It is no secret that many Americans grapple with insomnia and other sleep problems. Research suggests that between 50 million and 70 million Americans have a sleep disorder. In a CDC survey, researchers found that up to 35% of American adults indicate suffering from too little sleep.
Although experts report higher insomnia and sleep disorder cases among men, women, and particularly pregnant women bear the brunt of sleep disorders. Researchers estimate that more than 6 million women are pregnant at any one time in the United States. A study conducted in 2016 suggested that up to 78% of pregnant women experience sleep-related problems at one point or another during the term of the pregnancy. Other researchers put this number at 79%.
Whatever the case, it is clear that sleep is one of the biggest problems pregnant women face. However, considering the hormonal, emotional, physical and mental changes that pregnant women experience, this comes as no surprise.
Sleep Problems, Sleep Medication and Pregnancy
Sleep problems are quite a nuisance, and many people are likely to resort to using sleep medication to solve their sleeping problems. However, according to many doctors, pregnant women ought to take sleeping pills only upon consultation and approval of their physicians. Even when expectant mothers use sleeping pills, they should not do so for extended periods of time.
According to the Food and Drug Administration (FDA), there are five distinct categories of drugs for pregnant women based on the safety level.
- Class A drugs are those that do not pose any known risks to the fetus. This is based on controlled human studies.
- Class B drugs are those that are considered safe for use among pregnant women, but this is based on animal studies rather than well-controlled human studies.
- Class C drugs are those whose safety is seen as uncertain. No human studies exist for these drugs, and even the animal studies that exist have demonstrated some element of risk to the fetus. Pregnant should only take these when they need them.
- Class D drugs are those that are considered to increase the risk of birth defects and other pregnancy and birth-related problems. However, some pregnant women may take them if their medical needs so demand.
- Class X drugs are those that pose significantly more risks to the fetus than they benefit the mother.
It is important to note that there are no sleeping pills under the Class A category of drugs for pregnant women. While non-medication solutions are more advisable for pregnant women experiencing sleep problems; there are certain Class B and C drugs available for pregnant women. These drugs include Benadryl and Ambien both of which are Class B drugs, as well as Lunesta, Sonata, and Rozerem all of which are Class C drugs.
Most importantly, any pregnant women aiming to use these medications should only do so after consulting their doctors. In addition to that, experts recommend using these drugs as a short-term solution only. This is because extended use can trigger dependency and addiction leading to withdrawal symptoms after delivery. For example, Phenobarbital (more commonly known as Luminal) is used as a short-term treatment for sleeping problems. However, it is also highly addictive, and prolonged use may lower the IQ of the baby and may even case jaundice.
(Source: The Bump )
Common Pregnancy Related Sleep Problems and Sleeping Aid Recommendations
There are many causes behind sleeping problems among pregnant women. The best way to tackle sleep problems in pregnancy is to understand the underlying problem and subsequently identify a tailored solution for the problem.
Insomnia is a condition that features symptoms such as increased difficulty in falling and staying asleep. It may also feature symptoms such as waking up too early and feeling not well rested. Pregnant women often face emotional and hormonal changes which may lead to stress and anxiety both of which are linked to insomnia. Additionally, pregnancy symptoms such as nausea, back pain, and the fetal movements may also cause insomnia.
Insomnia is very common throughout the pregnancy, and for most women, it is very agonizing. There is a common consensus that one of the best solutions for insomnia is practicing good sleep hygiene. These include;
- Taking daytime naps of utmost 30 minutes
- Avoiding stimulants such as caffeine and nicotine particularly in the hours before bed time.
- Exercising even as little as 10 minutes every day. However, pregnant women should avoid engaging in stringent routines close to bedtime. However, experts also agree that the effects of nighttime exercise vary from one person to another. Some good exercises include aerobics, walking, and cycling.
- Ensuring one is exposed to adequate sunlight in the daytime and darkness in the night. This is meant to enhance and maintain a healthy sleep-wake cycle.
- Enhancing the sleep environment to make it more sleep-friendly. This includes getting a comfortable mattress and comfortable pillows, keeping the room cool (between 60 and 67 degrees), as well as turning off and avoiding sources of white light such as lamps, cell phones, TV screens and computer screens. Additionally, one may also use heavier curtains, eye shades, ear plugs, white noise machines and any other devices or strategies that may make the room more relaxing.
2. Restless Leg Syndrome (RLS)
This is a common problem, especially in the third trimester. Many medical experts are unsure of the causes of RLS, but research shows that as many as 15% of pregnant women suffer from RLS in the last trimester.
Some of the symptoms of this condition include;
- A tingly, crawling or achy feeling in the legs
- A sudden urge to move the legs to bring relief.
- Feeling worsens at night and especially before sleeping.
Risk factors for RLS include iron deficiency, folate deficiency, hormonal changes and especially an increase in estrogen and pregnancy. However, during pregnancy, RLS normally occurs in the 7th
or 8th month of pregnancy and disappears within a month after delivery of the baby.
Pregnant women who experience RLS are advised to avoid the following;
- Taking drugs used to treat RLS.
- Caffeine (Even a seemingly insignificant amount of caffeine can worsen the symptoms of RLS)
- Antihistamines such as those found in cold and allergy remedies. For example, while Benadryl is known to help make people drowsier, it may also make it harder to sleep since it may amplify the RLS symptoms.
- Although quinine may help in the relief of RLS symptoms, pregnant women should not take it without consulting with their doctors first. This is because researchers have not yet determined its safety level, particularly during pregnancy.
