Knowledge | Sleeping poorly during pregnancy? Do not let alarming studies increase your anxiety—expert guidance on what can actually help
Insomnia during pregnancy is difficult enough, and a study has added another concern: insufficient sleep during pregnancy may affect fetal brain development and contribute to delays in children’s learning and social behavior. Co-authored by Peng Zhu, PhD, a professor of maternal, child, and adolescent health at Anhui Medical University in China, the study noted potential risks to both mother and baby.
For expectant mothers already tossing and turning all night, however, findings like these may make sleep even harder.
Natalie Solomon, a clinical psychologist specializing in sleep and reproductive psychology at Stanford University School of Medicine who was also eight months pregnant, said: “Being repeatedly told that you are harming yourself and your baby is not helpful to anyone, especially a pregnant woman who is already sleeping poorly.”
Poor sleep does not mean you are not trying hard enough; forcing yourself to sleep can make it worse
“Trying to make yourself sleep is like trying to escape quicksand,” Solomon said. “The harder you try, the deeper you sink.” Frequent nighttime urination and physical discomfort that makes it hard to find a comfortable position already create many physiological barriers. Adding anxiety can make sleep feel almost impossible.
Fortunately, evidence-based strategies are available.
Evidence-based approaches to insomnia during pregnancy
Solomon recommends several clinically supported relaxation techniques:
Progressive muscle relaxation: starting with the feet, tense each muscle group for a few seconds and then relax it while breathing deeply. Randomized controlled trials show that this can ease anxiety and insomnia during pregnancy.
Guided imagery: picture a calm, safe setting, such as a forest or beach, and imagine yourself immersed in it.
Box breathing: inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and hold again for 4 seconds. This rhythm can slow the heart rate and reduce nervous system tension.
Scheduled worry time: set aside a specific period each day to think about concerns, such as 10 minutes during the day, to reduce racing thoughts at night.
If these strategies do not provide enough relief, professional help is important. Dr. Zhu said, “When insomnia causes significant distress, consult a sleep medicine center or maternal-fetal medicine specialist.” A doctor may recommend cognitive behavioral therapy for insomnia (CBT-I), an established non-drug treatment for chronic insomnia that has also been shown to work during pregnancy.
In some cases, a doctor may recommend an antihistamine such as diphenhydramine (Benadryl) as a short-term sleep aid, but only after medical evaluation.
Insomnia is not always anxiety: two other major causes
Solomon noted two other main causes of insomnia during pregnancy besides emotional stress:
Too little “sleep opportunity”: there may simply be too little time available for sleep. She suggests asking family or friends to help with household tasks or childcare. Do not be embarrassed: “You are creating the physical conditions your baby needs to develop. That is a reasonable request.”
You may also consider a doula for prenatal or postpartum support. Organizations such as DONA International can help you find a certified doula.
Physical discomfort: this is especially common in late pregnancy. The American Pregnancy Association recommends sleeping on the left side to support circulation. Common strategies include:
Place a pillow between the legs or under the abdomen to ease back pain;
Elevate the upper body to reduce acid reflux;
Use a U-shaped pregnancy pillow to maintain a side-sleeping position;
If you occasionally want to sleep on your stomach, try an inflatable pillow with a recessed center.
Tired during the day? These counterintuitive tips may help restore your sleep rhythm
Standard insomnia advice often says not to sleep during the day, but Solomon believes pregnant women can nap if they limit the timing:
Keep naps to 20-30 minutes;
Try to nap before 6 p.m.
Another counterintuitive approach is to delay bedtime. Solomon explained: “Spending less time lying in bed can increase your sleep drive, making it easier to fall asleep when you go to bed.”
Reducing fluid intake during the two hours before bedtime may also reduce nighttime bathroom visits.
Most importantly, be kind to yourself.
“Some aspects of sleep are beyond our control, and trying to force yourself to sleep during pregnancy often backfires,” Solomon said. “The best thing you can do is protect your rest time and accept that some sleep disruption is normal.”
