Sleepless during pregnancy-Insomnia in Early Pregnancy: Why it Happens and What to Do

Most women experience some degree of sleep disturbance during pregnancy, and for a significant number of women sleep disruption may be quite severe. There are many different causes for sleep disturbance during pregnancy, and choosing the appropriate intervention relies on an accurate diagnosis of the problem. Certain sleep disorders, such as restless leg syndrome and sleep apnea, are more common during pregnancy and may cause significant sleep disruption. Sleep disturbance may also be a symptom of depression or an anxiety disorder, thus it is important to screen for these problems. Many women with depression or anxiety have difficulty falling asleep or they wake early and are unable to return to sleep.

However, a Cochrane review emphasizes that more research is necessary to confirm this possible effect. Speepless of a toddler and Sleepless during pregnancy to two Blondes sucking cock, Allaya tries to raise her family with equal doses of optimism, discipline, and mostly age-appropriate humor. Avoid in Slepeless trimester Sleepless during pregnancy prevent Epstein cardiac anomaly. I have clinical insomnia and have to take ambian, but now we think I may be and am desperately trying to ween off for the baby. Physician intervention may be needed if there are pauses in breathing between snoring episodes indicating possible OSAH. Unlike sleep dufing which objectively Sleep hygiene refers to habits Sleeplexs make it easier to fall asleep. Between midnight bathroom breaks, out-of-control hormones, and pregnancy woes such as congestion and heartburnyou might be spending more time out of your bed than in it. It helps to read that other people have, and are going through a tough time balancing medications with the best outcomes for baby. As women enter Sleepless during pregnancy, a decrease in the production of certain hormones causes many physical and emotional changes.

World largest human dick. Pregnancy and Sleep

Doing what you can for as long as you can really…. A fan is often nice to keep a durint cooler, she said, plus it has the added benefit of blocking out noise inside and outside the bedroom, including a snoring bed partner. Researchers have found that not getting enough sleep during pregnancy could affect a woman in ways that go beyond feeling exhausted during the day, being irritable and having poor concentration. By the Sleelpess of a pregnancy, many durjng have a hard time just getting comfortable enough to sleep well. I never expected my recovery from my fifth baby to be easier, and I'm giving the credit to exercise. But women might be caught off guard by how worn out they feel in the early months of pregnancy. Although many Sleepless during pregnancy report strange dreams, the results from her research did not show any differences in dreaming across the trimesters compared with dreaming before a woman becomes pregnant. Follow Us On. Get updates. Sign up now. Most women experience sleep problems during pregnancy.

According to a study of pregnancies,

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If you buy something through a link on this page, we may earn a small commission. How this works. For a new mom-to-be, experiencing sleep deprivation after the baby is born is a given. Most women experience sleep problems during pregnancy.

Pregnant women tend to get more sleep during their first trimesters hello, early bedtime but experience a big drop in the quality of their sleep. It turns out that pregnancy can make you feel exhausted all day long. It can also cause insomnia at night. Insomnia means you have difficulty falling asleep, staying asleep, or both. Women can experience insomnia during all stages of pregnancy, but it tends to be more common in the first and third trimesters.

Between midnight bathroom breaks, out-of-control hormones, and pregnancy woes such as congestion and heartburn , you might be spending more time out of your bed than in it.

Sheer logistics play a role as well. By the end of a pregnancy, many women have a hard time just getting comfortable enough to sleep well. Other causes of insomnia can be stress-related.

These thoughts can keep you up at night, especially after your third visit to the bathroom. Instead, try writing down all of your concerns on paper. This will give you a chance to consider possible solutions. If there are no solutions, or there is nothing you can do, turn the page in your journal and focus on another worry.

This can help empty your mind so you can rest. Begin by trying to go to bed at the same time every night. Start your routine with something relaxing to help you unwind. Avoid screen time at least an hour before bed. Try reading a book instead. Taking a soothing bath might also make you sleepy. This is especially true during early pregnancy. To be safe, avoid hot tubs. Drink plenty of water throughout the day, but minimize drinking after 7 p. Try to avoid caffeine starting in the late afternoon.

Eat a healthy dinner , but try to enjoy it slowly to reduce your chances of heartburn. Eat a light snack if you need to eat something late in the evening. Something high in protein can keep your blood sugar levels steady through the night. A warm glass of milk can help you feel sleepy, too. Learn about more foods and drinks that can improve sleep. Stay active during the day so you can rest at night.

Make yourself comfortable. Lie on your side, tuck a pillow between your knees, and use one under your belly as it gets bigger. If breast tenderness is bothering you, opt for a comfortable sleep bra that fits properly.

