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

Congratulations! You've made it to the final third! Now what?

Many sleep problems return as your body and baby both grow more rapidly as you near the end of pregnancy. You may find you cannot sleep at all at night, thanks to the kicking baby and other pregnancy-related sleep disturbances. Knowing what you can expect and preparing for it can be helpful in getting through these last 13-15 weeks.

The main problems pregnant women experience with sleep during the third trimester relate to the following challenges: 

1. Bladder issues
2. Fatigue 
3. General discomfort
4. Heartburn 
5. Obesity
6. Snoring

Let's take a closer look. 

Bladder pressure returns in the last third of pregnancy because, you guessed it, there's little room left for all your different parts in the presence of your growing baby. You may even feel as if you are being kicked or pushed on by the baby as they float about in the womb. It will make you want to use the bathroom a lot, but don't limit your consumption of fluids if this is the case. Solutions? Time your water drinking so you get most of your fluids during the day, if that helps keep you in bed more at night. Try to lean forward when on the toilet to fully empty the bladder, as well. 

Some people find the new-fangled device, the Squatty Potty, a great tool for helping to void urine as it allows you to tilt your pelvis in a way that makes urination and defecation easier to complete. Fully voiding the bladder may help give you more uninterrupted sleep at night or during naps.

Fatigue comes back again, maybe worse than ever. It's all for the same reasons before: either your body is working in overdrive and you need to rest and recharge your batteries, or you may have some hidden sleep breathing issue or restless legs concern interrupting your ability to sleep soundly.

Solutions? Nap whenever possible, and look into advice from your doctor for any nighttime sleeping issues which might be disrupting your sleep pattern if they relate to discomfort in the legs or breathing.

See Also:
Adventures in Sleep
for the Pregnant Woman, Part One:
The First Trimester
---
Adventures in Sleep
for the Pregnant Woman, Part Two:
The Second Trimester
---
Adventures in Sleep
for the Pregnant Woman, 
Postpartum Edition

General discomfort with your pregnant body is a common problem at bedtime; it's hard to find a comfortable position for sleeping. Your baby maybe be very active, it seems, at night (which is not necessarily true; you might just notice their activity more when you are at rest). Finally, you may suffer from back pain (especially sciatica) from carrying out your load, and that can interfere at night when trying to get comfortable for sleep. 

Solutions? Enjoy the feelings that come from your kicking baby! It's a good sign that all is going well from the inside. Using pillows to prop you up and/or support your back while sleeping is a popular solution when the belly becomes too big to move about easily. Sometimes a recliner makes for the perfect solution, and don't forget to consider propping up the head of your bed by 3 inches. Easy lower-back stretches, massages, and warm baths can help with back pain before bedtime, as well.

Heartburn, gas and reflux come back with a vengeance, too; your digestive system is cramped and overtaxed with processing your meals. It may even make you less hungry; the thought of discomfort after meals can be a real motivation for not eating at a time when your baby needs you to be eating well. 

Solutions? Propping up the head of your bed by 3 inches uses gravity in your favor to keep food moving downward through your digestive tract. This may also be a good time to use a recliner. Eat smaller meals made of complex carbohydrates and lean proteins more frequently to keep a steady supply of nutrients without sending your system into turmoil. Avoid high-fat foods or foods you know will make you gassy. Drink your water, too, as it is essential for good digestion. There are some calcium products that are safe to use for heartburn during pregnancy; ask your doctor if you can't seem to surmount these challenges at night. There's no need to suffer unnecessarily.

Aside from obstructive sleep apnea, obesity during pregnancy
can bring on a host of other unwanted problems. 

Obesity can become a problem at the end of pregnancy. You are supposed to gain some weight, but sometimes the weight gain becomes very hard to control, and yet you still need to eat to support the baby. It is concerning not just from a general standpoint, but because it can become a major risk factor for sleep apnea during late-stage pregnancy; the extra tissue in your neck and throat can threaten to block your airway at night, which puts both you and baby at risk for hypertension, insulin resistance and other problems.

Solutions? Try to exercise however much you are able in order to maintain good metabolism. Choose foods that are nutrient dense but not calorie dense. Avoid empty calories and high-fat foods, especially take-out, fast food and junk food. It's of questionable value to you and your baby. Ask your doctor for help if you wake up with headaches, see a rise in blood pressure, start retaining water unnecessarily, or have sore throats or dry mouth upon awakening as each of these may signal the presence of upper airway resistance or apnea. 

Snoring will likely return in the third trimester. It may be harmless but it could also indicate upper airway resistance or apnea. You don't have to be overweight to snore. You could have allergy issues, or problems with nasal or sinus congestion that mean you have extra mucus or swollen membranes getting in the way of your ability to breathe while asleep. 

Solutions? It never hurts to use saline nasal spray to keep passages moist and to relieve elevated levels of mucus. Ask your doctor to check out your options for safely treating concerns about nighttime congestion.