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?
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Nausea or Throwing Up - During the first trimester, most women feel nauseous or vomiting during the night.
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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
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Hormonal Factors - Progesterone causes sleepiness during the day and fragmented sleep during the night. Increasing oxytocin and cortisol levels can create anxiety and stress.
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Bloating - Pregnancy hormones slow down digestion which causes bloating and gas trouble.
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Breast Tenderness - Due to hormonal changes, the breast will feel sore and tender.
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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.
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Shortness of Breath - The growing fetus puts pressure on the diaphragm, which is situated below the lungs leading to breathing difficulties.
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Anxiety - All women have anxiety during pregnancy due to the thoughts and worries spinning in their heads and keeping them away from sleeping.
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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.
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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.
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Frequent Urination - Frequent urination during nighttime can disturb sleep.
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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,
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Avoid Caffeine - Coffee keeps everyone awake, so it is advised to avoid it, especially during the evenings.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Good Fragrance - A sachet tucked into the pillowcase, or lavender-scented pillow can help in relaxation and bring on sleep faster.
Is Taking Melatonin During Pregnancy Recommended?
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.
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Promethazine - It can be used for mothers with a severe or chronic sleep disorder.
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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.
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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.
