Will the Sandman Ever Come?

By Ann Douglas

Here’s proof positive that Mother Nature has a rather wicked sense of humor: at the time in your life when you are most in need of sleep, sleep can be frustratingly elusive. Either you find it hard to settle down to sleep in the first place or you end up tossing and turning all night. So what’s an exhausted mother-to-be to do? Well, for starters, you might want to take solace in the fact that you aren’t the only pregnant woman in your prenatal class who is unwillingly burning the candle at both ends. Sleep deprivation is a pregnancy rite of passage for most mothersto- be. Studies have shown that 97% of women in their third trimester report waking up at least once during the night and 92% report sleeping restlessly. So what’s causing the expectant mothers of the nation to toss and turn at night when they should be somewhere in Dreamland? A smorgasbord of pregnancyrelated aches and pains, that’s what.

The fun starts in the first trimester. By the time you’re 10 to 12 weeks pregnant, rising levels of estrogen, prolactin, and progesterone can interfere with your ability to get a solid night’s sleep. You may find it hard to get to sleep in the first place, thanks to your oh-so-tender breasts, and even if you do settle into a deep sleep, you’re likely to find yourself trekking to the bathroom at least once in the middle of the night. You can blame your midnight strolls on both the pressure of the growing baby on your bladder and the hormonal effects of progesterone. (Progesterone acts on the smooth muscle of your urinary tract, causing you to need to urinate more frequently than usual.) And, of course, if you’re bothered by nausea and vomiting in pregnancy (the preferred term for “morning sickness”
these days), then you may find that the queasiness that you’re experiencing can get in the way of a good night’s sleep, too.

Fortunately, you get a bit of a reprieve in the second trimester – at least in so far as those middle-of-the-night treks to the bathroom are concerned. As the baby continues to grow, her position changes: because she’s not camped out on your bladder any longer (well, at least for now), you don’t have to urinate with quite the same frequency. The only bad news on the sleep front during the second trimester is that you may start snoring. According to psychologist Amy R.Wolfson, Ph.D., author of The Woman’s Book of Sleep (Oakland, California: New Harbinger Publications, Inc., 2001), approximately 30% of pregnant women start snoring during the second trimester – many for the first time in their lives. The culprit? Swelling in the nasal passages caused by rising estrogen levels.

The third trimester is, by far, the worst trimester when it comes to sleep. Heartburn, an increased need to urinate, sinus congestion, leg cramps, and difficulty finding a comfortable position all conspire against you in your quest for rest. The best way to manage sleep disturbances in late pregnancy is to practice good “sleep hygiene.” That means sticking to a regular sleep schedule; avoiding daytime naps; exercising regularly; avoiding caffeine within six hours of bedtime (assuming, of course, that you haven’t kicked your caffeine habit altogether); and getting out in the daylight in the afternoon in order to keep your body’s internal clock functioning properly.And if those neverending middle-of-the-night treks to the bathroom are wearing you out, you’ll want to decrease your intake of fluids right before bedtime.

When it comes to getting comfortable (no small feat at this stage of the game!), the most comfortable sleep position also happens to be the one that maximizes blood flow to your baby: lying on your left side. If you have a tendency to roll forward, you could find yourself left with a nasty backache in the morning, so it’s a good idea to get in the habit of tucking a pillow in-between your knees. That should help to ease some of your physical discomfort at least.

The bigger challenge, of course, is to get your mind to wind down so that you can the sleep you need. After all, there’s plenty to think about as you come into the home stretch of pregnancy. You may find yourself feeling excited about meeting your baby, worried about the changes that motherhood may bring to your life, and nervous about the challenges that you may face while giving birth.

The best way to cope with this late-night parade of thoughts is to come up with an evening wind-down ritual. Make sure that you’re tired enough to go to sleep. Then have a relaxing bath, listen to soothing music, and read something that will help you to drift off to sleep. With any luck, the Sandman will find you and you’ll be able to settle down for a good night’s sleep. Happy dreaming!

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