Written by Dr.M.D.Mazumdar, MD
For many pregnant women, being unable to fall asleep at night is a very real problem.
Some women complain that they do manage to fall asleep but wake up again in the middle of the night and then stay awake for a very long time. Insomnia occurs mainly in the early pregnancy, becomes better in the second trimester and can again increase in the later part of pregnancy.
Causes of Insomnia
Hormonal imbalances in pregnancy are the main cause of insomnia. Progesterone, which is secreted in large amounts throughout pregnancy but has a surge in the first trimester has a strong effect on insomnia. Other hormones also increase in various degrees and this imbalance can cause differences in the metabolism of food, in the blood flow and in your psychological bearing.
Physical discomforts like heartburn, backpain, leg cramps can keep you awake.
Movements of the baby which appear to increase at night can disturb you. It is a common misconception that babies move more at night. But they only appear to do so because you are rest and are more aware of the movements.
Fears of the coming labour and childbirth. You may have concerns about your health or the baby's health and may worry about miscarriage /abortion. There may even be more specific reasons for anxiety, such as financial worries. An unplanned pregnancy is another cause for anxiety and keeping you awake at night.
Dreams which are usually the result of your subconscious fears can wake you up and prevent you from going back to sleep.
Increased frequency of passing urine can wake you up repeatedly. In the first trimester, the uterus is small and remains inside the pelvic cavity. It pushes against the bladder decreasing the bladder capacity to fill with urine. So you need to pass urine more frequently. In the last trimester, the large uterus once again presses against the bladder and causes frequent need to pass urine.
Uncomfortable body positions while sleeping in the last trimester can cause difficulty in sleeping. Backaches and leg cramps are also more common in this trimester.
What you can do to control Insomnia
Improve the posture you sleep in.Lie on the left side of your body - this increases the blood flow from the lower limbs to the heart and increases your comfort level. Since there is no pressure on the large blood vessels to and from the heart while sleeping in this posture, it improves blood supply to the baby.
Make a bedtime routine. Try to go to sleep and get up at the same time every day. Keep the room cool and dark. Light reading, soothing music, gentle yoga poses or relaxation exercises, a warm bath can also help.
Avoid screen time at least an hour before bed. Blue light from the TV, your mobile phone, or tablet can have an impact on your body’s circadian rhythm.
Place a pillow under your belly for support when you lie on your side. This will decrease the dragging sensation on the skin around your abdomen and back.
Place a pregnancy pillow, either C-shaped or S-shaped under the upper leg while sleeping, to support it so that the knee is more or less at the same level as your hips.
If your breasts are sore, invest in a good sleep bra made of soft cotton to support the breasts as they enlarge during pregnancy.
Elevate your head and upper back on a couple of pillows so that they are at a higher level than the lower part of your body. This will prevent heart burn as well as a stuffy nose. Avoid spicy foods.
You can invest in a good quality wedge or pregnancy pillow. This is a C-shaped or S-shaped pillow that can support your belly and upper leg. You can also use it later to support the baby while breastfeeding.
Cut back on the amount of fluids you drink after 6 pm at night. This will decrease the frequency of passing urine at night.
Avoid stimulants like caffeine and alcohol at least 4-6 hours before you go to bed.
Wear earplugs and an eye mask if noise and light wake you up. If you stay in an urban area, especially near a street, sounds of cars or other sounds can keep you awake.
If an itchy, dry skin is keeping you awake, apply a moisturizing lotion liberally before you go to sleep at night.
Other natural sleep aids like a glass of milk before going to bed, a warm shower or bath and 1-2 drops of chamomile or lavender on a tissue placed on the pillow are all known to have sedative effects.
Ask your doctor for a sedative if bad dreams are keeping you awake or you feel that the lack of sleep is affecting your health. Phenobarbitone 30 mg at night (available as gardinal tablets) have no side effects on the baby and can be used safely during pregnancy. Melatonin, Tryptophan and 5 HT are natural sleep tabets and can help you to control your insomnia.
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