Daytime Naps: Pregnancy's Best-Kept Sleep Secret

Pregnancy can be a tiring time, and it's common to feel more fatigued than usual during the first and third trimesters. This is often due to hormonal changes, such as increased progesterone levels, which can make you feel sleepy. By the third trimester, carrying around the extra weight of a baby and the emotional anxiety of impending labour can also make you feel tired.

In addition to hormonal changes, there are several other reasons why pregnant people may feel sleepy during the day. Pregnancy-related discomforts, such as heartburn, leg cramps, nausea, and frequent urination, can interrupt sleep at night. Increased stress and anxiety levels can also lead to restless nights, leaving people feeling more tired during the day.

However, it's important to note that while occasional daytime naps can be beneficial, too much napping can disrupt nighttime sleep.

Hormonal changes and their effects on the body

Hormonal changes during pregnancy can significantly impact a person's sleep. In the first trimester, a spike in progesterone can lead to increased drowsiness and feelings of fatigue. This is necessary to support the pregnancy but can result in a shift in the body clock, making you feel tired during the day and affecting your sleep at night. Additionally, hormonal changes can cause a decrease in blood pressure and blood sugar levels, contributing to feelings of exhaustion.

As the pregnancy progresses, the growing belly and increased weight can make finding a comfortable sleeping position challenging. The second trimester often brings some relief, but by the third trimester, high levels of estrogen can cause rhinitis (swelling of the nasal tissue), which is associated with snoring and obstructive sleep apnea.

Hormonal changes can also impact the digestive system, causing constipation, indigestion, and heartburn, which might be worse at night. These issues, combined with frequent urination due to increased kidney productivity and bladder pressure from the growing baby, can further disrupt sleep.

Furthermore, hormonal fluctuations can contribute to restless leg syndrome, a condition characterized by a strong urge to move the legs. This can be triggered by rising estrogen levels or a lack of specific nutrients like folic acid and iron.

To mitigate the effects of hormonal changes on sleep during pregnancy, it is recommended to maintain a consistent sleep schedule, limit screen time before bed, and make dietary changes such as avoiding carbonated drinks, citrus, and spicy or fatty foods, which can trigger acid reflux. Gentle exercises, such as yoga and swimming, can also help improve sleep quality.

Gastroesophageal reflux disease (GERD)

Pregnancy can cause GERD due to the extra pressure on the stomach. This pressure can prevent the muscular ring from closing properly, leading to the reflux of food and liquid. GERD is a common cause of insomnia in pregnant women across all trimesters, affecting around a quarter of pregnant women in the first trimester and up to half in the third.

GERD can be treated with antacids, and there are also lifestyle changes that can help reduce symptoms. These include avoiding spicy and fatty foods, as well as limiting food intake close to bedtime.

Insomnia

Causes of Insomnia During Pregnancy:

• Increased metabolism and heart rate
• Physical discomfort, such as back pain, leg cramps, or restless leg syndrome
• Nighttime bathroom trips due to increased urinary frequency
• Anticipation and anxiety about the arrival of the baby
• Frequent and vivid dreams
• Hormonal changes, particularly increased progesterone levels, which can cause excessive daytime sleepiness
• Gastroesophageal reflux disease (GERD)
• Sleep apnea

Risks of Sleep Deprivation While Pregnant:

Sleep deprivation during pregnancy has been linked to various health complications, including:

• Gestational diabetes
• Preterm birth
• Longer labour
• Preeclampsia
• High blood pressure
• Self-reported stress and depression

Tips to Cope with Pregnancy Insomnia:

• Try new sleeping positions, such as sleeping on your left side, which facilitates blood flow to major organs and the fetus.
• Prepare for bedtime with a warm bath or massage.
• Create a comfortable sleep environment: a cool, dark, quiet room with relaxing sounds can be soothing.
• Try relaxation techniques, such as meditation or progressive muscle relaxation.
• Exercise regularly, but preferably earlier in the day.
• Avoid stimulants like caffeine, nicotine, and alcohol.
• Treat congestion with nasal strips or sprays to aid breathing.
• Talk to your healthcare provider if insomnia persists, as underlying conditions like gastroesophageal reflux disease, restless legs syndrome, or sleep apnea may require specific treatment.

Sleep apnea

Pregnancy can increase the risk of developing sleep apnea due to weight gain, anatomical factors, and hormonal changes. The risk factors for sleep apnea in pregnancy include a history of sleep apnea or snoring before pregnancy, obesity, family history of obstructive sleep apnea, heart or kidney failure, large tonsils and thick neck, and chronic hypertension.

The biggest symptom of sleep apnea during pregnancy is snoring. Other symptoms to look out for include feeling especially tired during the day, waking up with a headache, atypical weight gain for pregnancy, snoring or choking during sleep, and elevated blood pressure.

There are a range of treatment options for sleep apnea during pregnancy. Milder cases are usually treated by having the patient sleep on their side, using a wedge pillow to help keep the airway open, or using a dental device to keep the jaw forward. For moderate to severe sleep apnea, doctors will likely recommend the use of a continuous positive airway pressure (CPAP) machine, which provides continuous air pressure to keep the airways open.

Frequent urination

The need to urinate frequently during pregnancy is caused by the pregnancy hormone hCG, which increases blood flow to the pelvic area. This increased blood flow can also lead to increased sexual pleasure during pregnancy. However, it also means that the kidneys become more efficient, and the body gets rid of waste more quickly.

As the uterus expands, it pushes down on the bladder, urethra, and pelvic floor muscles, further increasing the urge to urinate. Near the end of the third trimester, when the baby is preparing for childbirth, the head "drops" down into the pelvis and presses on the bladder.

While increased urine production is a normal part of pregnancy, there are some strategies that can help reduce the frequency of urination:

• Try to empty your bladder completely by leaning forward while urinating.
• Avoid diuretics like caffeine, which will make you need to pee more often.
• Don't cut back on liquids, as this can lead to dehydration and urinary tract infections. However, you can reduce the amount you drink before bed to limit night-time bathroom trips.

Frequently asked questions