Playtime in utero: Why pregnant moms have trouble sleeping
The importance of sleep for healthy development
When you are pregnant, especially during the third trimester, getting a good night’s sleep can feel like a game of hide-and-seek, frustratingly out of reach when you need it most. But quality rest is essential for the health of both mom and baby.
Dr Mokgohloe Phasha, an obstetrician-gynaecologist practising at Netcare Park Lane Hospital, stresses the importance of sleep during pregnancy. She explains that while sleep is vital for everyone’s health, new research suggests that there may be lasting developmental effects for children of mothers who are significantly sleep deprived during pregnancy.
“Sleep disturbance occurs commonly in pregnancy, although it is often under-reported as women tend to accept it as the norm and therefore simply persevere in the belief that it is part and parcel of pregnancy. While it is a common experience of pregnancy, some of the potential causes of disrupted sleep can be managed to help you get some much-needed rest during these crucial months,” she says.
Dr Mokgohloe Phasha is an obstetrician-gynaecologist practising at Netcare Park Lane Hospital
Some causes of insomnia are specifically pregnancy-related, such as severe nausea and vomiting, frequently needing to urinate because of the uterus pressing on the bladder, aches and pains associated with pregnancy, heartburn, and dyspnoea or difficulty in breathing – particularly in the third trimester.
“Some women may experience carpal tunnel syndrome, with swollen hands and painful wrists keeping them awake at night, while pregnancy-related hormones may also cause expectant mothers to feel drowsy and sleepy during the day,” Dr Phasha explains.
Dietary factors that could contribute to sleeplessness include too much caffeine, which is found in coffee, tea, and chocolate, as well as deficiencies in micronutrients 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 or may lead to new onset symptoms in women who have not previously been diagnosed with an anxiety disorder. This can significantly contribute to insomnia if not appropriately addressed in consultation with your obstetrician,” Dr Phasha notes.
Medical causes of insomnia, such as sleep apnoea, should also be investigated if sleep disturbance is persistent, as this can also potentially have a negative impact on the wellbeing of mother and baby.
“Studies have found that more women report insomnia in the third trimester than in any other. This can be explained by a surge in progesterone and an enlarged uterus, which pregnant mothers would notice makes it uncomfortable to sleep on either side,” Dr Phasha says.
“At this advanced stage of pregnancy, we discourage pregnant women from sleeping on their back or stomach – positions that might have felt most comfortable before pregnancy.”
Another obstacle to a good night’s sleep, according to Dr Phasha, 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 very well be playtime in utero for her unborn baby. Vigorous foetal movements during this time can often disturb a pregnant woman’s sleep,” she says.
“The value of sleep for foetal, pregnancy, and postpartum outcomes should not be underestimated, and 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 more at risk for neurodevelopmental delays in areas including social, emotional, behavioural, motor, cognitive, or speech skills.”
Five 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 6 pm, to allow time for sufficient gastric emptying before bedtime, reducing the severity of heartburn
- Keep physically active with moderate exercise throughout pregnancy
“Enough quality sleep is fundamental for everyone’s health and wellbeing, and pregnancy is no exception. Make a point of discussing any symptoms that may be disturbing your sleep to find a solution with your obstetrician or maternity team,” Dr Phasha concludes.
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