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Pregnancy Insomnia: Symptoms, Causes, Treatment And Remedies

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Sleep deterioration is one of the natural consequences of pregnancy. The growing bump, frequent urination, leg cramps, or even the anxiety about the baby’s arrival could all make it difficult for you to sleep.
A study by the US National Sleep Foundation states that 78% of pregnant women report sleep disturbances (1).
This MomJunction post throws more light on the causes, associated symptoms, and remedies for insomnia during pregnancy.

Pregnancy Insomnia And Its Symptoms

Pregnancy insomnia is the difficulty in falling asleep or remaining asleep during pregnancy. In general, you may perceive it as a poor-quality or inadequate sleep. Though a miserable condition, it is unlikely to harm your growing baby.

It is usually normal to experience insomnia during pregnancy. The incidence may be highest in the third trimester than the first and second trimesters because of the increasing abdomen size and perception of labor (2).

You may probably have one or more of the following symptoms that might indicate insomnia in pregnancy (3).

  • Trouble in falling asleep during the night
  • Waking up frequently during the night
  • Waking up too early
  • Not feeling that you have adequately rested, even after a full night’s sleep
  • Feeling sleepy during the day
  • Daytime tiredness
  • Depression and irritability
  • Difficulty paying attention
  • Increasing worries about sleep

What Causes Insomnia In Pregnancy?

You could experience sleepless nights because of the following conditions.

  1. Backache: With the growing uterus, the back muscles are strained as the abdominal muscles stretch. It may result in low back pain and discomfort where the pain may worsen during nighttime leading to sleep disturbance in some pregnant women (4). Also, the prolactin hormone in pregnancy causes ligaments to relax, which could lead to backache and discomfort.
  1. Heartburn: The growing uterus misplaces the intestines and the lower esophageal sphincter, which pushes the stomach acids up, back to the esophagus. They become bothersome in the third trimester and may disrupt sleep (5).
  1. Restless leg syndrome: Improved blood circulation and the bump’s pressure on the nerves and muscles may lead to leg cramps. Also, RLS is common in the third trimester and is associated with frequent limb movements during sleep. These changes might cause a disturbance in the sleep, leading to insomnia (6).
  1. Shortness of breath: Your growing uterus applies pressure on the diaphragm, which is underneath the lungs. This increased pressure could make it difficult to hold the breath, making it difficult to sleep (7) (8).
  1. Snoring: The nasal passages swell during pregnancy, increasing your risk of snoring. Also, the extra pressure from the growing circumference could make the snoring worse. This might block breathing during sleep, forcing you to wake up multiple times during the night (9).
  1. Anxiety: The excitement, worry, and thoughts about the baby, labor, and changes in lifestyle could give you sleepless nights (10).
  1. Stress: Though pregnancy is a time of relaxation, you may often find yourself stressed. Stressing about labor and parenthood might give you the jitters and disturb your sleep pattern (11).

Identifying the actual cause could help in finding an effective solution for pregnancy-related insomnia.

Can Insomnia Be An Early Sign Of Pregnancy?

Insomnia can be common during pregnancy, but it is not an accurate early indicator of pregnancy. It is because insomnia may not present as a sign of pregnancy in some women, and insomnia can occur in non-pregnant women as well.

Tips To Reduce The Risk Of Pregnancy Insomnia

The following tips might help in reducing the sleep disturbances, and optimize your pregnancy sleep.

