Sleep is one of the most important physiological cycles that every human needs. Sleep expert and neuroscientist Dr Merrill Mitler in NIH says that “Sleep services all aspects of our body in one way or another: molecular, energy balance, as well as intellectual function, alertness and mood. “The US National Sleep Foundation’s Women and Sleep Survey in 1998 found 78% of women reported disturbed sleep during pregnancy and 15% of women developed Restless Legs Syndrome (RLS) during the third trimester of pregnancy. The severity of sleep disorders increases with the advancement of pregnancy. The National Sleep Foundation advises 7-9 hrs of sleep every day. But during pregnancy, many women find it difficult to sleep for the recommended hours due to various reasons.
During the first trimester, severe daytime tiredness, nausea and vomiting, an uncomfortable rise in body temperature, breast tenderness and frequency of needing to pass urine are commonly experienced. In the second trimester, women feel more energetic and have better sleep quality. Swelling on the feet and wrist, SI joint dysfunction, pain in the pubic area when turning, pain on the side of the abdomen and cramps in the calf muscles when sleeping are common complaints. With progressive weight gain, women might complain of excessive snoring and rhinitis due to congestion in the nasal passage. The third trimester is generally accompanied by difficulty in finding a comfortable position to sleep due to a growing baby bump. It’s most challenging to get good quality sleep during the third trimester. Heartburn, gastric reflux, severe lower back pain with aches around the joints and muscles, vivid dreams about labour, increased anxiety, stress and frequent trips to the bathroom, restless leg syndrome, obstructive sleep apnoea and gastric reflux might aggravate during this time.
Sleep deprivation during pregnancy can promote unwanted conditions like Gestational Hypertension, an increase in stress and anxiety, Gestational Diabetes Mellitus, preeclampsia and preterm births. Studies have also found that sleep deprivation during pregnancy has evidence of developing postpartum depression. Here are some ways to sleep better during pregnancy:
Maintain good sleeping hygiene: Use breathable and comfortable bed sheets and thicker curtains, organise your bedroom and maintain a comfortable cool room temperature. Core body temperature can increase to 0.2 degrees during pregnancy. An increase in blood volume and higher heart rate increases metabolic rate which in turn increases the core body temperature. Maintaining a cool temperature can help women fall asleep faster and better. Melatonin is a hormone secreted by the pineal gland in response to darkness, which helps in sleep regulation and signalling night and day. It is also referred to as a human sleep hormone.
Walking: Walking is the easiest and most cost-effective way to maintain your aerobic capacity, and endurance and help keep your pregnancy weight gain in check. You can start with light to moderate walking around 3000 to 5000 steps in a day during the first trimester if you do not have complications like spotting or bleeding. And gradually increase the steps as you progress to the second and third trimester Aerobic walking for four weeks elicits significant improvement in sleep duration.
Antenatal exercise: Exercise not only helps in improving your endurance and preparation for normal delivery. It also helps strengthen your muscles, works on your flexibility and improves posture and balance. Antenatal exercise helps you alleviate pregnancy-related musculoskeletal complaints like lower back, knee pain, pelvic joint dysfunction, and rib alignment issues. Research also states that exercise gives a positive impact on the quality of sleep in pregnant women. WHO recommends 150 min of exercise per week during pregnancy with healthy non-complicated pregnancy.
(The author is a Bengaluru-based physiotherapist.)