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Sleep during pregnancy is extremely important. In fact, if one thing is certain, it is that among the major issues to be taken into account in pregnant women or young parents is that of sleep. Primarily for parents and children alike, the quality of sleep can influence the physical and mental health of the family and make daily life more complicated. Hence the importance of putting into practice certain habits and measures that will promote healthy sleep patterns in pregnant women.

Why is sleep so important during pregnancy?

Sleep is important during pregnancy because it affects not only the expectant mother but also her unborn baby. The immune system itself can be affected by a lack of sleep which can have consequences for the fetus. If there are real sleep disturbances, they should be identified early in pregnancy since there is a dynamic relationship between sleep and immunity. The faster these disorders are detected, the easier it is to find solutions with the expectant mother, who should not hesitate to talk to her doctor.

A dynamic relationship between sleep and immunity

Cytokines are important for many processes related to pregnancy and in excess, they attack and destroy healthy cells, destroy certain tissues in pregnant women and inhibit their ability to defend themselves , as well as their baby, against certain diseases. In fact, in pregnant women, excess cytokines can also disrupt the spinal arteries leading to the placenta, cause vascular disease, lead to depression and promote prematurity. Previous postpartum studies have already shown higher concentrations of inflammatory cytokines in women with unfavorable pregnancy outcomes such as preeclampsia and preterm birth. Although infection accounts for half of these unfavorable results, researchers show that certain behavioral processes such as disturbed sleep can play a key role, given this relationship between sleep disturbances and immune function. Finally, they point out that these higher concentrations of inflammatory cytokines are particularly found in depressed pregnant women.

Addressing sleep disorders in pregnant women

Pregnancy causes many physiological, hormonal, morphological and even psychological changes that can influence and disrupt the sleep architecture of pregnant women. The quality and duration of sleep are reduced during pregnancy, sleep is shallower and more sensitive to noise or light.

These disorders becomes more and frequent as the pregnancy progresses. In fact, at the start of pregnancy, women who complain 11 of sleep disorders would represent about 75.1% while in the 3rd quarter they would be 93.3%.

In the 1st trimester, the pregnant woman is under the influence of hormonal changes and more particularly the increase in progesterone, a hormone known for its sedative effect which explains the increase in sleep time and the presence of daytime sleepiness with the need for naps. However, the effectiveness of sleep decreases in comparison with the period before pregnancy. Nightly awakenings are infrequent, but sleep can be disturbed by the minor ailments of pregnancy (nausea, vomiting, pollakiuria).

In the 2nd trimester, the total sleep time decreases, nocturnal awakenings are more frequent always linked to the “little ailments” of pregnancy but also to other causes such as increased nightmares, nighttime cramps, low back pain and restless leg syndrome.

In the 3rd trimester, the decrease in sleep time becomes more pronounced. At this time, a pregnant woman sleeps on average less than 8 hours per night. The sleep itself changes in its composition with a greater proportion of light slow sleep phases and awakenings associated with even more frequent nocturnal awakenings. They are particularly related to active fetal movements (AFM), pollakiuria, difficult positioning, ligament pain, uterine contractions (UC), low back pain, gastroesophageal reflux disease, cramps, causing increased sleep disturbances.

Furthermore, due to respiratory changes (reduction in the size of the airways, nasopharyngeal changes, etc.), increased fetal volume (ascension of the diaphragm) and hormonal variations, there is more difficulty breathing and more snoring in the 3rd trimester. The number of slow deep sleep phases decreases. This has the consequence of limiting the restorative effect that sleep should provide.

As childbirth approaches, some women are more anxious, pregnancy is a time when psychological changes may appear. Indeed, it is a moment where the woman may feel vulnerable and have anxieties, worries reverberating on her sleep. The 3rd trimester of pregnancy is therefore characterized by increased snoring, sleep disturbances, daytime fatigue, decreased daytime alertness and poor sleep.

Weight is the main risk factor influencing changes in sleep and needs to be taken into account. A woman with excessive weight gain during pregnancy is at greater risk of reporting abnormal sensations in the legs, frequent nighttime awakenings, and excessive daytime sleepiness. Likewise, a woman with a body mass index (BMI) greater than 25 before pregnancy is more prone to snoring. Likewise, a statute

Likewise, a low socioeconomic status would influence the quality of sleep in pregnant women.

Pregnancy can therefore be marked by minor sleep disorders linked in part to the pregnancy itself and its physiological changes. But it can also predispose and /or cause sleep pathologies which can have repercussions on the maternal and fetal health.

Can I take medication to sleep better when pregnant?

