Insomnia is never a good thing, but when you’re pregnant, it can be even more difficult to deal with. We know that sleep deprivation can have devastating effects on your work, mental health, physical health, and safety, and it is even more complicated in pregnancy.
Having trouble with sleep in pregnancy has been associated with numerous complications, including depressive symptoms and preterm labor. It can even make your labor more painful or make you more likely to need a cesarean birth. Insomnia in pregnancy can also be a predictor of postpartum depression in women with previous depression, though there is some indication that treating insomnia in the third trimester may negate the effects after you’ve had the baby.
Defining insomnia during pregnancy
Insomnia may simply be a natural part of pregnancy. Many people think insomnia is something that plagues pregnant women only in the third trimester. The truth is that many pregnant women experience sleep disturbances, even as early as the first trimester.
Insomnia is often used as a blanket term to cover a lot of different sleep problems. The most common sleep disturbances covered by the term insomnia are the inability to fall asleep or the inability to stay asleep. Pregnant women also may deal with frequent nighttime waking or problems sleeping due to conditions like restless leg syndrome (RLS).
According to one study, about three-fourths of women report some form of sleep disturbances during pregnancy, and the same number reported napping during the day. All women in the study reported frequent nighttime waking.
How do you treat insomnia in pregnancy?
Being pregnant makes treating insomnia more complicated. The typical medications can’t be used because of the potential effects on the baby. That means we have to treat sleep issues in pregnancy with mostly environmental, mental, and emotional factors.
For many pregnant women, simply getting comfortable is a challenge. After the first few months, sleeping on your stomach usually becomes hard or impossible to do without expensive pillows. Your back may hurt, your knees may ache. Your hips feel like they will fall apart. You can’t sleep on your back because it can increase the risk of complications like stillbirth, according to some studies. (Though it should be noted that this does not seem to apply to those who wake up on their backs and roll over.)
Lying on your side, either left or right, may be be the best option. You can try sleeping with a rolled towel behind your back for support, and to remind you not to sleep on your back. You may also want to consider a pillow between your knees. This helps your knees, your hips, and your back. While you will roll over frequently, you can quickly learn how to manage the number of pillows you have in bed with you.
Pregnant women tend to feel a bit warmer than everyone else due to hormones and increased blood flow. Being too warm can lead to sleep disturbances. You might try throwing the covers off your side of the bed, sleeping with the ceiling fan on, and even sleeping in the nude. Having a cool environment can aid in both falling and staying asleep.
Another issue to tackle is light. Looking around your environment might help you find culprits: Is it really dark when you sleep? Is your alarm clock glowing? Light seeping in through the crack in the curtains or under the door? Consider what you can do to limit any light in your room while sleeping.
Bright lights and computer screens before bed can also make it more difficult to sleep. It is recommended that you stop using screens at least an hour before you want to go to bed. Try a bath, reading, or relaxation to calm your nerves and prepare you for sleep.
Sharing a bed
This may seem extreme, but sometimes, sleeping with another human being doesn’t work well at the end of pregnancy. Consider sleeping elsewhere or having your partner move. This might be something to try if nothing else is working. It doesn’t have to be every night, or forever — just long enough to allow you to get some sleep and feel better. Your partner might also report better sleep by not sharing the same space with you, even if they are on the couch.
Medications for treating insomnia in pregnancy
Sometimes your practitioner may recommend sleep aids. Some are more natural, like supplementing your body’s own melatonin. There may also be very short-term instances, like illness, where sleep aid medications are recommended for very short periods. Your doctor or midwife will discuss with you what works best in your situation.
At the end of the day, what matters is that you are getting enough sleep to safely function. Working with your practitioner, your partner, and your environment can help you get more sleep, be that during the day with naps or at night when the rest of the world is asleep. When you sleep better, you’ll feel better.
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Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.