Keep your room cool, dark, and quiet for optimal sleeping conditions. Use a nightlight in the bathroom for those midnight visits. The dim light will be less jarring than a bright overhead light. Practice meditation , or try relaxation techniques and exercises. These methods are often taught in childbirth classes. For most women, insomnia during the first trimester will pass. But skip any sleep-inducing supplements, medicines , or herbs until you consult with your doctor.

If you're experiencing changes to your dreams since your pregnancy began, you aren't alone. Learn more about what the causes may be, what types of…. Is that nausea you're feeling actually morning sickness? Learn more about when morning sickness starts, when it ends, and how to manage the symptoms…. Intermittent fasting is generally not recommended during pregnancy. We'll tell you why and explain other options. I never expected my recovery from my fifth baby to be easier, and I'm giving the credit to exercise.

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So you think you're pregnant. The first thing you do is Learn more about DIY bleach pregnancy tests, from what positive and…. You may have seen stories about people making their own toothpaste pregnancy tests. But do they really work? Find out why you shouldn't count on the…. How to Kick Insomnia in Early Pregnancy.

Understanding insomnia Causes during pregnancy Better bedtime routine Diet and exercise Comfort is key Try to relax Takeaway If you buy something through a link on this page, we may earn a small commission. What is insomnia? What causes insomnia during pregnancy? There are many reasons you might be wide awake in the wee hours. These can include: need to urinate frequently nausea or vomiting back pain breast tenderness abdominal discomfort leg cramps shortness of breath heartburn vivid dreams Other causes of insomnia can be stress-related.

Being up front with your partner about your feelings and worries can also help you feel better. Develop a bedtime routine. Diet and exercise. Diet and exercise can have an impact on your sleep. Drink up Share on Pinterest Drink plenty of water throughout the day, but minimize drinking after 7 p. Eat to sleep Share on Pinterest Eat a healthy dinner , but try to enjoy it slowly to reduce your chances of heartburn.

Exercise Share on Pinterest Stay active during the day so you can rest at night. Comfort is key. Making yourself — and your bedroom — more comfortable can result in better sleep. Get comfortable Share on Pinterest Make yourself comfortable. Climate change Share on Pinterest Keep your room cool, dark, and quiet for optimal sleeping conditions.

Try to relax. Practice ways to feel more relaxed at night. Relax Share on Pinterest Practice meditation , or try relaxation techniques and exercises. When Does Morning Sickness Start? Read this next. Letter from the Editor: Welcome to Parenthood The newest brand from Healthline that focuses on your life and your well-being through the lens of becoming a parent.

The dim light will be less jarring than a bright overhead light. Practice meditation , or try relaxation techniques and exercises. To relieve the queasiness, some women eat crackers or dry cereal before getting out of bed in the morning. Where to give birth: your options Antenatal classes Make and save your birth plan Pack your bag for birth. Jump to Your Week of Pregnancy.

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Insomnia During Pregnancy: How to Sleep Better While Pregnant

Sleep disturbances are common in pregnancy. Insomnia is a frequent sleep disturbance experienced by pregnant women which can be primary or due to co-morbid conditions.

The differential diagnosis of insomnia in pregnancy includes anxiety disorders, mood disorders, breathing related sleep disorders and restless legs syndrome. Early interventions to treat the sleep disturbance are recommended to avoid adverse pregnancy outcomes. Management strategies include improving sleep hygiene, behavioral therapies, and pharmacotherapy. The risks of pharmacotherapy must be weighed against their benefits due to the possible risk of teratogenicity associated with some medications.

We searched PubMed and Google Scholar employing a combination of key words: pregnancy, sleep disturbances, Obstructive Sleep Apnea, Sleep disorders and insomnia. We included original studies, review articles, meta-analysis and systematic reviews in our search prioritizing articles from the last years. Articles older than 15 years were only included if their findings had not been superseded by more recent data. Further selection of articles was done from bibliographies and references of selected articles.

Sleep disturbances in pregnancy are common and cause considerable morbidity. Management includes a combination of non-pharmacological and pharmacological treatments carefully weighing the risks and benefits of each for the expectant mother and fetus. Sleep duration and quality related changes in pregnancy may be due to many proposed and interrelated mechanism like hormonal, physiologic, metabolic, psychological and posture related changes.

For example during first trimester, a rise in progesterone levels may cause excessive day time sleepiness, decreased muscle tone, increased risk of sleep apnea, snoring and sleep interruptions. Frequent trips to the bathroom, nausea and vomiting, pregnancy related discomfort like back pain, fetal movements and gastro-esophageal reflux can also impair the quality of sleep. Anxiety during pregnancy may be further amplified by concerns about labor, delivery and its outcome.

Poor quality sleep is not only a core feature of prenatal, intra-natal and postpartum depression, but also a risk factor for mood disturbances in pregnancy.

