11 May 2015

WOMEN & SLEEP || Adventures in Sleep for the Pregnant Woman, Part One: The First Trimester

See Also:
Adventures in Sleep
for the Pregnant Woman, Part Two:
The SecondTrimester
Adventures in Sleep
for the Pregnant Woman, Part Three:
The ThirdTrimester
Adventures in Sleep

for the Pregnant Woman,
Postpartum Edition
The first trimester may be smooth sailing for you or it may lead to all kinds of surprises. Knowing what to expect can help to offset the worst things that could happen to your sleep. Now is the time to get into the practice of listening to signals from your body: if you're tired, sleep. If you're hungry, eat. If you feel overwhelmed, slow down. Learn your cues now; this is a skill you will need from here on out, not only for helping yourself but also in your role as a future mother.

The main problems women have with sleep during their first trimester fall into the following categories:

1. Insomnia or daytime sleepiness, or both
2. Swelling and excess bodily fluids
3. "Morning sickness"
4. Nightmares
5. Changes in appetite

Let's take a closer look.
Sleep problems (insomnia or daytime sleepiness) can be blamed mostly on surging hormones (namely, progesterone). This is because your body is in constant chemical flux while it adjusts to the ongoing changes taking place not only in your womb, but in your brain, your blood, nearly every other organ. 

If you can't sleep at night, check in with yourself to make sure it's not due to any stress or anxiety brought about by the uncertainties of pregnancy and future motherhood; these will also interfere with your ability to sleep well.
Solution? Progesterone levels can lead to daytime drowsiness and nighttime restlessness; it's just part of the territory.

Take naps when you can. If you are working while pregnant, ask for a private space to nap during the day; many offices are now more open to cat naps as a way to refresh employees, leaving them more productive. 

Also, don't let insomnia stress you out, and if you find you are worried about your pregnancy and the future, find someone to talk to about it. 

Learn new ways to relax at bedtime and practice simply resting if you can't sleep so that your body still gets a physical reprieve. Being flexible is key.
Extra body fluids means you have more blood in your body as well as more fluids collecting (you'll notice this mostly in your feet or your breasts). The extra body fluids may mean you need to use the bathroom more often at night and find it hard to get in a comfortable position due to the discomfort of swelling. Breasts may feel tender. If you sleep on your stomach, any swelling there could make it hard to achieve a comfortable position for sleeping. 

You may also find it harder to breathe at night; this is because your nasal passages may also be swollen, or you may be collecting the day's swelling in your neck tissues, leading to potential airway blockage as you sleep.
Solution? If you have extreme swelling, mention it to your healthcare professional. Edema can signal potential problems that should be addressed right away. 

If it's just an annoyance, but does not alarm you, then keep drinking your water as a way to flush out your system. Becoming dehydrated will just make you more fatigued. Your body is built to collect some extra fluid during pregnancy so that it can help build the amniotic sac. If that means you need to use the restroom more often at night, then it's something you'll need to adjust to (cutting back at night can help, if need be). 

Also, learning how to sleep on your side can help with multiple comfort issues: left-side sleeping offers some relief from reflux and both partial and complete obstructions of the airway (apnea); it also improves blood flow between your body and your womb and better assists your system in voiding wastes. 

When you lay down at night to sleep, fluids that have collected in your feet will redistribute across all of your tissues (gravity) and that could mean you may be experiencing apneas at night. 

If your bed partner tells you they have noticed you gasping for sleep or snoring when you weren't snoring before, speak with your doctor about getting a sleep study to rule out (or rule in) sleep apnea as the culprit behind your sleep problems. 

Nausea and vomiting, incorrectly dubbed "morning sickness," can happen at any time and doesn't wait until morning to present itself. You may find yourself feeling sick at 2pm or 2am as well as 7am.  

While there's no specific reason behind these side effects of pregnancy, they are usually the result of your swiftly changing body chemistry, matched with heightened sensitivity to odors and taste. Your digestive system is also making changes and the result may lead to feeling sick to one's stomach.

When nocturnal queasiness strikes, it can cut significantly into quality sleep time. If it is an ongoing problem and you are sick and vomiting around the clock, contact your doctor immediately.

Solution? Mild carbohydrate snacks like crackers, kept on your nightstand, can take the edge off nausea. 

So can avoiding high-fat acidic foods before bedtime, which can lead to reflux and gastrointestinal issues. 

Acupressure wrist devices (used for seasickness), when worn to bed, may help. 

Ginger tea at bedtime is helpful for some, but make sure it is only ginger (other herbs can be dangerous to take during pregnancy). 

Ultimately, don't let this common problem get you down; try to remember that it is usually temporary and goes away for most mothers by the end of the first trimester, if not sooner. 

For those who have extreme problems, consulting your healthcare professional about an anti-nausea drug may be the only way to conquer the problem of nausea and vomiting. 

Vivid dreams are a product of brain and body chemistry changes blended with your own anxieties about being pregnant and anticipating the new work of mothering. 

You will have both positive and negative emotions at this time: mood swings are normal as you begin to reinvent who you are with the prospect of becoming a mother. Dreams and nightmares are one way your consciousness allows you to work off some of that extreme anxiety or anticipation. 

You may also just notice your dreams are more vivid because you'll wake up more frequently due to a need to use the bathroom; that unexpected wake time might interfere with one of your REM (rapid eye movement) or "dream" cycles, meaning you are likely to remember your dreams than if you'd just slept right through them.

Solution? If you have extreme emotions about being pregnant, you may want to get some help to manage your anxiety. If it's not extreme, then try capturing your dreams in a journal. 

Vivid dreams, in and of themselves, are not a bad sign of anything. They just happen. If the content and tone of your dreams is more or less positive, especially, try to find ways to enjoy this experience. 

Appetites change dramatically during the first trimester. You are eating for two, after all! Your metabolism is racing! For some women, this means constant hunger and cravings for odd foods; for others, it means food aversions. 

Food cravings and insatiable hunger can keep up the most ardent sleeper. 

For food aversions, the mere thought of certain foods right before bed can launch a wave of nausea.

Solution? Manage your meals so that you have them evenly spaced throughout the day, and choose healthy snacks between them to cut down on hunger pangs. 

It's okay to indulge in cravings if they are healthy, but portions and frequency of cravings of high-fat, less-healthy foods should be held in check. 

Also, try to keep your nighttime foods limited to lower fat, lower acid foods to ward off reflux. 

If you have food aversions, go ahead an honor them as long as they don't get in the way of eating healthy, keeping in mind that, if you don't eat enough calories, by nighttime your hunger pangs may present as nausea. 

Some healthy snacks to have on hand for all hours of the day and night include fresh fruit, cut raw vegetables, avocado, whole grains, whole grain breads and crackers, peanut butter, cereal with milk, hard-boiled eggs, low-fat cottage cheese, cheese sticks, and lean organic cold cuts.