Adequate Rest And Quality Sleep In Pregnancy

Why it’s important and how you can get better quality sleep while expecting

Both fatigue and insomnia are common complaints during pregnancy. In the first trimester, a rise in hormone levels can make you feel more tired than usual. Later in pregnancy, the weight of the baby and size of your bump can make it difficult to find a comfortable sleep position.

It’s obvious that you feel tired – your body is working hard to grow a new person. Getting adequate rest is important for your own health and your baby’s growth and development. Sleep isn’t a luxury, it’s essential for healing, rejuvenation and healthy body functioning. Research has linked a lack of sleep during pregnancy with a higher risk of experiencing complications like gestational diabetes mellitus (GDM) and hypertension (high blood pressure), with an added risk for preeclampsia. This is a serious pregnancy complication characterised by hypertension and protein in the urine, with risks to you and your baby.

Rest and Sleep

While the terms ‘rest’ and ‘sleep’ are often used interchangeably, they are not the same. Sleep is a state of altered consciousness that allows the body and brain to slow down and recharge. Sleep is as important to our bodies as food and water – we need it to survive. People who don’t get adequate amounts of sleep may struggle to concentrate or control emotions.

Rest refers to a period of relaxation where you quiet your mind and relax your body. Rest has important benefits for mental health and physical wellbeing. During periods of stress, taking rest can help to reset the body and mind. Meditation or writing in a journal are restful activities that can help you cope better with stress.

More About Sleep in Pregnancy

Sleep is measured in both quantity and quality. This refers to how much sleep you get and whether your sleep was fitful or restless. Adults need about seven or eight hours of sleep per day. Pregnant women should aim for at least this amount. Tiredness may lead you to sleep more, but common pregnancy complaints can also lead to poor sleep quality and insomnia – and ultimately much less sleep than you need.

1^st trimester

Sleep is impacted by rising levels of progesterone. You may feel tired through the day and exhausted by night-time. Some women experience the opposite and may struggle with insomnia at this early stage. Complaints that can impact sleep in this trimester are morning sickness, tender or painful breasts and frequent urination

2^nd trimester

Getting regular sleep in this trimester is important to prepare your body for labour and delivery. Just as fatigue and morning sickness usually settle and many women feel rejuvenated, a number of new complaints begin and these may impact on the quality of your sleep. These include:

• leg cramps – painful cramps in the calves that strike at night
• pain from loosening ligaments
• back pain
• vivid dreams or nightmares
• headaches
• nasal congestion

3^rd trimester

A host of pregnancy complaints can impact on the quantity and quality of sleep, making the third trimester the most difficult for getting a good night’s rest. A number of women experience insomnia which can be linked to increased stress, anxiety and depression. Other complaints include:

• heartburn and reflux
• frequent urination – the larger uterus puts extra pressure on the bladder
• restless legs syndrome (RLS) – feelings of itching, pulling or crawling in the legs that create an overwhelming urge to move them
• foetal movement
• size of your growing bump
• lower back pain

Some expectant moms start snoring in pregnancy. If this happens only occasionally, there is no cause for concern. If you snore very loudly (that it wakes you), you wake suddenly, gasping for a breath (your breathing starts and stops through the night), a condition called sleep apnoea, you should tell your healthcare practitioner or midwife. Snoring can increase your risk for high blood pressure.

Sleep Hygiene Tips

Increase your sleep hours by taking a nap during the day, if possible. Taking rest in the day can aid the quality of your sleep at night. Practice good sleep hygiene, practical things you can do that improve the quality of your sleep.

• Cut down on caffeine drinks from around 3pm in the afternoon. Drink fluids during the day, but reduce the amount about two hours before bed to reduce the amount of times you wake to use the bathroom.
• If you are exercising, complete your routine about two hours before bedtime.
• Aim to go to bed at the same time every night and wake up at the same time. If you have other children, plan your own bedtime just after theirs, to maximise your rest time.
• Spend an hour or two before bed unwinding from your day. Take a bath, read a book, write in a journal or ask your partner to give you a back or foot rub. If you go to bed an hour earlier  than usual, you can spend this time resting, to prepare your body and mind for sleep.
• Stop using electronic equipment about an hour before bed as the blue light on these devices can interfere with sleep. Check if your phone has a night-time mode setting and activate it.
• Make sure you are comfortable in bed. Your bedroom should not be too hot or cold. Layer bedding rather than use heavy blankets, so you can easily remove a layer if you feel too hot.
• From 28 weeks, sleep on your side. Lying on your back puts pressure on major blood vessels which can restrict blood flow to the baby.
• If you struggle to get comfortable, especially in the third trimester, use additional pillows to improve comfort. A pillow at your back can help provide additional body support, while a pillow between your legs provides extra support for your bump.
• If you struggle with reflux and heartburn, eat dinner about two hours before bedtime. Prop yourself up with pillows behind your back or raise your mattress if possible. Gravity will help to prevent stomach acids from pushing up into the oesophagus (food pipe), which causes discomfort and pain. Ask your healthcare provider to prescribe medication if you aren’t able to find relief.
• If you haven’t fallen asleep after about 20 minutes of trying, get out of bed and do a quiet activity (read, listen to quite music etc.) before heading back to bed a little later.

Many women are plagued by insomnia, especially in the third trimester when they desperately need sleep. Stress and anxiety may be a cause. If you are concerned about your baby, or worried about the birth, empower yourself as much as possible by learning what to expect during the labour and birth process.

Reach out to your healthcare provider or midwife if you have questions or concerns that you want to address.

Resources: https://www.pregnancybirthbaby.org.au/; https://www.webmd.com/; https://www.alaskasleep.com/; https://familydoctor.org/; https://www.hopkinsmedicine.org/;https://www.sleep.org/; https://www.sleepfoundation.org/; https://www.healthline.com/; https://www.whattoexpect.com/; https://kidshealth.org/; https://www.sleephealthfoundation.org.au/; https://www.babycentre.co.uk/