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Are pregnant women sleeping for two?

by Dr. Adrian Williams

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We know that pregnant women have difficulties sleeping, but why? And what can they do about it?

Why does pregnancy affect sleep?

With a new baby in the house, we expect our sleep to be disturbed. But for many pregnant women, this begins many months prior to the arrival of their newborn. In fact, surveys have indicated that three out of four expectant mums experience interrupted sleep at some point during their pregnancy. (A form of preparation, perhaps!) It’s common to feel tired – even exhausted – but why does the developing baby influence the mother’s sleep? Are pregnant women sleeping for two?

What’s happening in the body

A few different changes create conditions which interfere with sleep. Hormonal changes, particularly an increase in progesterone, may lead to drowsiness. Cardiovascular changes, for example a doubling of the volume of blood circulating, means more urine is produced, along with nasal congestion when lying down to go to sleep. And then there are physical changes, with the growing uterus compressing the bladder and pushing up the diaphragm so that the lungs become smaller.

Restless legs, a condition which is common later in life, also affects pregnant women. These painful leg cramps and spasms are said to relate to magnesium deficiency, and at least one in six women experiences discomfort in her thighs or calves, or a creepy-crawly sensation that results in the need to move the legs, thus disturbing sleep. The lack of sufficient iron stores, so common in the childbearing age, is often responsible, so it’s important to keep watch on iron levels.

A third of women report heartburn, another progesterone-related condition which relaxes the sphincter muscles of the esophagus, allowing acid to “reflux” from the stomach. Snoring also increases due in part to nasal congestion and the compression of the lungs by the growing uterus. Why is this important? Well, it disrupts the snorer’s sleeping partner, of course, whose gentle nudge then disrupts the snorer. But snoring can be a marker for something more sinister – sleep apnea – which affects blood pressure and can lead to preeclampsia. Clearly not all snorers have this, but it is always good to get it evaluated.

So what should you expect, then? In the first trimester, drowsiness and more frequent trips to the bathroom during the night. Luckily, symptoms of morning sickness are rare at night. In the second trimester, which is usually better, you might experience some restless legs and heartburn. In the third trimester, you’ll likely snore and have difficulty finding a comfortable position to sleep.

Tips to help you sleep

Sleep is important at any stage of life, including pregnancy. Therefore, prioritize sleep as much as possible and consider these healthy sleep solutions:

  • Avoid caffeine

  • Drink plenty of water – up to two litres during the day though less in the evening

  • Exercise regularly

  • Put a nightlight in the bathroom so you don’t have to turn on bright stimulating lights

  • Have a light snack before bed (protein and complex carb, or perhaps warm milk)

  • Try a warm bath

  • Make sure your room is comfortably chilled

  • In the third trimester, sleep on your left side, and if there is restlessness in the legs, have your iron levels measured

  • If snoring is an issue, have it checked out, just to be on the safe side

  • Get some Headspace, of course

In Chinese medicine, the law of Mother and Child notes that if the mother is unhappy, the child will suffer. So if that the mother gets more sleep during pregnancy and after, the well-being in the household is better maintained. Let the lovely lady sleep.

Dr. Adrian Williams

Dr. Adrian Williams is the UK's first Professor of Sleep Medicine with a lifetime of experience in the field. This began at Harvard, followed by many productive years at UCLA, and now London. His clinical experience is extensive; his research has encompassed most areas of sleep, with his current interest focused on meditation as a way of improving sleep and, as a natural consequence, health.

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