Sleep disturbances affect health and quality of life and may also negatively influence obstetric outcomes. A recent study at University of California, San Francisco found that women who slept less than 6 hours per night were more likely to have longer labor and were 4.

Both non-pharmacological and pharmacological interventions may alleviate sleep disturbances. This review is intended to provide practitioners with an understanding of sleep changes in pregnancy and guide them in rational approaches to their management.

Sleep related problems are common during pregnancy including insomnia, RLS, sleep apnea, nighttime gastro-esophageal reflux disease GERD , back pain, quickening and frequent nighttime urination. Sleep problems and changes in sleep patterns start during the first trimester of pregnancy 1 most likely influenced by the rapid changes in reproductive hormone levels.

Levels of progesterone rise throughout pregnancy. At 36 weeks progesterone levels are 10 times greater than peak menstrual cycle levels.

Women during first trimester take day time naps in part due to fatigue. In animal studies, progesterone administration has been observed to have sedating effects, to reduce wakefulness, shorten the latency and increase the duration of non-rapid eye movement NREM sleep. In animal studies, estrogen selectively suppresses REM sleep 3 an effect possibly due to increased brainstem nor-epinephrine turnover. In an animal model, total sleep time increases during pregnancy, with an early but transient increase in REM duration, a sustained increase in NREM sleep over the course of pregnancy, and increased diurnal sleep during late gestation.

In human pregnancy, hypersomnolence is a common complaint during the first trimester. Similarly, a mean increase of more than 30 minutes of nighttime sleep was noted at 11 to 12 weeks of gestation in 33 women who underwent in-home polysomnography prior to conception and during each trimester of pregnancy.

By late in the second trimester weeks of gestation , total night-time sleep time falls. During the third trimester, the majority of women have sleep difficulties. There is no evidence of a shift in circadian phase e.

Despite these changes and reduced sleep time as compared to first 2 trimesters, total sleep time normalizes to almost pre-pregnancy levels. There is no evidence of changes in circadian rhythm with melatonin levels showing a diurnal rhythm. In 3 rd trimester, sleep disturbances are due to general discomfort caused by backache, urinary frequency, fetal movements, GERD and leg discomfort.

Sleep problems increase in the first 6 months after child birth with total nocturnal sleep time of less than 6 hours. Insomnia is defined both as a symptom and as a disorder. As a symptom this clinical condition is quite common in practice, however, as a diagnosis, insomnia has multiple defined sub-classifications in DSM 5 Diagnostic and Statistical Manual-5th Edition Table-I.

Common pregnancy related complaints like back pain, nocturia, fetal movement, breast tenderness and leg cramps can negatively affect sleep quality and quantity. Daytime effects of insomnia include hypersomnia, fatigue and mood changes. Insomnia can also negatively impact partner relationship and interfere with mother-infant bonding. Moreover, sleep disturbances in 3 rd trimester are associated with increased perception of labor pain, longer labor and increased operative births.

Patients with insomnia have high pro-inflammatory cytokines which is also seen in postpartum depression, preterm birth and other pregnancy complications. Clinicians should address the sleep disturbances promptly because it puts the pregnant women at higher risk of complications like depression in late third trimester or after child birth.

Sleep disturbance assessment should include careful screening of primary mood disorders like major depressive disorder MDD or bipolar disorder or primary anxiety disorders like generalized anxiety disorder GAD , post-traumatic stress disorder PTSD , panic disorder or obsessive compulsive disorder OCD because these conditions can present as prenatal insomnia. As with MDD, diagnostic criteria for conditions such as GAD may overlap with common symptoms of pregnancy including being easily fatigued, difficulty concentrating, emotional reactivity, and muscle tension.

For the diagnosis of GAD, patients also manifest excessive anxiety and worry that is difficult to control for at least 6 months and cause clinically significant distress and impairment. Similarly, difficulty falling or staying asleep and restless sleep are included in the diagnostic criteria for PTSD but patients with PTSD also have other symptoms such as hyperarousal, increased reactivity, flashbacks, and avoidance of traumatic stimuli.

They are also central features of manic and hypomanic episodes which are an important consideration in evaluating pregnant women with sleep problems. Due to the overlap of symptoms of pregnancy with neurovegetative symptoms of depression, the diagnosis of mood disorders becomes very challenging. Clinicians can rely on several elements to diagnose primary mood disorder.

For instance, pregnant women with depression experience anhedonia diminished interest or pleasure in all or almost all activities nearly every day.

Other symptoms like psychomotor retardation, feeling of worthlessness, excessive or inappropriate guilt and recurrent thoughts of suicide are primarily experienced by pregnant women with depression.

