Pregnancy Insomnia - Cause | Prevention | Treatment | Complications
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Pregnancy Insomnia - Cause, Prevention, Treatment and Complications

Written by
Dr. Asha. C
and medically reviewed by Dr. Mekala. S

Published on May 30, 2022 and last reviewed on Jun 23, 2023   -  5 min read

Abstract

Insomnia is a sleep disorder that can cause health issues during pregnancy. This article explains the causes, prevention, and treatment of pregnancy insomnia.

Introduction:

Pregnancy is a thrilling time for most women, but physical discomforts and hormonal changes associated with carrying a child can cause sleep disturbance. It is very common for women to feel tired during pregnancy, especially in the first and last trimesters, and with each trimester, new sleep challenges arise.

What Is Insomnia?

Insomnia is a common sleep disorder. It comes in a few different forms. Some people find trouble falling asleep when they try to go to bed or wake up early and have trouble going back to sleep. Between the various physical discomforts of pregnancy and the worries of bringing a child into the world, there may be plenty to keep you up at night. Early interventions to treat sleep disturbance are highly recommended to avoid complications during pregnancy.

What Are the Causes of Pregnancy Insomnia?

  • Nausea or Throwing Up - During the first trimester, most women feel nauseous or vomiting during the night.

  • Backaches - As the center of gravity shifts forward, the back muscles overcompensate and become sore. Additionally, the loosening of the ligaments also causes back pain

  • Hormonal Factors - Progesterone causes sleepiness during the day and fragmented sleep during the night. Increasing oxytocin and cortisol levels can create anxiety and stress.

  • Bloating - Pregnancy hormones slow down digestion which causes bloating and gas trouble.

  • Breast Tenderness - Due to hormonal changes, the breast will feel sore and tender.

  • Heartburn - The muscle relaxation in the digestive system takes place due to hormonal changes. This makes the stomach acid burn the way back up to the esophagus.

  • Shortness of Breath - The growing fetus puts pressure on the diaphragm, which is situated below the lungs leading to breathing difficulties.

  • Anxiety - All women have anxiety during pregnancy due to the thoughts and worries spinning in their heads and keeping them away from sleeping.

  • Leg Cramps and Pain - Changes in the blood circulation and pressure from the baby on the muscles and nerves cause leg cramps. Many women get a creepy-crawly feeling in their legs, known as restless leg syndrome.

  • Snoring - Due to swelling of the nasal passage during pregnancy, snoring occurs. The extra pressure caused due to the growing belly can also be a reason; this can cause breathing difficulties.

  • Frequent Urination - Frequent urination during nighttime can disturb sleep.

  • Hot Flashes - Pregnant women mostly get hot flashes which cause a sudden feeling of warmth in the face, chest, and neck.

When Does Insomnia During Pregnancy Start?

Insomnia can start at any point during pregnancy, but many pregnant women experience insomnia during the second and third trimesters, where other pregnancy symptoms also increase, and a growing belly makes it more difficult to sleep.

How to Prevent Insomnia During Pregnancy?

By following good sleep hygiene, insomnia can be prevented. These are a few steps to be followed to prevent insomnia,

  • Avoid Caffeine - Coffee keeps everyone awake, so it is advised to avoid it, especially during the evenings.

  • Be Stress and Emotional Free - If there are persistent worries that are not allowing you to sleep, talk about them with your partner or a friend and sort them out. Meditation, yoga, or listening to music can also help.

  • Make a Bedtime Routine - Try going to sleep and waking up at the same time every day. Schedule activities before bedtime such as light reading, gentle yoga poses or relaxation exercises, soothing music, a warm bath, prenatal massage, and sex.

  • Eat Small and Early Meals - A large meal eaten late in the evening will not promote sleep, so try to eat a lighter, earlier dinner.

  • Cut Down Water - Drink the daily requirement of fluids earlier in the day and cut down on drinking after 6 P.M. This may help to reduce frequent urination after falling asleep.

  • Exercise - Do some exercise daily during pregnancy because exercise can make them sleep better at night. Avoid hitting the gym near bedtime because post-workout buzz can cut down sleep.

  • Wean off the Screen - Using a phone, laptop, e-reader, TV, or tablet, before bed can mess with sleep. The screen’s blue light causes sleepiness and suppresses levels of melatonin. So, stay away from gadgets at least an hour before bed.

  • Make It Comfortable - Use a mattress and pillows that provide good support without feeling like bricks. Open a window to keep the room well ventilated, airy, and not stuffy.

  • Good Fragrance - A sachet tucked into the pillowcase, or lavender-scented pillow can help in relaxation and bring on sleep faster.

Melatonin is a hormone produced by the body to naturally regulate sleep-wake cycles, which might seem like an easy fix for patients with insomnia. But its impact on pregnancy has not been clearly studied. The doctor prescribes an occasional and very small dosage of melatonin for pregnant women struggling with insomnia.

What Is the Treatment for Insomnia?

Treatment for insomnia during pregnancy is prescribed only during the severe phase, after the failure of non-pharmacological management of insomnia.

