How to Sleep Well Throughout Each Stage of Pregnancy

Sleep can be a challenge before and after pregnancy. With a little awareness, parents can navigate well through the challenges of sleep at each stage. (Photo courtesy of istockphoto.com)

Sleep and Fertility

While research is still uncovering the specific interactions between sleep health and fertility, it’s generally accepted that healthy sleep is necessary for optimal fertility. It is well understood that shift workers, from medical residents to night-shift factory workers, tend to be significantly less fertile than their non-shift working counterparts. This is likely due to the role of sleep and circadian rhythm in regulating the production and synchronization of hormones, including luteinizing hormone, prolactin, melatonin and progesterone, that are essential to fertility. Women with atypical work schedules are at a higher risk for reproductive difficulties at all stages, from conception to birth. There is solid evidence that sleep disorders contribute to, and occur alongside, fertility problems. The most well-established association is between Obstructive Sleep Apnea (OSA) and Polycystic Ovary Syndrome (PCOS), the most common endocrinopathy in women and one of the leading causes of female infertility. Evidence indicates that OSA drives metabolic abnormalities, inflammation and hypertension that contributes to PCOS. OSA has also been linked to male infertility through different mechanisms.

Sleep During Pregnancy

Pregnancy itself generally disrupts sleep. The sheer number and amount of hormonal changes virtually guarantee that sleep will be a challenge at some point during gestation, to say nothing of the stresses related to growing and planning for a new baby. The main hormonal culprit is progesterone, which disrupts regular sleep patterns by making expectant mothers sleepy during the day while contributing to nasal congestion and heartburn. Estrogen can also contribute by facilitating uncomfortable swelling of feet and ankles. In the third trimester, regular nightly increases in oxytocin can cause short contractions. The energy needs of the fetus, especially when organs are initially developing during the first trimester, also induce daytime sleepiness and perturb normal patterns of sleep and wake. As the pregnancy progresses, the uterus presses on the bladder, increasing the frequency of urination at night, and the stomach, causing uncomfortable gastric reflux and round ligament pain during the third trimester of pregnancy. When combined with the nausea, cramps and joint aches that are experienced by the vast majority of pregnant women, as well as fetal movements and sleep position restrictions experienced by all, regular quality sleep can be elusive.

Bringing Home Baby

Now that the baby’s been delivered the real challenge begins. New mothers need adequate sleep in order to ensure production of prolactin, which is essential for breastfeeding. During the first week or so after bringing baby home, focus on getting as much rest as possible: sleep when the baby sleeps, have dad or family members give bottles during the night feedings or during the day in order to minimize the impact of sleep deprivation during the first few weeks. Experts agree that breast milk is healthier, and less expensive, than formula, so focusing on rest, and facilitating lactation, pays off quickly. While mom’s focus may center on the practical aspects of infant care, this time period is also an opportunity for new dads to take on the mantle of “sleep general”. By taking control of sleep-related distractions and providing support for the new routine around baby’s eating and sleeping needs, dads can improve the sleep of both their partner and their newborn.

Thrive Global

More than living. Thriving.

Jeffrey S. Durmer, MD PhD

Written by

Dr. Durmer is a sleep health expert, Neurologist, Georgia State University professor and the Chief Medical Officer of FusionHealth in Atlanta, Georgia.

Thrive Global

More than living. Thriving.