during pregnancy?

Here are additional tips to help you get quality sleep during pregnancy:

• Go to bed at the same time every night and wake up at the same time every morning. This helps regulate your sleep cycles and get your body used to a set schedule. To help you fall asleep, create a relaxing environment before bed. It could be dimming the lights, using calming aromas, or listening to soft music.
• Avoid bright lights in the evening and early morning, especially televisions and computers. They emit a blue light that can disrupt your circadian rhythm and make it harder for you to fall asleep.
• Some people feel restless or have trouble sleeping after drinking caffeine. But, for some, caffeine can actually improve sleep quality. So if this is something you want to try, do it in moderation so you don't end up feeling worse than before.
• Taking a warm bath or shower before bedtime can help relax your muscles and make it easier for you to fall asleep. But, make sure the water temperature is comfortable so you don't get too hot or cold.

When does pregnancy insomnia end?

Pregnancy insomnia can be pretty tough to deal with, but it is completely treatable and will pass. You can work to cope with the symptoms as best you can until your body settles down after the baby is born.

Good sleeping habits will help you sleep well. This will be good for both mother and baby.

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If you have a history of insomnia, don’t try to handle these symptoms on your own. They might not work. Try out the tips we’ve laid out and see how they help. 

Every mum is different, and the effects of pregnancy insomnia on each woman will be different.

Some mothers have a little bit of trouble sleeping, but they get over it. Other mothers have a lot of trouble sleeping and it takes time for them to get back to good sleep.

Be aware of the risks associated with sleep deprivation and try to take measures to avoid them. This might include moving your alarm clock away from your bed or getting rid of it altogether.

If you are still struggling, speak to a doctor or medical professional. They might be able to help you feel better. Save yourself some stress and make sure you’re getting the rest that you need.

This article was first published in theAsianparent.