Knowledge | Sleeping poorly during pregnancy? Do not let alarming studies increase your anxiety—expert guidance on what can actually help
Knowledge | Sleeping poorly during pregnancy? Do not let alarming studies increase your anxiety—expert guidance on what can actually help
Insomnia during pregnancy is difficult enough, and a study has added another concern: insufficient sleep during pregnancy may affect fetal brain development and contribute to delays in children’s learning and social behavior. Co-authored by Peng Zhu, PhD, a professor of maternal, child, and adolescent health at Anhui Medical University in China, the study noted potential risks to both mother and baby.
For expectant mothers already tossing and turning all night, however, findings like these may make sleep even harder.
Natalie Solomon, a clinical psychologist specializing in sleep and reproductive psychology at Stanford University School of Medicine who was also eight months pregnant, said: “Being repeatedly told that you are harming yourself and your baby is not helpful to anyone, especially a pregnant woman who is already sleeping poorly.”
Poor sleep does not mean you are not trying hard enough; forcing yourself to sleep can make it worse
“Trying to make yourself sleep is like trying to escape quicksand,” Solomon said. “The harder you try, the deeper you sink.” Frequent nighttime urination and physical discomfort that makes it hard to find a comfortable position already create many physiological barriers. Adding anxiety can make sleep feel almost impossible.
Fortunately, evidence-based strategies are available.
Evidence-based approaches to insomnia during pregnancy
Solomon recommends several clinically supported relaxation techniques:
Progressive muscle relaxation: starting with the feet, tense each muscle group for a few seconds and then relax it while breathing deeply. Randomized controlled trials show that this can ease anxiety and insomnia during pregnancy.
Guided imagery: picture a calm, safe setting, such as a forest or beach, and imagine yourself immersed in it.
Box breathing: inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and hold again for 4 seconds. This rhythm can slow the heart rate and reduce nervous system tension.
Scheduled worry time: set aside a specific period each day to think about concerns, such as 10 minutes during the day, to reduce racing thoughts at night.
If these strategies do not provide enough relief, professional help is important. Dr. Zhu said, “When insomnia causes significant distress, consult a sleep medicine center or maternal-fetal medicine specialist.” A doctor may recommend cognitive behavioral therapy for insomnia (CBT-I), an established non-drug treatment for chronic insomnia that has also been shown to work during pregnancy.
In some cases, a doctor may recommend an antihistamine such as diphenhydramine (Benadryl) as a short-term sleep aid, but only after medical evaluation.
Insomnia is not always anxiety: two other major causes
Solomon noted two other main causes of insomnia during pregnancy besides emotional stress:
Too little “sleep opportunity”: there may simply be too little time available for sleep. She suggests asking family or friends to help with household tasks or childcare. Do not be embarrassed: “You are creating the physical conditions your baby needs to develop. That is a reasonable request.”
You may also consider a doula for prenatal or postpartum support. Organizations such as DONA International can help you find a certified doula.
Physical discomfort: this is especially common in late pregnancy. The American Pregnancy Association recommends sleeping on the left side to support circulation. Common strategies include:
Place a pillow between the legs or under the abdomen to ease back pain;
Elevate the upper body to reduce acid reflux;
Use a U-shaped pregnancy pillow to maintain a side-sleeping position;
If you occasionally want to sleep on your stomach, try an inflatable pillow with a recessed center.
Tired during the day? These counterintuitive tips may help restore your sleep rhythm
Standard insomnia advice often says not to sleep during the day, but Solomon believes pregnant women can nap if they limit the timing:
Keep naps to 20-30 minutes;
Try to nap before 6 p.m.
Another counterintuitive approach is to delay bedtime. Solomon explained: “Spending less time lying in bed can increase your sleep drive, making it easier to fall asleep when you go to bed.”
Reducing fluid intake during the two hours before bedtime may also reduce nighttime bathroom visits.
Most importantly, be kind to yourself.
“Some aspects of sleep are beyond our control, and trying to force yourself to sleep during pregnancy often backfires,” Solomon said. “The best thing you can do is protect your rest time and accept that some sleep disruption is normal.”
Source:
Collected online