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Healthy Woman

Sexual & Reproductive Health

Get a Good Night’s Sleep During Pregnancy

pregnant woman in bed

Pregnancy is a magical time in many ways, but your sleep schedule during these nine months might be less than dreamy. The growing belly, the aches, the pains, the heartburn — many women experience sleepless nights long before there’s a hungry, crying infant in the picture.

Having trouble sleeping is common during pregnancy, says Grace Pien, M.D., M.S.C.E., assistant professor of medicine at the Johns Hopkins Sleep Disorders Center. A growing belly, pressure on the diaphragm, increased urinary frequency, gastroesophageal reflux disease (GERD) and restless legs syndrome (RLS) are just a few of the hurdles standing between you and a restful night.

Changes can begin as early as the first trimester, when women feel drowsier than normal due to a spike in progesterone, a hormone made by the ovaries and the placenta during pregnancy. The second trimester often brings some relief, says Pien. But by the third trimester, it can become hard to find a comfortable sleeping position. At this stage, high levels of estrogen can also cause some women to develop rhinitis (swelling of the nasal tissue), which can be associated with snoring and obstructive sleep apnea

How Lack of Sleep Affects Pregnancy

Lack of sleep is more than an inconvenience. New research suggests that women who don’t get enough sleep during pregnancy may have higher risks of developing pregnancy complications including: 

  • Preeclampsia, or high blood pressure
  • Gestational diabetes 
  • Longer labors and higher rates of cesarean section, particularly among women who get fewer than six hours of sleep over the course of 24 hours

Restless Legs Syndrome and Pregnancy

Restless legs syndrome (RLS), an uncontrollable urge to move the legs while at rest, is usually associated with older adults. But it’s also one of the most common reasons for sleeplessness during pregnancy. 

RLS typically occurs in the evening, often when you get into bed. Though it’s uncomfortable, there is a silver lining: It doesn’t last forever. “It does get better after delivery and actually pretty quickly, within the first week or so,” Pien says.

RLS is often linked to anemia, which is common in pregnant women. Talk to your doctor about taking prenatal vitamins and supplements, such as folic acid and iron, to keep anemia under control.

How to Get Enough Rest While Pregnant

You’ll probably endure plenty of sleepless nights once the baby arrives, so it’s important to get enough sleep while you can. For occasional help, over-the-counter remedies containing diphenhydramine are fairly safe, Pien says. 

For more chronic sleep problems, lifestyle changes like abandoning television and electronics before bed are helpful. Pregnant women should not underestimate the effect of stress on their sleep. Stress reduction techniques are essential.

“It's clearly a time when there are a lot of biological changes going on, but, in addition, expectant parents may be moving homes or just trying to figure out what they’re going to do after the baby is born,” Pien says. “There can be a lot of other stressors, and sometimes the first chance that people get to think about it is when the lights go out.”

She suggests making to-do lists for the next day before bedtime to avoid taking stress to bed with you.

Once the baby comes, make sure to prioritize sleep, even though your lifestyle will change.

“People are going to want to come over, but don’t worry so much about making sure that the house is clean and all of that,” she says. “Set priorities around getting enough sleep, and know that it’s going to take a few months.”

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