08 May 2015

WOMEN & SLEEP || Introducing Adventures in Sleep for the Pregnant Woman

It may or may not surprise the new mother-to-be to learn that their sleeping habits may suffer even before they have their baby, even as soon as a few short weeks into pregnancy. In fact, the sleep deprivation that comes of starting a new family can begin well before the baby is even born!

The first part of a woman's pregnancy is a busy time for the body; major changes are taking place that may not be outwardly obvious. The bloodstream is racing with new levels of progesterone, which can lead to swelling, changes in the actual structure of certain tissues, extreme changes in energy levels, unusual cravings, nausea and, for many, a deep desire to sleep all day every day. 

Over the next few days, SHC will discuss the "adventures in sleep" by breaking down what to expect by way of trimesters before birth and into the days postpartum. Generally speaking, however, a woman who is newly pregnant can expect to experience changes with some or all of the following body functions over the course of their pregnancy. 

Anxiety: The uncertainties of pregnancy, when added to the day's list of other worries, can take its toll on sleep. 

Appetite: Some women have immense cravings and feel like they cannot eat enough. These feelings don't just happen during mealtimes, either; sometimes hunger pangs can wake up the soundest sleepers when they are pregnant. 

Congestion: Your body overall will swell as it holds more fluids, and that can lead to stuffy noses that can make it difficult to breathe comfortably at night.

Fitness impacts: Levels of fatigue may swing high or low depending upon the pregnancy. Also, one's ability to exercise can be interrupted by many of these other symptoms. Exercise can help tremendously with a good night's sleep, but if it's done too close to bedtime, it can leave stress hormones at too high a level to promote an easy transition to sleep. 

Frequent urination: The uterus and the bladder will have many battles over real estate across the entirety of pregnancy as pressure from the uterus will place more voiding demands on the bladder. This can mean lots of nocturnal awakenings to use the bathroom.

General discomfort: The processes that define pregnancy are complex; so many different organs and tissues are undergoing transformation more or less at the same time. Your body, no doubt, will feel different and, sometimes, downright uncomfortable. Sleeping may be an uncomfortable experience as the body shape changes, weight distribution falls out of normal balance and joints and connective tissues try to keep everything in place. 

Heartburn and indigestion: This is a common side effect of pregnancy and can lead to reflux disease at night, which can keep many pregnant women up late (especially if they are having nighttime food cravings). 

Insomnia: There are multiple reasons why pregnant women, who are tired all the day, end up suffering with insomnia as well. Blame it on body chemistry and changes in mood, but don't rule out other possibilities, like sleep apnea or restless legs.

Leg cramps: Again, this is a chemistry imbalance; the body needs its electrolytes and when it doesn't get them in full balance, the legs are often the first place to reveal this problem. Nighttime charleyhorses can result; they are no fun during the day, and at night, they can be tenfold worse because they disrupt your sleep. 

Medications: If you are taking any medications while pregnant, make sure it is safe to do so. And keep in mind that medications are essentially chemistry. You add chemistry to your body chemistry every time you take a drug; at nighttime, this can lead to problems with insomnia when chemistry collides. 

Nausea: Some women experiences runs of nausea that blunt their appetite; unfortunately, morning sickness doesn't always wait until morning.

Restless legs: This could have been a "thing" before pregnancy, or it could happen while being pregnant. There are multiple causes for these and they should be identified and treated whenever possible. One cause among pregnant women is anemia; the twitching and discomfort can make it very difficult to fall asleep.

Sleep apnea: More general edema in the body means plumper tissues and more opportunities to interfere with the upper airway. Swollen areas around the feet during the day can become swollen areas around the neck at the end of the day when the pregnant woman lies down to sleep, as fluids are redistributed. This can lead to sleep breathing disorders like Upper Airway Resistance Syndrome (UARS) and Obstructive Sleep Apnea (OSA). 

Snoring: Just as with sleep apnea, the added fluids that build up in the body can create resistance in the upper airway; add to that any congestion issues in the nasal passages and the odds of becoming a first-time-ever snorer are pretty good.

Vivid dreams: Dreams are a product of REM activity. With all the other changes in the body, it's not surprising to learn that the brain is also adjusting, redirecting focus, learning, processing anxiety, consolidating new information as memories. Pregnancy is a heightened state; it makes sense that crazy dreams would follow.

Stay tuned: next week SHC will discuss sleep challenges based specifically on what's going on during the trimesters.