  1. Do not drink water before sleep time: If your sleep is getting disturbed due to frequent bathroom trips in the night, then limit your intake of fluids before you go to sleep.
  1. Limit caffeine intake: Avoid caffeine before bedtime. Tea, coffee, chocolate, and beverages have caffeine content that might keep you active during the night.
  1. Drink lots of water during the day: Dehydration could lead to leg cramps, so have enough water during the day. Keeping your body hydrated may help to eliminate toxins (11).
  1. Have a balanced diet: Eat a healthy and balanced diet of organic fruits and vegetables, proteins, good fats, and leafy greens and vitamin B-rich foods. The deficiency of vitamin B6 could also lead to insomnia (12). Also, leg cramps associated with insomnia could be due to insufficient intake of some nutrients, especially magnesium (13)
  1. Follow exercise routine: Aim to exercise for at least 30-minutes every day. You may walk or enroll in specialized swimming or prenatal yoga or pregnancy exercise classes. Exercising releases hormones in the body and could help lower the risk of anxiety and depression (14).
  1. Have a warm water bath every evening: A warm bath is relaxing and refreshing and promotes a good night’s sleep. It may also help reduce pregnancy pains and aches.
  1. Write a to-do list: Make a comprehensive list of all the things to do at this time. Create a schedule and stick to it. Having a rigid plan might help you to be in control and lower stress levels and could promote peaceful sleep.
  1. Be open: If you are worried, stressed, or anxious, talk about it with your partner or with anyone you are comfortable talking. Talking about your feelings may lighten the burden and keep your stress levels under control. Have a support system of people that may reassure you and help you in need.
  1. Pillows for comfort: You may use extra pillows to support your bump, and in between your knees for a comfortable night’s sleep. Invest in a pregnancy pillow, which is specifically designed to support pregnant women.
  1. Try doing something if not sleepy: If you are not able to sleep, get off the bed and try reading a book, listening to music, or doing anything else that could make you feel drowsy. Also, gentle yoga and relaxation exercises might make you feel sleepy.
  1. Sleep at different intervals: Take naps during the daytime whenever possible. Go to bed early, or sleep for extended hours in the morning. This may help you to make up for the sleep you lost during the night.
  1. Stay away from electronic gadgets: Electronic screens and devices might affect your mind by interrupting your sleep pattern. They emit blue light that could interfere with your sleep cycle. The signals from blue light keep you awake and stressed, and therefore it is better to stay away from light rays after sunset (15).
  1. Indulge in sex: It might help in releasing feel-good chemicals, the endorphins that relax you, and help you sleep.
  1. Visualization exercise: Lie down in a cozy place and think that you are in a beautiful location, such as the countryside or the beach. Breathe deeply and focus on your exhalation. As you breathe, your body and mind relax, which could promote sleep (16).

The use of herbs may also promote a good night’s sleep. Read more about it in the next section.

Natural And Alternative Remedies For Pregnancy Insomnia

Here are a few natural ways that may induce sound sleep.

1. Aromatherapy with essential oils

  • Oils of lavender, chamomile, and ylang-ylang could comfort your nerves (17). Take around two to three drops of any of these oils on a tissue paper and place it under your pillow.
  • A warm shower before you go to bed offers both warmth and relaxation. Adding a few drops of essential oil to the bathwater makes it better.
  • Avoid using a vaporizer, if you are, for more than 20 minutes as it might cause nausea or a headache.
  • Get a neck and shoulder massage with the recommended essential oils, after diluting them with grapeseed oil or olive oil.

These aromatherapy uses of essential oils are based on the common beliefs of the people and lack adequate support from scientific research.

2. Bach’s flower remedy

The homeopathy solution contains brandy and extracts of flowers. It might ease the tension and general stress. There is no proper evidence to support this theory, but most women find it helpful.

  • If you happen to wake up in terror at night, due to a bad or a vivid dream, then take two drops of Mimulus to beat fear and Rock Rose to fight terror (18).
  • Weariness, which could be a result of improper sleep during the night, could be treated by hornbeam.

3. Herbal teas

Some herbs have relaxing and soothing properties and might be effective in inducing peaceful sleep (19).

  • Valerian, kava, and St. John’s wort could be helpful.
  • Add one tablespoon of these dried herbs to one cup of boiled water. Allow it to steep for one hour, strain, and warm it up again before consumption.
  • You may have one cup each in the morning, afternoon, and night.
  • Do not take Valerian tea during the daytime as it has sedative properties.

