Gina Johnson
Sleep is one of the three pillars of health, alongside a good diet and moderate exercise. However, getting a good night's sleep can be difficult during pregnancy. The majority of pregnant people experience sleep problems, particularly in late pregnancy. This is due to a combination of physical changes, such as a growing fetus, a growing belly, and the associated aches and pains, as well as biological changes, such as increased progesterone and estrogen levels, which can cause drowsiness and rhinitis (swelling of the nasal tissue). As a result, many pregnant people turn to sleep aids and medications. However, the safety of many sleep aids for pregnant people and their fetuses has yet to be verified, and healthcare providers often opt not to recommend any sleep aids during pregnancy. So, is it safe to take sleep medication when pregnant?
| Characteristics | Values |
|---|---|
| Sleep quality during pregnancy | Poor sleep quality, frequent waking, and fatigue are common during pregnancy. |
| Sleep patterns | Decreased deep sleep, non-REM sleep and increased REM sleep, which is more easily interrupted. |
| Sleep duration | Pregnant women need more sleep, recommended 8-10 hours, and may require more time in bed or naps. |
| Sleep position | Sleeping on the side is recommended, preferably the left side, to ensure adequate blood flow. |
| Sleep disruptions | Frequent urination, heartburn, shortness of breath, leg discomfort, nausea, and anxiety are common disruptions. |
| Sleep aids | Melatonin supplements are commonly used, but limited research exists on their safety. Healthcare providers may suggest non-medication alternatives first. |
| Stress | Stress reduction techniques are important as stress can impact sleep quality. |
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What You'll Learn
Sleep aids and medication
Sleep is one of the three pillars of health, alongside a good diet and moderate exercise. Doctors recommend that adults get seven to nine hours of sleep per night, with pregnant women requiring eight to ten hours. However, hormonal changes during pregnancy can cause mood swings and fatigue, making it difficult for expectant mothers to get the sleep they need.
Pregnant people should consult a healthcare provider before taking any new medication or supplement, including over-the-counter sleep aids. While some sleep aids may be deemed safe for pregnant people, the limited research on their effects on fetuses means that many healthcare providers opt not to recommend them. Melatonin supplements, for example, have been linked to lower birth weights in animal studies, and are known to cross the placenta and raise melatonin levels in fetuses. However, there is currently no evidence that melatonin supplements are harmful to human fetuses.
If non-pharmacological measures fail to alleviate sleep problems, certain sleep aids may be an option. Some of the most common sleep aids used during pregnancy are melatonin supplements and antihistamines. Pregnant people should be aware of the potential risks associated with taking sleep aids, as the safety of many of these products for pregnant people and their fetuses has yet to be verified.
Instead of medication, healthcare providers may recommend non-medication alternatives to treat sleep difficulties during pregnancy. These can include stress reduction techniques, such as making to-do lists for the next day before bedtime to avoid taking stress to bed. Relaxing activities such as meditation or reading under a soft light may also help pregnant people fall back asleep if they wake up during the night.
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Hormonal changes
Pregnancy is a time of significant hormonal changes, which can have various effects on the body and sleep quality. Hormonal fluctuations during pregnancy are associated with several physiological and organ system changes.
One of the critical hormones affected during pregnancy is progesterone, a hormone produced by the ovaries and placenta. Progesterone levels increase during the first trimester, causing drowsiness and contributing to the development of restless legs syndrome (RLS). RLS is a common reason for disrupted sleep during pregnancy, characterised by an uncontrollable urge to move the legs while resting. The respiratory system also undergoes changes due to hormonal influences, with progesterone stimulating the respiratory centre and increasing ventilation and respiratory rate to meet the growing fetus's oxygen demands.
Additionally, hormonal changes can lead to acne development, particularly during the second and third trimesters. These hormonal fluctuations impact skin pigmentation, causing darkening of the areola and hyperpigmentation, which can result in changes to the colour of moles, freckles, and birthmarks. Stretch marks, medically known as striae gravidarum, are another common skin change during pregnancy, caused by the combined effects of skin stretching and hormonal changes on skin elasticity.
Hormones also influence taste and smell during pregnancy. Dysgeusia, a decrease in the ability to taste, is common in the first trimester, and some women experience a metallic taste in their mouths, which can aggravate nausea. Hormonal changes can also lead to a heightened sense of smell, with many pregnant women reporting increased sensitivity to various odors.
Lastly, hormonal changes during pregnancy can impact sleep quality. While the amount of deep, non-REM sleep decreases, REM sleep, a form of sleep where individuals are more easily awakened, increases. This change in sleep structure may be nature's way of preparing women for the frequent awakenings associated with motherhood.
Overall, the hormonal changes during pregnancy are extensive and varied, influencing multiple aspects of a woman's physical and sensory experiences.
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Sleep positions
Sleep is a time when your body resets and repairs itself. It is when your brain makes memories, your blood vessels restore themselves, and your immune system is strengthened. However, during pregnancy, hormonal changes, a growing baby bump, and other biological changes can make it difficult to get a good night's sleep.
As your pregnancy progresses, sleeping on your back can become problematic. The growing uterus can put pressure on the inferior vena cava, a major vein that carries blood back to the heart, which may reduce circulation to both the pregnant person and the fetus. This can lead to dizziness, shortness of breath, or lower blood pressure. Doctors typically recommend shifting to a side-sleeping position during the second and third trimesters to avoid these issues.
Sleeping on your stomach can also become uncomfortable as your pregnancy progresses. Your breasts become more tender, and your abdomen continues to grow, making it challenging to sleep on your tummy. Using a donut-shaped pillow with a hole in the middle may help you sleep comfortably on your stomach.
