Getting a good night’s sleep when pregnant, especially during the third trimester, can be frustratingly out of reach when you need it most.
Pregnant women need their sleep, says Dr Mokgohloe Phasha, an obstetrician-gynaecologist, practising at Netcare Park Lane Hospital. “Sleep disturbance occurs commonly in pregnancy, although many women tend to simply persevere in the belief that it is part and parcel of pregnancy.”
causes of insomnia
“Disturbed sleep is common during pregnancy. However, some of the potential causes can be managed,” she says.
Some causes of insomnia are specifically pregnancy-related, such as:
- severe nausea and vomiting
- frequently needing to urinate because the uterus is pressing on the bladder
- aches and pains associated with pregnancy,
- heartburn and dyspnoea or difficulty breathing – particularly in the third trimester.
“Some women may experience carpal tunnel syndrome with swollen hands and painful wrists that keep them awake at night. Pregnancy-related hormones may also cause expectant mothers to feel drowsy and sleepy during the day,” Dr Phasha explains.
Dietary factors that may contribute to sleeplessness include excessive caffeine intake and micronutrient deficiencies, such as magnesium, which can lead to restless leg syndrome.
“Pregnancy can be overwhelming for an expectant mother and may worsen symptoms of anxiety for women who have a pre-existing anxiety disorder. It may also lead to the onset of anxiety in women not previously diagnosed with an anxiety disorder. Anxiety can significantly contribute to insomnia if not appropriately addressed in consultation with your obstetrician,” Dr Phasha notes.
Medical causes like sleep apnoea should also be investigated if sleep disturbance is persistent, as this can potentially negatively impact the mother and baby’s wellbeing.
“More women report insomnia in the third trimester than in any other, according to studies,” says Dr Pasha. “This can be explained by a surge in progesterone and an enlarged uterus, making it uncomfortable for them to sleep on either side. “We discourage pregnant women from sleeping on their back or stomach at this advanced stage of pregnancy.”
Read our article on how to cope with common pregnancy ailments.
playtime in utero
Another obstacle is that babies in the womb do not follow the same sleep-wake patterns as their mother. “It may be night-time for the mother, but it may be playtime in utero for her unborn baby. Vigorous foetal movements during this time can often cause a pregnant mother to waken,” she says.
quality sleep matters
Dr Phasha explains that while sleep is vital for everyone’s health, new research suggests there may be lasting developmental effects for children of mothers who are significantly sleep-deprived during pregnancy.
“The value of sleep for foetal, pregnancy, and postpartum outcomes should not be underestimated. There is some evidence to suggest that women who sleep for less than seven hours could be at higher risk of developing insulin resistance or gestational diabetes. While their children could potentially be at greater risk of neurodevelopmental delays in areas including social, emotional, behavioural, motor, cognitive or speech skills.”
tips for pregnant women to help improve their sleep
- Report symptoms of sleep disturbances to your obstetrician or healthcare team.
- Avoid taking naps during the day to help you sleep better at night.
- Steer clear of caffeinated drinks or hot, spicy food.
- Eat an early supper (before 6pm) to allow time for sufficient gastric emptying before bedtime. This will help reduce the severity of heartburn.
- Stay physically active with moderate exercise throughout pregnancy.