4. Cherry juice

Tart cherries are a source of melatonin and a good alternative to hypnotic drugs. Consuming cherry juice twice a day is likely to reduce the intensity of insomnia. However, further studies are needed to know about its actual mechanism (20)

5. Cognitive-behavioral therapy (CBT)

It works by identifying and dealing with the thoughts and actions that affect your sleep pattern. The treatment employs different methods to target your sleep problems to improve sleeping habits and mood (21).

6. Acupuncture

These therapies may be helpful in reducing anxiety, stimulating melatonin production, and promoting undisturbed sleep, thus minimizing the risk of insomnia (22). Pressure points that are believed to work for insomnia include the Heart 7 (inner wrist crease towards the little finger side), Urinary bladder 10 (in the depression of the nape), Conception vessel 17 (center of the breastbone) and Kidney 6 (inside of the ankle bone). But further research is needed to establish their effectiveness.

7. Massage therapy

Studies report improved mood, reduced anxiety, better sleep, less back pain, and decreased stress levels with massage and relaxation therapies (23).

Always consult your doctor before trying out any natural and alternative medicines.

Some form of insomnia in pregnancy is likely to be normal and common. Moms adapt to less sleep, which is an instructive way of helping new moms adjust to reduced sleep by the time the baby is born. In case insomnia turns debilitating, or anxiety-provoking and unmanageable, seek medical advice.

Do you have something to share about pregnancy insomnia? Let us know in the comment section below.

References:

1. AM Hashmi et al.; Insomnia during pregnancy: Diagnosis and Rational Interventions; Pak J Med Sci. (2016)
2. A Kızılırmak, S Timur, B Kartal; Insomnia in Pregnancy and Factors Related to Insomnia; ScientificWorldJournal. (2012)
3. Insomnia; The Ohio State University Wexner Medical Center
4. Jennifer Sabino and Jonathan N. Grauer; Pregnancy and low back pain; Curr Rev Musculoskelet Med (2008)
5. Sleep and Pregnancy; American Academy of Family Physicians; familydoctor.org (2017)
6. R. Gupta et al.; Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment; Acta Neurol Scand (2017)
7. 5 Facts About Insomnia; Rush University Medical Center
8. Dyspnea (Shortness of Breath); Rush University Medical Center
9. Sleeping By the Trimesters: 3rd Trimester; SleepFoundation.org
10. Jodi A. Mindell et al.; Sleep patterns and sleep disturbances across pregnancy; Sciencedirect Journal; Elsevier (2015)
11. Carolina Marcus and Brenda A Seaman; Maternal Sleep & Sleep In Infants; University of Rochester Medical Center, NYS Maternal & Infant Health Center of Excellence (2017)
12. K L Lichstein; Vitamins and Sleep: An Exploratory Study; Sleep Med. (2009)
13. Khalida Shaikh et al.; Magnesium Associated Complications in Pregnant Women; World Applied Sciences Journal 17; The Pennsylvania State University (2012)
14. Reviewed by S Pusalavidyasagar, A Manvikar; Manage Insomnia Naturally; University of Minnesota
15. HengYu Chi; Effects of Screen Light Filtering Software on Sleep and Morning Alertness; Central Washington University (2017)
16. Overcoming insomnia; Harvard Mental Health Letter
17. Aromatherapy; Mercer University
18. Dr. B Deekshitulu P V; Coping With Stress the Bach Flower Way; The International Journal of Indian Psychology (2014)
19. M Sharma et al.; A Comprehensive Pharmacognostic Report On Valerian; International Journal of Pharmaceutical Sciences And Research (2010)
20. Wilfred R. Pigeon et al.; Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults with Insomnia: A Pilot Study; J Med Food. (2010)
21. Tomfohr-Madsen LM et al.; Sleeping for Two: An Open-Pilot Study of Cognitive Behavioral Therapy for Insomnia in Pregnancy; Behav Sleep Med. (2017)
22. da Silva JB et al.; Acupuncture for insomnia in pregnancy–a prospective, quasi-randomised, controlled study.; Acupunct Med. (2005)
23. D Hollenbach et al.; Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review; J Can Chiropr Assoc. (2013)
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