Insomnia during pregnancy

Pregnant women often experience insomnia; sleep disturbances are among the most common side effects of pregnancy. The very architecture of the sleep cycle can change in pregnancy. In the third trimester such disorders as sleep-disordered breathing and restless leg syndrome often appear. The first trimester more frequently sees the worst insomnia though; this is probably due to the initial changes in the serum hormone profile. Indeed, there are differences in sleep architecture between younger women and post-menopausal women, even aside from pregnancy. Pregnant women experience changes in core body temperature as well as melatonin, cortisol, thyroid stimulating hormone (TSH), and prolactin levels. Increased risks of insomnia coincide with the late luteal phase of the menstrual cycle, during and after pregnancy, and during the peri-/postmenopausal period.

Three trimesters were sometimes designated in folklore: weary, cheery, and dreary. There is some truth to this with regard to the sleep cycle. Women in the first trimester are prone to sleepiness due to higher levels of progesterone and nighttime urination which interrupts sleep. Surveys show about a quarter of women experience first trimester sleep disturbance.

Pregnancy affects sleep through hormonal changes, physiologic changes, physical factors, and behavioral changes. Snoring and sleep apnea become more common as the woman gains weight.

Some doctors do allow their patients to take antihistimines during pregnancy, but as always when pregnant, consult your doctor before taking any medication, over-the-counter or otherwise, when pregnant.

The third trimester is the worst as far as sleep for the new mother. Three quarters of women report sleep disturbances in the final trimester due largely to the combination of hormone changes and the physical discomfort of an expanded belly. The sleep disorder Restless Leg Syndrome, which is fairly rare, strikes 15% of women in the final trimester, although it almost always disappears after birth. Many women also start snoring during pregnancy because the nasal passages swell. If the snoring escalates to apnea, the doctor should be immediately informed, as apnea cuts off air supply and can contribute to hormone surges. Snoring and sleep-disordered breathing in pregnant women has been connected to an increase in preeclampsia. When women are at risk for preeclampsia become pregnant, their doctors screen them for snoring and sleep apnea. Sometimes these women are asked to be tested in a sleep study.

Postpartum depression often results in insomnia, and sometimes insomnia contributes to postpartum depression. If the latter is the case, it is important that the insomnia be treated.

More on sleeping problems in women

Mayo Clinic on insomnia

Cleveland Clinic on insomnia

Sleep Disorders

Dyssomnias

Parsomnias

"It’s been a hard day’s night
I’ve been workin´ like a dog
It’s been a hard day’s night
And I’ll be sleepin´ like a log…. "

(John Lennon and Paul McCartney)