During pregnancy, the use of drugs to help fall asleep is tricky because you have to choose a treatment that does not impact the development of the baby and does not cause any addiction. To avoid any problem, you should talk to your doctor about your sleep problems. He or she will decide whether to prescribe you drugs. Avoid taking over-the-counter drugs at all costs without consulting your doctor.

How to sleep better when pregnant

Sleeping during pregnancy is easier said than done! Pregnant, your hormones disturb your sleep, your nights are restless, you are tired during the day and your belly, which is growing, makes you feel uncomfortable to settle down. Here are 9 tips to apply month by month to sleep better while pregnant.

Between 1 and 3 months of pregnancy: find the right sleep rhythm!

During the first trimester of pregnancy, you are particularly tired due to your hormonal production and in particular the relaxing effects of progesterone. And you will have to get used to it for a while! During the first, second and third months of pregnancy, you are often prone to insomnia. Result: you constantly want to sleep, and your nights are generally not very restful. Rest assured: this state of drowsiness generally passes at the end of the 3rd month of pregnancy.

  • Tip 1:  Try not to nap too much

If you feel very tired during the day, give yourself nap time after lunch and / or on weekends. But be careful not to disrupt your sleep pattern, opt for short naps of less than an hour, preferably before 4 p.m.

  • Tip 2: rethink your bed

Gastric reflux and nausea in the first few months also disrupt sleep because they irritates your throat and makes you cough. In addition, from the 3rd month, estrogen causes swelling of the mucous membranes, which clog your nose and lead to snoring. To avoid those unpleasant situations, place a few pillows under your head and elevate your mattress so that your lying body is tilted about 30 degrees.

  • Tip 3: avoid the vicious circle of insomnia

Can’t sleep? Yes! But do not stay in your bed going around in circles, otherwise you will generate additional stress… and at the same time, put off sleep a little longer! If you’ve been awake for 10 minutes, get out of bed and indulge in some 15-minute relaxation activity: reading, meditating, etc. And then go back to sleep!

Between 4 and 6 months of pregnancy: no more fatigue, optimize your sleep!

As you enter the second trimester of your pregnancy, your nights become more peaceful, and you sleep like a baby again. To get good quality rest, take special care to eat a balanced diet and avoid activities that stimulate your body before bed.

  • Tip 4: avoid caffeine like the pest

Coffee is permitted to pregnant women in moderation (approximately 1.5 cups of coffee or three or even four cups of tea). Note, however, that these exciting substances are not immediately removed by the body. To sleep better, especially at 5 months or 6 months of pregnancy, stick to your morning coffee and stop consuming caffeine after 1 p.m. Even better, avoid it totally!

  • Tip 5: turn off the screens!

The computer screen or that of your smartphone is very bright, which stimulates your body and prevents you from getting in a good mood for sleep. An hour before going to bed, turn off the computer or the television. Opt for relaxing activity like reading, stretching, or a massage by your partner or self-massage.

  • Tip 6:  adopt a bedtime ritual

To fight against fatigue during pregnancy, nothing beats a bedtime ritual. The goal: to help your mind and body relax. Take the time to take a hot shower or bath and prepare yourself to sleep.

Between 7 and 9 months of pregnancy: put an end to fatigue with the right position

At the end of the second semester, your sleep disturbances return. You have trouble finding the right position to sleep because of your belly taking up space. Around the 6th month or the 7th month of pregnancy, your sleep becomes light, you are prone to insomnia and baby movements in your belly can wake you up in the middle of the night.

  • Tip 7: adopt the right position

At the end of the 2nd trimester of pregnancy, sleep on your left side instead. Indeed, in this position, the circulation of blood is facilitated because the vena cava, located on the right, is not being compressed. You can continue to adopt this position during the eighth and the 9th month of pregnancy, by placing a pillow under your belly and another between your knees.

  • Tip 8: stretch to avoid cramps

Night cramps, especially in the calf, are the daily lot of pregnant women! To prevent them, stretch before going to bed and elevate your bed slightly to promote venous circulation.

  • Tip 9: eat light!

To sleep well, your body temperature should be relatively low. Since digestion increases body temperature after dinner, it is best to wait at least 1 hour or even 1.5 hours before going to bed. In addition, a too abundant meal accentuates this phenomenon. So be sure to eat light and adopt a diet low in protein (meat, cheese, etc.), especially before bed.

Conclusion

If the quality of sleep plays a major role in our daily physical and mental health, this is all the more the case when we are about to welcome a newborn baby. It is essential to clearly identify the main risk factors upstream in order to be able to provide the appropriate solutions when the time comes.

Betsy Wilson

A true science nerd and pediatric nursing specialist, Betsy is passionate about all things pregnancy and baby-related. She contributes her expertise to the Scientific Origin.