Pregnancy is a time of great need when it comes to energy and sleep – the body is working hard to sustain the development of another life, so it needs all the rest it can get! If you’re pregnant, you might be getting used to hearing people say that you ‘should get all the rest you can, because you won’t get any when the baby comes!’, but it isn’t as simple as it sounds. Many women find it extremely difficult to get enough sleep during pregnancy, whether it be due to pelvic pain, heartburn, inability to fall asleep or sleep disruption. But what can we do about it?

It should be noted that from 16 weeks onward it is considered unsafe for a woman to sleep on her back during pregnancy. This is because the increasing size and weight of the uterus, developing baby, placenta and fluids place pressure on the abdominal vessels, and can lead to problems with blood flow to the placenta. The recommended position for sleeping is on the left side, as this allows for optimal blood flow for both the mother and baby. If you are lying on your back and start to feel dizzy, you should always roll onto your left side.

If you suffer from pelvic pain during your pregnancy, the chances are that you will have difficulty getting comfortable to sleep at night. The hips and low back can ache, the muscles may cramp, and the sheer size of your abdomen can make it awkward to find a relaxed position for sleep. Many women find the use of a wedge-shaped pregnancy pillow under their tummy to be quite relaxing, as it takes pressure off the low back, ribs and abdomen while side-lying. Whilst in this position, it is a good idea to place a pillow between the knees to keep the hips in a neutral position, and take any force off the pelvis and low back, thus preventing any further inflammation of painful tissues when you are at rest. It can be difficult to roll over onto your other side with all these pillows in place, but it is worth the effort if it helps prevent pain and promote a better night’s sleep. There are many pregnancy-related pillows on the market to choose from as well!

Possibly the most common complaint of pregnant women, especially in the later stages of pregnancy, is the frequent need to urinate. This annoying phenomenon occurs both due to hormonal and physical reasons, and can lead to many a broken night’s sleep. A good way to curb the problem is to try and get all your fluid intake covered during the day, and avoid drinking too much from dinnertime onwards. If you do need to get up and go to the toilet, it is a good idea to limit or avoid turning on lights so you are not roused too much from sleep, and can nod off easily again when you return to bed.

Another reason that women struggle to sleep is heartburn or indigestion. The growing baby gradually takes up all available abdomen space, so the other organs can become pushed up higher into the chest, creating issues for breathing and digestion. Heartburn can be very unpleasant, and is worsened by lying down, as the stomach contents can easily flow back up the digestive tract, causing irritation. A common solution for this is to sleep slightly upright, with the upper back propped up on pillows. This can quickly become uncomfortable though, so a better approach is to try and prevent the onset of heartburn by reducing the volume of food in the stomach – eating smaller meals more frequently, eating your evening meal well before bedtime, and avoiding any rich or spicy foods that can irritate the oesophagus should they be pushed back up from the stomach. Antacids can also be effective for symptomatic relief, but not all are safe during pregnancy, so make sure you consult your pharmacist before taking any.

Many of us snore, but did you know that snoring can greatly increase during pregnancy? This is due to hormonal changes and fluid retention around the airways, which can compromise air flow. For most women, this will simply be an annoying or amusing side-effect of pregnancy, but if it becomes significant it can lead to sleep apnoea, which is a serious condition. Sleep apnoea involves the repeated interruption of breathing during sleep, which severely reduces the quality of sleep, resulting in fatigue, but can also compromise the oxygen levels in the body, with harmful effects for both mother and baby. If a family member has noticed that you snore and gasp for air overnight, or you wake feeling exhausted every day, you may be suffering from sleep apnoea, which needs to be properly evaluated. Speak to your obstetrician, midwife or GP if you have any concerns.

With all these changes going on, is it any wonder that pregnant women get any sleep at all? If you are still struggling with sleep after all these hints, make sure you speak to your health provider, but also consider some additional options such as relaxation, meditation and mindfulness. There is a lot to think about during pregnancy, and it can certainly be overwhelming, so some management strategies may be the very thing to help achieve those elusive restful nights. Happy sleeping!

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