Strategies for getting a better night sleep during pregnancy

It can be very difficult to get a good night's sleep when you're pregnant.

Jade Elliott spoke with Hannele Laine, an OB/Gyn from Intermountain Healthcare, about the reasons many women experience sleep challenges during pregnancy and some strategies to help you get a better night’s sleep.

Sleep disturbances are common in pregnancy, especially in the third trimester as your baby grows larger and it’s harder to get comfortable. Common problems include difficulty falling asleep, increased waking at night, experiencing lighter sleep and shortened sleep intervals of deep sleep, which can all leave you feeling less rested.

This is likely due to a combination of factors including hormonal, physical and emotional changes as well as medical issues related to pregnancy.

According to the National Sleep Foundation's 1998 Women and Sleep poll, 78 percent of women report more disturbed sleep during pregnancy, than at other times. Another study found that 97 percent of women had an average of three wakings per night in the third trimester. Lastly, there is some evidence that inadequate sleep - less than five to six hours, may negatively impact pregnancy and labor as well.

Physical causes of sleep problems during pregnancy:

• Nausea
• Heartburn/reflux
• Difficulty in finding a comfortable position
• Increased nighttime urination
• Restless legs
• Leg cramps
• Low back pain
• Sleep apnea

Emotional reasons sleep may be more difficult during pregnancy:

Many women worry about the birth, balancing motherhood and work, adding another child to the family, relationship changes and more. In addition, anxiety and depression are more common in pregnancy and the postpartum period and are frequently associated with sleep disturbances. And the current COVID-19 pandemic has added additional worries for pregnancy, delivery and motherhood.

But, there is hope! There are many things you can do to improve your sleep, including behavioral strategies, counseling and sometimes medication. Be sure to discuss sleep concerns with your doctor, especially if it’s impacting your normal functioning at work or with your partner or family. If you are having depression or anxiety, there is good evidence that treating it during pregnancy improves outcomes for women and their babies.

Tips for better sleep hygiene:

• Keep a regular sleep schedule.
• Create a relaxing bedtime routine – dim the lights, take a warm bath/shower, practice mind-quieting techniques.
• Reduce stimuli - no screen time on TV, phone, or computer for two hours before bed.
• Practice mindfulness or meditation.
• Exercise for a minimum of 20 minutes per day, but not close to bedtime.
• Avoid naps late in the day.
• Avoid caffeine in the afternoon or evening.
• Create a comfortable sleep position with extra pillows for cushioning (between legs, under your tummy or back).
• Plan for 7-9 hours of sleep.

Tips for pregnant women to improve their sleep:

• For increased nighttime urination – decrease fluid intake in the evenings.
• For heartburn/GERD – avoid food that are spicy, acidic or fried. Take an over the counter antacid such as Tums.
• For leg cramps – avoid soda/carbonated drinks. Add a calcium supplement like Tums.
• For restless legs – if your iron level is low, ask your doctor about an iron supplement.
• For sleep apnea -- if you snore three or more times per week or your partner reports you stop breathing during sleep, talk to your doctor about testing.
• Discuss any herbal supplements or over the counter medications with your doctor.
• If sleep issues don’t resolve, talk to your doctor about when sleep medications such as Unisom, Benadryl, or melatonin can be used during pregnancy.

Sleep post-partum is also an issue:

• Babies wake every three hours on average. So even though the sleep you get tends to be better quality, it is very disrupted and therefore easy to have inadequate sleep.
• Continue to practice good sleep hygiene postpartum.
• Go to bed at the same time as your baby if possible.
• Consider a morning walk to help with day/night rhythm.
• Sleep when the baby sleeps during the day.
• Ask your partner, friend or family to help you prioritize sleep. (They could watch the baby, or do laundry, grocery shopping, meal preparation, etc.)
• Contact your doctor if you note increased anxiety or depression.

For more information visit: https://intermountainhealthcare.org/services/women-newborn/

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.

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