Sleep School - Women and Sleep

Pregnancy: Sleeping for Two

Pregnancy is an exciting and physically demanding time. Physical symptoms (body aches, nausea, leg cramps, fetus movements and heartburn), as well as emotional changes (depression, anxiety, worry) can interfere with sleep. In the NSF poll, 78% of women reported more disturbed sleep during pregnancy than at other times. Sleep related problems also become more prevalent as the pregnancy progresses.

Women's Unique Sleep Experiences
Sleep is a basic human need, as important for good health as diet and exercise. When we sleep, our bodies rest but our brains are active. Sleep lays the groundwork for a productive day ahead. Although most people need eight hours of sleep each night, the National Sleep Foundation (NSF) 1998 Women Sleep Poll found that the average woman aged 30-60 sleeps only six hours and forty-one minutes during the workweek. Research has shown that a lack of enough restful sleep results in daytime sleepiness, increased accidents, problems concentrating, poor performance on the job and in school, and possibly, increased sickness and weight gain.

Getting the right amount of sleep is vital, but just as important is the quality of your sleep. Conditions unique to women, like the menstrual cycle, pregnancy and menopause, can affect how well a woman sleeps. This is because the changing levels of hormones that a woman experiences throughout the month, like estrogen and progesterone, have an impact on sleep. Understanding the effects of these hormones, environmental factors and lifestyle habits can help women enjoy a good night's sleep.

Tips that May Help Sleep. . .

		Make sure you mattress is comfortable and supports your entire body.
		Exercise regularly, but finish your workout at least three hours before bedtime. Exercise may relieve some PMS symptoms and increase the amount of deep sleep.
		Avoid foods and drinks high in sugar (including honey, syrup), and caffeine (coffee, colas, tea, chocolate), as well as salty foods and alcohol before bedtime. Caffeine and alcohol disturb sleep.
		Try to have a standard bedtime routine and keep regular sleep times. Make sure your bedroom is dark, cool and quiet and that your pillow, sleep surface and coverings provide you with comfort.
		Consult your healthcare professional, if needed.

First Trimester (Months 1-3)
High levels of progesterone are produced, increasing feelings of sleepiness. Also, the number of times a woman wakes up during the night to urinate increases. Disturbed sleep patterns may begin. Interrupted sleep can cause daytime sleepiness. Women tend to sleep more during this time than before they were pregnant, or later in pregnancy.

Second Trimester (Months 4-6)
Progesterone levels still rise, but slowly. This allows for better sleep than during the first trimester. The growing fetus reduces pressure on the bladder by moving above it, decreasing the need for frequent bathroom visits. Sleep quality is still worse than it was before pregnancy.

Third Trimester (Months 7-9)
Women experience the most pregnancy-related sleep problems now. They may often feel physically uncomfortable. Heartburn, leg cramps and sinus congestion are common reasons for disturbed sleep, as is an increased need to go to the bathroom. (The fetus puts pressure on the bladder again.) One recent study reported, that by the end of pregnancy, 98% of the women were waking during the night.

Snoring and Severe Daytime Sleepiness
Pregnant women who have never snored before may begin doing so. About 30% of pregnant women snore because of increased swelling the their nasal passages. This may partially block the airways. Snoring can also lead to high blood pressure, which can put both the mover and fetus at risk. If the blockage is severe, sleep apnea may result, characterized by loud snoring and periods of stopped breathing during sleep. The lack of oxygen disrupts sleep and may affect the unborn fetus. If loud snoring and severe daytime sleepiness (another symptom of sleep apnea and other sleep disorders) occur, consult your physician.

Restless Legs and Poor Sleep
More women (28%) than men (21%) report restless legs syndrome (RLS) symptoms in the NSF's 1998 Omnibus Sleep in America Poll and up to 15 percent of pregnant women develop RLS during the third trimester. RLS symptoms-crawling or moving feelings in the foot, calf or upper leg- momentarily disrupt sleep. Moving the legs can stop these symptoms temporarily, but the irritation returns when the limb is still. Fortunately, RLS symptoms usually end after delivery of the baby. However, women who are not pregnant can also suffer from RLS.

Medications used to treat RLS may cause harm to the fetus and should be discussed with a doctor.

Sleep tips for Pregnant Women

1. In the third trimester, sleep on your left side to allow for the best blood flow to the fetus and to your uterus and kidneys. Avoid lying flat on your back for a long period of time.

2. Drink lots of fluids during the day, but cut down before bedtime.

3. To prevent heartburn, do not eat large amounts of spicy, acidic (such as tomato products), or fried foods. If heartburn is a problem, sleep with your head elevated on pillows.

4. Exercise regularly to help you stay healthy, improve your circulation, and reduce leg cramps.

5. Try frequent bland snacks (like crackers) throughout the day. This helps avoid nausea by keeping your stomach full.

6. Special "pregnancy" pillows and mattresses may help you sleep better. Or use regular pillows to support your body.

7. Naps may help. The NSF poll found that 51% of pregnant or recently pregnant women reported at least one weekday nap: 60 % reported at least one weekend nap.

8. Talk to your doctor if insomnia persists.

Once her baby is born, a mother's sleep is frequently interrupted, particularly if she is nursing. Mothers who nurse and those with babies that wake frequently during the night should try to nap when their babies do. Sharing baby care to the extent possible, especially during the night, is important for the mother's health, safety, performance and vitality. After-birth blues (post-partum depression) may also be related to sleep problems. This is usually a temporary condition treatable with professional help.