Pregnancy and Sleep
During pregnancy there is a pool of resources being distributed to two places, the mother and the fetus. For this reason, often women have reduced iron and folate levels that make them a little more vulnerable to conditions such as restless leg syndrome during pregnancy. And certain hormonal situations during pregnancy can lead to insomnia.
Sleepiness is a common complaint in the first trimester, although it can vary by individual. In the first trimester morning nausea for a lot of women is a reason for early awakening. The second trimester tends to be the golden time for sleep, for two reasons. The baby is not too big in order to cause mechanical disruption, yet some of the more dramatic changes in the first trimester in terms of hormones are now regulated and the woman has adapted. However, things such as restless leg syndrome due to low iron or folate insufficiency can start to present.
Finally, during the third trimester usually the reason for not sleeping well is mechanical. The increased size of the abdomen forces the women to sleep in specific positions, which may make them uncomfortable. Pressure on the bladder can cause frequent trips to the bathroom interrupting sleep. And women who are predisposed to sleep apnea can sometimes develop a worsening condition during the last trimester of pregnancy because of the increased volume of breathing against resistance.
Treatment of Sleep Disorders during Pregnancy
It is necessary to avoid substances that can affect the fetus. Pregnancy is the time that it is most important to incorporate good sleep hygiene, because medication options are so limited by the risk of harmful effects. Unfortunately, most of the prescription medications used for sleep disorders are either suspected unsafe or definitely unsafe for use during pregnancy.
Sleep Post-Partum
Sleep changes post-partum not only for the women but also for the father of the baby. Babies do not follow the same natural day/night cycles as adults do, especially as a newborn. So the first week is probably the most dramatic because the baby can wake up at any time for feedings. Immediately post-partum there will be frequent awakenings, however, generally nature has made us capable of adapting to that. It is a natural shift work sleep disorder and we compensate from the sleep loss by taking naps. The common advice given to post-partum women is to sleep when the baby sleeps. However, since newborns sleep about 18 hours a day it is practically impossible to always sleep when the baby sleeps. But the principle is not to put your needs (the mother or father) as secondary. The sleep needs of the mother are just as important as the needs of the baby.
