During pregnancy a woman goes through many different changes, one of which is her sleeping habits. Her sleeping patterns and sleep quality will both be affected during this time. This can be due to both the physical discomforts of pregnancy and the emotional stress that can occur that might cause sleep problems for the mother-to-be. The anticipation or excitement of having a baby and becoming a mother or even the anxiety of labor and delivery are all examples of emotional stress that can occur and result in exhaustion.
Exhaustion is a common complaint for pregnant women, particularly during the first and third trimesters. A lot of women can be caught off guard by just how exhausted pregnancy may make them feel.
Hormone Changes During Pregnancy
Hormonal changes during pregnancy can be quite dramatic and can affect many aspects of the body and brain. A woman’s mood, physical appearance, metabolism, and sleep pattern can all be change easily.
One of the major hormones that can cause disruptions with sleep is progesterone. Progesterone works to relax smooth muscle and can cause heartburn, nasal congestion, and even frequent urination which can disrupt getting eight hours of sleep. Progesterone can also increase the amount of time that it takes to fall asleep, decrease wakefulness during the night, and reduce the amount of REM sleep that a woman gets.
Estrogen is another hormone that can affect sleep during pregnancy. Estrogen makes blood vessels larger during pregnancy, which may lead to swelling or edema in the legs and feet. This could increase congestion of the nose which can disrupt breathing during sleep.
First Trimester and Sleep
Even in the first trimester of pregnancy, progesterone is already rising and can make a woman feel both drowsy and cause a more frequent need to pee. Which is usually only just the beginning of sleep disruption. The urge to urinate more frequently can cause the bladder to act sluggish which can result in a woman waking up more often throughout the night.
Along with the growing need to urinate, nausea can also be to blame for sleep disruptions in early pregnancy. Morning sickness does not always occur during the morning and can happen at any time of day.
A woman may also notice that they are running hotter than normal, especially when they sleep due to an increased metabolic rate. Finding a comfortable temperature or using a fan at night can help to avoid even further sleep disruptions.
Second Trimester and Sleep
The second trimester is often referred to as the “easiest trimester”. At this point most hormones begin to level out and a woman’s body has adjusted to pregnancy.
However, some women do begin to experience leg cramps at night during this time. Some women even begin to experience something known as restless leg syndrome, which can begin in the evening hours of second trimester and can continue to become more severe into the third trimester. This is where the legs feel as if you can feel the blood running in your veins and can happen while lying down or sitting and may be extremely uncomfortable. Many times the only solution to this is to get up and walk around, which can cause getting back to sleep to become quite difficult.
As pregnancy progresses women may notice an increase in vivid dreams as they sleep. Which can sometimes cause nightmares that can be hard to fall back asleep after. Moms to be also may begin to experience heartburn that can keep them up at night.
Third Trimester and Sleep
Studies suggest that once a woman reaches her third trimester the overall quality of her sleep suffers. She may have more trouble falling asleep and the amount of times that she wakes up will increase from that of second trimester.
By this point in the pregnancy it can be hard to find a comfortable position to sleep in due to an increasing belly and a more active baby. Snoring is also more common during this point in pregnancy possibly due to more nasal congestion and weight gain.
Studies show that 30.3 % of pregnant women will suffer from restless sleep in the third trimester and 98% of are affected by multiple nighttime awakenings. Many of the issues that can cause this are:
- Leg cramps
- Frequent urination
- Back pain
- Joint pain
- Shortness of breath
- Vivid dreams or nightmares
- Breast tenderness
Because women in their third trimester are more likely to suffer from sleep disruptions around 65% of them are also affected by daytime sleepiness.
Sleep Patterns Throughout the Trimesters
Studies have shown that pregnant women’s characteristics of sleep change throughout the trimesters.
- First trimester- During the first 12 weeks of pregnancy the total amount of sleep time a woman has will increase, with a longer sleep period at night and daytime naps. Many women complain of poor sleep quality during this time due to frequent awakenings.
- Second trimester – From weeks 13 to 28 sleep has been shown to improve for most women. They have better sleep efficiency and spend less time awake throughout the night. Yet the closer towards 28 weeks a woman becomes, the more her awakenings during the night increase.
- Third trimester – Weeks 29 to full term is where women tend to experience the most nighttime awakenings and spend more time awake. Women also may find themselves sleeping more throughout the day. Their sleep is no longer in a deep sleep state but is lighter and more frequent.
Ways to Improve Sleep Quality
Much like the idea of “eating for two” during pregnancy a woman is “sleeping for two”. So it is very important that she gets good quality sleep. Here are a few ways to try to improve sleep quality and lessen disruptions during pregnancy:
- Pillows can be used to become more comfortable throughout your pregnancy. Try using one in between your knees, one under the belly, and one behind your back to help support your body.
- Avoid your back. Pregnant women are advised to avoid sleeping on their back once in the second and third trimesters as a heavy uterus can press on the nerves in the spine and major vein that carries blood between the lower body and the heart resulting in dizziness.
- Lay on your left side. Women in their second and third trimester are also encouraged to sleep on their left side to help improve the flow of blood and nutrients to the developing fetus.
- Avoid fluids before bed. It is important to drink plenty of water and fluids throughout the day. While pregnant you should be increasing the amount that you drink and not decreasing. However, it can help to avoid multiple trips to the bathroom at night if you stop drinking water an hour or so before bedtime.