- It is also advisable to avoid reading or watching television while in bed before sleeping. Lying still for long periods is likely to trigger RLS.
Other possible sleep aids for RLS include;
- Taking a warm bath
- Engaging in relaxation exercises
- Using hot or cold packs on the legs
- Getting a massage
- Sometimes it may also help to take supplements of iron, magnesium, vitamin B12, or folate. However, pregnant ladies should only take these after consultation with their doctors.
3. Recurrent Urge to Pee
This is a common problem in the third trimester as well as in the first trimester. Experts attribute the constant need to pee while pregnant to several factors;
- The significantly higher levels of hCG in the body.
- Kidneys are forced to filter up to 50% more blood than in a woman who is not pregnant. This also translates to more urine production.
- When the pregnant woman is in the third trimester, the uterus exerts more pressure on the bladder which makes it harder to hold the pee for long.
The frequent need to pee ultimately means that pregnant ladies experience difficulties in falling and staying asleep as well as in getting good quality sleep.
To tackle sleep problems related to frequent peeing, experts suggest the following sleep aids;
- Drinking a lot of fluids during the day and cutting back on fluid intake in the hours before bedtime.
- Installing dim lighting in the bathroom and keeping it on through the night to make it easier to go to the bathroom (without fully waking up) and also makes it easier to fall back to sleep.
4. Heartburn (Nighttime GERD/ Acid Reflux)
Heartburns are a normal part of pregnancy. In fact, quite some women experience acid reflux for the first time during pregnancy. For some pregnant women, heartburns may start from the first trimester while for others it starts in the second and third trimesters.
The physical and hormonal changes that pregnant women go through play a huge role in the increased occurrence of heartburn. One of these is the increased production of a hormone known as progesterone. This hormone relaxes the valve separating the esophagus from the stomach. Ultimately, this makes it easier for gastric acid to come up and cause a burning sensation in the throat. In the third trimester, the baby bump also tends to push up the stomach increasing the frequency of heartburn. The frequency of heartburns is known to increase at night when one is lying down.
To avoid heartburn and sleep better at night pregnant women should;
- Avoid eating foods that are spicy, greasy or too acidic.
- Eat smaller meals
- Allow a gap of at least 2 hours between dinner time and bedtime.
- Sleep in a position in which their heads are raised. A good way to prop up the head is to use a couple of pillows.
- Antacid medication such as Tums, Maalox and Rolaids may also help.
- Pregnant may also use preventive medication like Zantac but in consultation with the doctor. According to experts, Zantac is a good sleep aid because it is in the category of H2-receptor blockers which work better at night.
- Sit upright for some hours after eating
- Wear loose-fitting clothes
5. Nasal Congestion and Snoring
Nasal congestion is common all through the pregnancy. According to research, pregnant women have increased levels of estrogen and progesterone which in turn increases their blood volumes in the body.
Subsequently, the increased blood volume also increases in the membranes in the nose causing them to enlarge and produce even more mucus which ultimately leads to a stuffy nose and even post nasal drip in the later stages of the pregnancy. This may also make the woman cough more at night.
The stuffy nose may also cause snoring which may make both the pregnant woman and her partner uncomfortable during sleep.
To tackle nasal congestion and snoring, experts suggest;
- Using saline nasal sprays and nose strips. These help to ease the nighttime stuffiness that pregnant women experience, and they indirectly act as sleep aids.
- If stuffiness persists, pregnant women should consult with their doctors regarding other possible options such as steroid nasal sprays or decongestants. However, women should avoid using these in the first trimester.
6. Sleep Apnea
Pregnancy is also a risk factor for sleep apnea. This is a disorder in which the pregnant woman experiences brief interruptions in breathing. Sleep apnea is particularly common in overweight pregnant women. Sleep apnea is also linked to other pregnancy complications such as low birth weight and gestational hypertension among others. Women with sleep apnea are also more likely to experience feelings of sleepiness during the day. According to doctors, heavy snoring that also includes long pauses, gasping or even choking during sleep is a major symptom of sleep apnea.
To treat sleep apnea and enhance the quality of sleep, several recommendations are given;
- Pregnant women who are overweight must implement lifestyle changes. This could include strategies such as enrolling in a healthy weight management plan.
- Experts also suggest using adhesive breathing strips to open the nostrils and improve breathing.
- One may also decongest the nose using saline sprays, humidifiers, or decongestants. Nonetheless, it is still important to do this in consultation with the doctor.
- For severe cases of sleep apnea, doctors may recommend a continuous positive airway pressure machine (CPAP). Considered an effective sleep aid for people with sleep apnea, CPAP features a mask which the pregnant woman wears over her nose. The mask is connected to a small pump which provides a continuous and gentle flow of air to keep the nasal airway open.
7. Other Sleep Aids for Pregnant Women
- According to experts, pregnant women may also engage in relaxation exercises such as yoga and stretching to enhance their sleep. These exercises help to relax the woman, keep her toned, flexible and even emotionally balanced (in the case of Yoga). There are numerous poses which are deemed suitable for pregnant women.
- Secondly, deep breathing and other breathing exercises may also help to ease muscle tension and lower the heart rate. This makes them an effective sleep aid.
- Women ought to avoid smoking tobacco and drinking alcohol during pregnancy.
- Aromatherapy may also help. However, experts suggest approaching this solution with caution and to avoid using it during the first trimester.
- Pregnant women who experience difficulties in sleeping should avoid staying in bed when they lose sleep. It is advisable to only go to bed when sleepy.
- It is also advisable not to stress over the lack of sleep as this may worsen the problem even more.