Sleep in Pregnancy: Mental Health
During pregnancy women experience so many physical changes in their bodies. Not only is there a little baby growing inside you, but such physical changes can lead to the development of sleep disturbances, or exacerbate pre-existing sleep conditions. Fatigue and the presence of sleep disturbances are amongst the more frequent and persistent complaints reported by pregnant women; more than 80% experience insomnia symptoms at some point during pregnancy, and more than 75% complain of disturbed sleep and a great desire to nap during the day, with the highest prevalence of disturbances occurring in the third trimester.
The principles of good sleep during pregnancy encompass all the tricks of ensuring good sleep outside of pregnancy: switch off electronic devices, have some “wind down” time prior to sleep, and make sure the bedroom is comfortable, quiet, dark and cool.
But when it came to those nine months before baby number two, I made some special changes which specifically tackled the mental side of sleeplessness and pregnancy.
Don’t throw it all away
Heartburn occurs in around 75% of pregnancies and, along with nausea (who on earth called it “morning” sickness?!) which can occur at night, to interrupt restful sleep.
Review what and when you are eating and drinking. If you suffer from heartburn, avoid heavy or spicy/acidic meals and foodstuffs just before bedtime. Try instead to have a lighter meal in the evening, and avoid eating 2-3 hours before bed. If nausea is a problem, a bland snack, like dry crackers just before bed can help. Finally, review your caffeine intake (present in coffee, tea, soft drinks and chocolate) and cut back, particularly in the afternoon and evening. Be aware that government guidelines now recommend pregnant women have no more than 200mg of caffeine per day – equivalent to around 2 cups of instant coffee – as increased caffeine intake may be associated with low birth weight.
Snooze, don’t lose
It is estimated that roughly 9% of non-pregnant women are snorers, in comparison to 11-35% of women who snore during pregnancy. The narrowing and closure of the upper airway in sleep is known as sleep apnoea, and causes multiple pauses in breathing. Physiological and hormonal changes, such as weight gain and the enlarging of the uterus, contribute to these breathing-related sleep disorders. In addition, increased oestrogen causes the lining of the nasal passages to swell, heightening nasal congestion and narrowing of the upper airway. Symptoms include witnessed “pauses” in breathing at night, waking up choking or gasping for air, loud snoring and daytime sleepiness.
Both snoring and sleep apnoea contribute to sleep disruption and daytime fatigue. Excessive weight gain, smoking, alcohol and sedatives are all best avoided in any case during pregnancy, but will also reduce snoring. Sleeping on your side and/or with your head slightly elevated in bed may also help. But, as always, you should see your doctor or midwife for a detailed assessment if you or your partner are concerned about sleep apnoea.
Sleep disturbances and daytime fatigue in pregnancy are common, so you’re not alone in wandering the hallway at night or tossing and turning to find the most comfortable position! The key is to find time to relax, take a nap if you need to, eat well, and don’t be afraid to discuss your issues with your GP or midwife.