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Insomnia in pregnancy: see possible causes and tips to combat

Pregnancy is a phase of many changes in a woman’s life. Among them, insomnia in pregnancy is a frequent report, which usually generates a lot of discomfort and even some concern. After all, “is it normal”? Check out the answer to this question and see possible causes for the pregnant woman’s difficulty falling asleep, staying asleep or both.

Is it normal to lose sleep during pregnancy?

Gynecologist and obstetrician Karina Tafner (CRM-SP 118066), specialist in Gynecological Endocrinology and Human Reproduction and in Assisted Reproduction, says yes. “Sleep disorders are very common in pregnancy and, among them, insomnia is one of the most frequent, experienced by pregnant women, affecting approximately 78% of pregnant women”, she says.

Possible causes

Karina highlights that the duration and changes in sleep quality related to pregnancy can occur due to several interrelated mechanisms, among which she briefly quotes:

  • Hormonal changes;
  • Physiological changes;
  • Metabolic changes;
  • Psychological changes;
  • Postural changes.

Women can experience insomnia during all stages of pregnancy, as Karina points out, but it tends to be more common in the first and third trimester.

Insomnia in the first trimester

The gynecologist explains that problems and changes in sleep patterns begin during the first trimester of pregnancy, probably influenced by rapid hormonal changes. “In human pregnancy, hypersomnolence is a common complaint during the first trimester, mainly due to the increase in progesterone, a hormone that can also cause decreased muscle tone, increased risk of sleep apnea, snoring and sleep interruptions”, comments Karina.

Insomnia in the second and third trimester

Karina points out that total nighttime sleep time decreases towards the end of the second trimester (23-24 weeks of gestation). “Most women experience sleep problems in the third trimester, with over 98% reporting nighttime awakenings due to general discomfort caused by back pain, increased urinary frequency, fetal movements, GERD (Gastroesophageal Reflux Disease), shortness of breath and discomfort in the legs, such as cramps”, he explains.

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Another point to be considered is that anxiety is very common during pregnancy, as the gynecologist comments, with thoughts and concerns about labor, what the new life will be like with the arrival of the baby, etc. “These thoughts can keep the expectant mother up at night,” she says.

Does insomnia in pregnancy harm the baby?

“For whatever the reason for insomnia during pregnancy, it is important to understand that it is not harmful to the baby, but to the pregnant woman”, considers Karina. Insomnia causes daytime hypersomnia, fatigue, and mood swings. “It can also negatively affect the relationship with the partner and interfere with the mother-baby bond”, explains the gynecologist.

In addition, sleep disturbances in the third trimester are associated with increased perception of labor pain. “Patients with insomnia have high pro-inflammatory cytokines, which are also seen in postpartum depression, preterm birth, and other pregnancy complications,” she explains. “Physicians should address sleep disorders immediately because they increase the risk of complications such as depression in the late third trimester or after the child is born.”

16 tips to fight insomnia in pregnancy

To treat the problem, Karina explains that it is important for the doctor to ask about difficulties in starting sleep, maintaining or waking up and understanding environmental and behavioral factors. “Obtaining a complete medical history, including risk factors, is essential for diagnosis and treatment, and early intervention is recommended.” According to the gynecologist, some measures that can be used to combat insomnia during pregnancy are:

  1. Use dim night lights in the bathroom: Bright light can make it difficult to get back to sleep.
  2. Be careful with fluids: drink plenty of fluids throughout the day, but limit your intake after 5pm to decrease frequent urination.
  3. Avoid caffeine and chocolate: these foods should be avoided especially in the late afternoon or evening.
  4. Avoid foods that cause heartburn: spicy, heavy and fried foods contribute to heartburn.
  5. Take daytime naps: prefer morning naps if necessary.
  6. Exercise: If clinically appropriate, exercise 30 minutes every day, preferably 4 to 6 hours before bedtime.
  7. Keep the environment comfortable: it is important that the bedroom provides the necessary comfort for a good night’s sleep.
  8. Avoid other activities when you’re in bed: eating, watching TV, playing video games or making long phone calls can keep you up at night.
  9. Avoid cell phone: at least an hour before bed, avoid screen time (especially cell phone).
  10. Take care of the position: sleeping lying on your left side, with your knees and hips bent and with pillows between your knees, below your abdomen and behind your back, helps to reduce pressure on your lower back.
  11. Have a routine: try to sleep and wake up at the same time each day to reset your internal clock.
  12. Use relaxation techniques: one of them is progressive muscle relaxation (PMR), which includes alternating contraction and relaxation of different muscles, before each sleep period.
  13. Take care of breathing: use deep abdominal breathing with relaxing thoughts before bed.
  14. Use the bed only for sleeping: adopt this habit and don’t use the bed to lie down at other times of the day or to watch television, for example.
  15. Do stimulating things: If you can’t sleep, get up and do something minimally stimulating, like taking a hot bath, knitting, reading a light book, etc. Staying in bed and worrying perpetuates insomnia.
  16. Use cognitive therapy: It should be aimed at anxiety, catastrophic thinking about not sleeping, and developing realistic expectations about sleep duration.
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Karina points out that sleep aids are often considered safe for occasional use during pregnancy. “However, you should never take any sleeping pills or other medications during pregnancy (prescription, over-the-counter, or herbal) unless it has been prescribed or approved by your doctor,” she warns. The same goes for chamomile, valerian, or lemon balm teas, which have calming properties that help you relax.

Controlling anxiety is essential to avoid insomnia in pregnancy. Pregnancy is a phase that generates doubts and anxieties, but these must be taken to the obstetrician so that he can clarify such questions and, thus, they do not make you “lose sleep”. Also know the symptoms of urinary tract infection in pregnancy.

Tais Romanelli

Journalist graduated in 2009 (58808/SP), freelance writer since 2013, totally adept at working from home. Communicative, always full of topics to talk about and inspiration to write. Responsible at work and outside of it; dedicated to commitments and the people with whom she lives; in love with family, dogs, home, the sea, moments of tranquility and also excitement.

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