Sleeping for two: Pregnancy and sleep

After learning they are pregnant, mums-to-be start to think ahead. Choosing names, picking a nursery theme, and making career decisions are front of mind, but so is worrying about sleepless nights once the baby comes. However, many women don’t realise that getting enough sleep during pregnancy can be just as challenging.

Sleep is important to one’s health and wellbeing, and even more so when you’re “sleeping for two” (or more!). How well you sleep will depend on a number of factors, but most women can expect certain changes as their pregnancy progresses.

First Trimester

Many women feel fatigued during the first stage of pregnancy 1. It’s no wonder—this is a time of rapid growth and development for the foetus 2. Progesterone, a hormone essential to pregnancy, increases. Whilst progesterone is good for gestational health, it also induces sleep 3. It may feel impossible to stay awake during these early days, especially if you are caring for other children or working.

Second Trimester

The second trimester is generally regarded as the most comfortable. If morning sickness disturbed your slumber during the first trimester, this will hopefully stop now. You may also have more energy and feel less inclined to take an afternoon nap. It’s important to maintain a sleep schedule during this time to ensure you get plenty of rest.

Third Trimester

This is often the most challenging portion of any pregnancy. Babies gain most of their weight in the weeks just before birth, meaning mum will also gain extra weight during this time 4.  Discomfort from back pain and leg cramps makes sleeping more difficult. You will likely feel the need to urinate frequently, meaning more night time bathroom trips.

Tips for getting sleep during pregnancy

So how can an expectant mother get a little rest? Here are a few tips that may help:

  • Maintain your normal sleep routine as best you can. A good night time routine may help you wind down before bed and cues your body that it’s time for sleep. Continuing your normal pre-bed rituals will help as you navigate pregnancy changes. If you indulge in bad sleep habits, now is a great time to establish a better routine!
  • Avoid drinking before bed.  Your baby needs room to grow, and he or she is not shy about taking it! As you head into your third trimester, more pressure is placed on your bladder, meaning you’ll likely experience more frequent urination. Late night trips to the toilet may not be unavoidable, but easing back on liquid consumption close to bedtime will hopefully decrease the number of times they disrupt your sleep. (If you do decrease how much you drink before bed, be sure to increase your intake during the day. It’s important to stay well hydrated!)
  • Elevate your head. Many women experience heartburn during their pregnancy. Try elevating the head of your bed or mattress to avoid or prevent this sleep disrupter 5. Elevating your head can also help with snoring (more on that later.).
  • Relieve pain safely. Back and leg pain interrupting sleep is a common pregnancy complaint. An easy way to deal with this is by taking pain medication. This is OK as long as your doctor agrees, but keep in mind that some common pain relievers contain as much caffeine as a small cup of coffee 6. Stretching, using a heating pad, and massage are alternative ways to ease the pain. Support pillows are also a good option to help prevent back pain whilst sleeping.

Sleep apnea and pregnancy

Along with the usual pregnancy aches and pains, some women may also develop obstructive sleep apnea (OSA) in their third trimester. Weight gain and increased oestrogen levels contribute to OSA, as can general breathing difficulty caused by organs shifting to accommodate the growing baby.

If you are pregnant and suspect you may have sleep apnea, it’s important to speak with your GP or OB/GYN. Untreated sleep apnea could lead to negative health outcomes for mum and baby in some women 7, 8. Depending on the severity of OSA, a sleep specialist may recommend CPAP therapy or other measures, such as avoiding excess weight gain and elevating your head whilst sleeping.

Women diagnosed with OSA prior to pregnancy can continue their CPAP therapy unless advised otherwise by their doctor.  It’s also important to meet with your sleep specialist or clinician during pregnancy and after birth to monitor your therapy. Therapy pressure needs can change over time due to weight gain and hormone changes, two factors that definitely apply to pregnancy! Your specialist or clinician can make changes as you progress and after birth, if needed.

Do you know someone who’s expecting?

Sleep Well,

The sleepvantage Team


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