Pregnancy Sleep Struggles: Why You’re Not Alone and How to Cope
I’ll be the first to admit that my pregnancy was worse than I could have possibly imagined. I know that sounds hyperbolic, but it honestly was. I say that because I want to have a super honest conversation about pregnancy and postpartum. Poor sleep is a major side effect of pregnancy, on top of all the other BS that comes along with it (looking at you, health problems, depression and anxiety). But there are things we can do to help!
I want to share with you some of the physical changes that underlie these experiences as well as get real about how to cope.
So first off, let’s chat about how hormones impact sleep during pregnancy. I gave a bit of a primer on reproductive hormones in my last blog, you can read about it here. So I’ll talk a little more about what happens during pregnancy.
Once the fertilized egg is implanted in the uterus all hell breaks loose in the body. Just kidding, but really there is a dramatic surge of hormones, the likes of which your body has never seen before (unless you’ve had a previous pregnancy).
First Trimester
Progesterone is a really important hormone here (it literally means pro-gestation). Its main goal is to keep the pregnancy going. It does this by making sure that the uterine lining is nice and thick to support a growing embryo. A side effect of this large dose of progesterone that we’re getting daily is extreme fatigue.
For me, the crushing fatigue made it really difficult to get out of bed. The nausea I experienced added insult to injury here because I couldn’t move without feeling sick. These aren’t necessarily bad things because they’re signs of a healthy pregnancy, however, laying in bed all day is a recipe for insomnia.
My Advice: try to find a comfortable spot to rest that is not your bed. If you nap, feel free to do that in bed, but if you’re awake and just needing physical rest, do so on the couch or in chair. Keep regular bed and wake times and stay consistent. If you’re feeling like you need more sleep feel free to expand your sleep window by setting an earlier bedtime or a later wake time, just keep it consistent. Finally, if nausea is severely impacting your daytime functioning, speak to your OB about medications. There are safe and effective medications for nausea and they can be a lifesaver. Do not live in misery being fearful of medications during this time, talk to your doctor about ways that you can get relief (and keep your sanity).
Second Trimester
By the second trimester, most women get a bit of a reprieve from symptoms but remember this is all relative. Just because you’re feeling somewhat better doesn’t mean that you’re 100%. You are still more easily fatigued and need to pace activities.
Your growing belly will also make for more general discomfort. The fetus pushing on your stomach will likely cause heartburn, you might experience leg cramps and frequent urination, and maybe even snoring as it becomes more difficult to breathe.
My Advice: If you are snoring much more than is typical for you or you start noticing that your sleep quality is really bad even after sleeping all night long or you are excessively sleepy, it’s really important that you mention that to your OBGYN. Some women do experience pregnancy-induced obstructive sleep apnea, which means you could be experiencing pauses in breathing while you’re sleeping. This is a dangerous condition, but it is easily treated. So make note of these symptoms and advocate for you and your baby’s health.
Third Trimester
I hate to say it, but the symptoms I just described will become more likely during the third trimester. That growing fetus is starting to get big and space is limited! Progesterone is working to help relax smooth muscles so that your uterus and other muscles can make room for baby.
Unfortunately, this relaxing of the muscles can lead to constipation and acid reflux. The reflux can be a big sleep disrupter. Additionally, high levels of estrogen can cause nasal congestion, increased body temperature, and heightened sensitivity to discomfort.
My Advice: If reflux is causing you issues, talk to your doctor about starting medication. A proton pump inhibitor helped me quite a bit and research indicates that it’s safe for baby, but definitely speak to your OB about it first! Additionally, nasal strips can be helpful for keeping your nasal passages open, which can help you breathe better during sleep. They aren’t cute, but honestly who cares by this point, right? Wear layers and keep the house cool. Layer your bedsheets as well so that if you get hot you can easily peel off a layer and get right back to sleep.
The Takeaway
These are just a few of many coping strategies. The message that I’m hoping to send is that suffering isn’t an inevitable part of the process. Yes, poor sleep is normal during pregnancy, but just because it’s normal doesn’t mean that there aren’t ways to find help. If you are really suffering, ask for help. And if you don’t get the help you need, ask louder. Advocate for yourself, because your emotional health during this time is important. I’m here if you need additional support for either your sleep or mental health. If you’re ready to chat, schedule a free 15 minute consultation call now.