Moreover, assessment of time course, frequency and severity of symptoms can differentiate between pregnancy symptoms and symptoms of MDD. According to DSM-5, symptoms should not only occur for most days over a 2 week period but should also cause significant distress in social, occupational and other areas of functioning.

Pregnant women can present with MDD, but a past history of mania or hypomania would suggest Bipolar Disorder, leading to different pharmacological treatments like mood stabilizers before the postpartum period, a time with higher risk of recurrent mood episodes. Obstructive Sleep Apnea-Hypopnea OSAH Obstructive sleep apnea is a breathing related sleep disorder characterized by repeated episodes of apnea cessation of breathing or hypopnea decrease in the flow of breathing accompanied by oxygen desaturation secondary to obstruction of airflow in the upper airway.

In addition, higher circulating levels of estrogen cause edema of mucous membranes which can lead to nasal congestion and pharyngeal constriction, another cause of breathing related sleep disorders. In patients who suffer from RLS before pregnancy, symptoms can worsen during gestation. RLS is often under-diagnosed owing to lack of awareness of clinicians and because symptoms can be similar to leg cramps which is quite common in pregnancy.

A thorough sleep history which includes the diagnostic criteria of RLS can help with accurate diagnosis. Iron deficiency ferritin can be associated with RLS in pregnant women via changes in dopamine transporter functioning. Untreated RLS increases risk of depressed mood, and RLS related sleep deprivation is linked to adverse effects like prolonged labor, heightened pain perception and discomfort during labor, higher rates of C-section, preterm labor and elevated inflammatory cytokines.

It is important that clinician should inquire about difficulties in sleep initiation, maintenance or early morning awakening and understand environmental and behavioral factors. Obtaining a complete medical history including risk factors is pivotal for diagnosis and treatment and early intervention is recommended. Sleep Hygiene and Sleep Education Non pharmacological interventions like sleep hygiene and education should be considered as first line strategies. Table-II It is heartening to know that most of the sleep problems experienced by pregnant women tend to improve with child birth.

Sleep hygiene strategies can significantly improve the quality of sleep without the need to resort to medications. These include:. Use dim nightlights in bathroom as bright light can make it difficult to go back to sleep. Drink plenty of fluids in daytime but limit their intake after 5pm to decrease frequent awakenings for urination.

Avoid spicy, heavy and fried foods to decrease heart burn. Over the counter antacids may be used. If medically appropriate exercise 30 minutes every day preferably 4 to 6 hours prior to bed time. Instead get out of bed, take a warm bath and do something non-stimulating such as knitting, reading a book, etc.

Avoid activities like eating, watching TV, playing videogames or other electronics or lengthy cell phone calls while in bed. Sleep lying on the left side with knees and hips bent and pillows between the knees, under abdomen and behind the back to reduce pressure on lower back.

In addition a heating pad on the back may reduce pain and improve sleep. For Restless Legs syndrome have your physician evaluate you for folic acid or iron deficiency. Snoring is common during pregnancy. Physician intervention may be needed if there are pauses in breathing between snoring episodes indicating possible OSAH. Behavioral Therapy Behavioral therapies for insomnia in addition to sleep hygiene and stimulus control include: relaxation, sleep restriction, cognitive therapy and cognitive behavioral therapy for insomnia CBT-I.

Stimulus control includes using your bed only for sleep. If unable to sleep get up and do something minimally stimulating. Staying in bed and worrying about not sleeping perpetuates insomnia. Relaxation techniques like progressive muscle relaxation PMR which includes alternately tightening and relaxing different muscle can be used before each sleep period. Abdominal deep breathing with relaxing thoughts can also be helpful if used before each sleep period. Sleep Restriction not lying in bed for extended periods of time prevents circadian clock shifts and is helpful in preventing insomnia.

Restricting the time in bed to the amount of sleep reported on a sleep log improves sleep efficiency. Sleep efficiency is computed as time asleep divided by time in bed. Cognitive Therapy is directed at anxiety, catastrophic thinking related to not sleeping and having the patient develop realistic expectations about duration of sleep.

Some patients have predetermined ideas about the amount of sleep needed to function well. Cognitive behavioral therapy for insomnia CBT-I , includes daily sleep logs, a session on sleep education, two sessions with focus on stimulus control and sleep restriction followed by 2 sessions on cognitive therapy as outlined above followed by a session on sleep hygiene and a final session to integrate information from all of above session.

CBT-I also includes sleep hygiene and helping patient deal with maladaptive thoughts, beliefs and behaviors like watching TV in bed. In addition to cognitive therapy, other components of CBT-I include stimulus control therapy and sleep restriction. Patients are asked to go to bed only when sleepy and to use their bed for sleep only.

However, it is not known if these techniques improve insomnia in pregnant women as well.