The best sleep position during pregnancy is sleeping on your side, also known as the "SOS" (sleep on side) position. Sleeping on your left side is generally recommended as it facilitates blood flow, ensuring that vital organs and the baby receive the necessary nutrients and oxygen. It also decreases the likelihood of swelling in the ankles and legs. Sleeping on your right side is still considered safe, especially if it is more comfortable or if left-side sleeping is not sustainable throughout the night.
To get comfortable in the side position, you can try crossing one leg over the other and placing a pillow between your legs and behind your back. Using extra pillows can provide support and help you get a better night's sleep. A wedge-shaped pillow or a full-body pregnancy pillow may also be helpful.
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Stress and anxiety
Pregnancy is a time of many changes, and it is normal to experience some stress and anxiety. However, high levels of stress that continue for a long time can cause health problems like high blood pressure and heart disease, and can increase the chances of having a preterm or low-birthweight baby.
Pregnancy-related stress can stem from worrying about the health of the baby, concerns about miscarriage, uncertainty or fear about becoming a mother, relationship changes, work-related stress, and the logistics of accommodating a new family member. It can also be caused by external factors such as economic problems, exposure to racism, an abusive partner, or living in an unsafe or unstable environment.
If you are experiencing stress or anxiety during pregnancy, it is important to talk to your healthcare provider. They can help you identify the sources of stress and provide guidance on managing your mental health. Treatment and counseling are available, and early intervention is safe and important for both your health and the well-being of your baby.
- Establish a sleep schedule: Lack of sleep can affect your ability to handle stress. Try to go to sleep and wake up at the same time each day.
- Meditate and breathe deeply: Meditation and deep abdominal breathing practices can help your body release endorphins, provide more oxygen to your brain, and stimulate your nervous system. Aim for 20 to 30 minutes of deep breathing practice daily to help manage anxiety.
- Exercise: Consult your doctor about safe and appropriate workouts during pregnancy. Exercise is a natural way to increase serotonin levels and decrease cortisol levels.
- Eat a healthy diet: Avoid caffeine, sugar, processed carbohydrates, artificial additives, and ensure sufficient protein intake. A healthy diet can positively impact your mood, ability to handle stress, and focus.
- Support network: Lean on your partner, family, and friends for support. Don't be afraid to ask for help and allow yourself to relax and put your health first.
- Prioritize self-care: Slow down, cut down on chores, and make time for activities that bring you relaxation and joy. Taking care of yourself is vital to taking care of your baby.
- Childbirth education: Consider taking a childbirth education class to help you know what to expect during pregnancy and after your baby arrives.
- Planning: If you're working, plan ahead for your time away from work, and use any time off to relax and prepare.
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Sleep patterns
Pregnant women may experience insomnia due to the added weight and discomfort from the growing fetus, which can make it difficult to find a comfortable sleeping position. The weight of the fetus can also put pressure on the diaphragm, making it harder to take deep breaths and leading to shortness of breath, which further disrupts sleep. Hormonal changes, such as increased levels of progesterone and estrogen, can cause drowsiness, especially during the first trimester, and can also contribute to snoring and sleep apnea. Additionally, frequent urination due to increased urine production and bladder pressure from the growing baby can interrupt sleep throughout the night.
Other factors that can contribute to sleep disturbances during pregnancy include heartburn, restless legs syndrome (RLS), gastroesophageal reflux disease (GERD), nausea, vomiting, leg cramps, back pain, anxiety, and stress. The third trimester is often the most challenging for sleep, with high estrogen levels causing rhinitis (swelling of nasal tissue), further contributing to snoring and breathing difficulties.
To optimize sleep during pregnancy, it is recommended to practice stress reduction techniques, such as making to-do lists before bedtime to minimize worry. Pregnant women should prioritize sleep and rest, even if it means taking afternoon naps or spending more time in bed. Sleeping on the left side is considered ideal, as it promotes better blood flow, but sleeping on the right side is also generally safe. Pregnant women should avoid sleeping on their backs for extended periods, as this can put pressure on the aorta and inferior vena cava, potentially reducing blood flow to the heart and the developing fetus.
While sleep aids and medications may be considered to alleviate sleep difficulties during pregnancy, the safety of many of these interventions for pregnant women and their fetuses has not been fully established. Melatonin supplements, for example, have been shown to cross the placenta and increase fetal melatonin levels, although there is currently no evidence of harm to humans. Therefore, non-pharmacological measures and lifestyle changes are typically recommended as the first line of treatment for sleep problems during pregnancy.
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Frequently asked questions
Sleep medication and supplements should only be taken under the supervision of a doctor. While insomnia during pregnancy is common, many sleep medications have not been tested for safety on pregnant women. Doctors may recommend non-pharmacological treatments, such as stress reduction techniques, lifestyle changes, and cognitive behavioural therapy.
The safety of many sleep aids for pregnant people and their fetuses has yet to be verified. Studies have found that melatonin use in pregnant animals has some risks, such as lower birth weights. However, there is currently no evidence that melatonin supplements are harmful to pregnant humans or their fetuses.
Pregnant women should try to optimise their sleep quality by following good sleep habits. This includes reducing caffeine intake, avoiding drinking too much liquid in the evening, and raising the head of the bed or using more pillows to manage indigestion.
Pregnancy can cause physical and biological changes that make it difficult to sleep. These include a growing belly, pressure on the diaphragm, increased urinary frequency, heartburn, and restless legs syndrome. Hormonal changes can also lead to mood swings and fatigue, particularly during the first trimester.
Yes, pregnant women need more sleep than the average adult. Doctors recommend eight to ten hours of sleep during pregnancy, compared to seven to nine hours for non-pregnant adults. Getting enough sleep is vital for the health of both the mother and the baby.