  • Promethazine - It can be used for mothers with a severe or chronic sleep disorder.

  • Benzodiazepines - These are medications that are commonly used to treat pregnant women. However, they are preferably avoided during pregnancy because they cause floppy infant syndrome if taken for long periods of time. It can also cause neonatal withdrawal syndrome.

  • Antidepressant - In pregnant women with severe insomnia, sedative-hypnotic or sedative-antidepressant is used. Drugs like Zolpidem have limited reproductive safety resources so their use is limited during pregnancy. Antidepressants are not only used for the treatment of insomnia.

What Are the Complications Caused Due to Insomnia During Pregnancy?

The complications caused due to insomnia are rare. Insomnia leads to generalized fatigue and lack of concentration. The complications are gestational diabetes, preeclampsia, fetal growth retardation, and preterm birth. It also affects labor by increasing the duration of labor, increasing the pain of labor, and a high chance of cesarean birth.

Conclusion:

Good sleep is important for healthy pregnancy outcomes for the mother and the baby. However, most women experience sleep disturbances during pregnancy. Insomnia can cause some mental and health issues. By practicing good sleep hygiene and behavior changes, insomnia can be prevented, and it is possible to treat insomnia during pregnancy successfully.

Frequently Asked Questions


1.

At What Time Does Pregnancy Insomnia Start?

Insomnia can be experienced during all phases of pregnancy. However, it can start in the second to the third trimester of pregnancy as the pregnancy symptoms intensify.

2.

How to Manage Pregnancy Insomnia?

Pregnancy insomnia can be managed by the following techniques:
- Practice better sleep hygiene. It means inculcating habits that make it easier to fall asleep.
- Try dietary supplements. Herbal and dietary melatonin supplements can be used but, only after a doctor’s consultation.
- Relaxation techniques like meditation, yoga, etc., can be practiced.
- Cognitive-behavioral therapy or CBT can help in managing thoughts and feelings, especially in those women suffering from anxiety or depression.
- Physical activities can be included in the daily routine on the doctor’s advice.

3.

How to Manage Pregnancy Insomnia?

Pregnancy insomnia can be managed by the following techniques:
- Practice better sleep hygiene. It means inculcating habits that make it easier to fall asleep.
- Try dietary supplements. Herbal and dietary melatonin supplements can be used but, only after a doctor’s consultation.
- Relaxation techniques like meditation, yoga, etc., can be practiced.
- Cognitive-behavioral therapy or CBT can help in managing thoughts and feelings, especially in those women suffering from anxiety or depression.
- Physical activities can be included in the daily routine on the doctor’s advice.

4.

What Are the Causes of Insomnia in Early Pregnancy?

Following are the causes of insomnia in early pregnancy:
- Frequent urination.
- Nausea and vomiting.
- Backache.
- Breast tenderness.
- Abdominal discomfort.
- Leg cramps.
- Shortness of breath.
- Heartburn.
- Vivid dreams.

5.

Why Does Pregnancy Insomnia Occur?

Pregnancy insomnia occurs due to hunger, anxiety, depression, and high levels of progesterone during pregnancy.

6.

For How Long Should a Pregnant Woman Sleep?

A pregnant woman should sleep for seven to nine hours daily.

7.

What Aids in Insomnia During Pregnancy?

Certain measures that help in insomnia during pregnancy. They are:
- Restrict caffeinated beverages. They not only keep the body awake, but also make it harder for the body to absorb iron from the diet.
- Drink lots of water during the day, but stop drinking it few hours before bedtime.
- Avoid the screens and scrolling through your phone, or watching television, tablet can keep you awake at night.
- Eat smaller and frequent meals and eat earlier.
- Ditch heartburn triggers such as chocolate, and greasy or spicy foods.
- Walk for about thirty minutes daily. Exercise helps in sleeping better.
- Take short naps during the day.
- Take a warm bath, or go for a massage.
- Practice prenatal yoga or other methods to relax.
- Keep the bedroom quiet, dark, and cool at night to assist you sleep.
- Follow a bedtime routine.
- Download and use a sleep or meditation application on your phone.
- Sleep on your side with the knees bent for comfort. This relieves backaches, heartburn, and hemorrhoids. Sleeping on the left side improves circulation and decreases foot swelling.
- Use extra pillows between your legs and under the small of the back to ease the pressure.

8.

Is It Fine to Have Insomnia in the Last Trimester of Pregnancy?

Yes, it is normal to experience insomnia in the third trimester of pregnancy due to the increase in belly size and pregnancy symptoms.

9.

For What Duration Does a Pregnant Woman Need to Sleep in the Third Trimester?

In the third trimester of pregnancy, most doctors recommend women to sleep for eight to ten hours per night.

10.

At What Time Does Pregnancy Insomnia Go Away?

Pregnancy insomnia lasts for the entire pregnancy. However, there may be up and down phases of it throughout the pregnancy.

11.

Does Pregnancy Insomnia Affect My Baby?

Pregnancy insomnia is miserable but it does not affect the baby.

Article Resources

Last reviewed at:
23 Jun 2023  -  5 min read

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