Insomnia during pregnancy

THE body experiences a number of physical and emotional changes in pregnancy and with the complex combination of changes, it will start to function differently. One change that experts have calculated to be common in at least 78 per cent of women is insomnia.

“Insomnia during pregnancy is a common occurrence; this is due to the discomfort of the growing foetus and foetal movements, discomfort from swollen legs, leg cramps and heartburn. Anxiety associated with the fear of pain during labour and delivery, social problems such as a lack of a supportive environment, example a partner who is not supportive, are also causes of insomnia,” Dr Keisha Buchanan, obstetrician-gynaecologist at ICON Medical explained.

She said that a number of other triggers such as stimulants in the diet including caffeine, some medications, and in rare circumstances underlying medical conditions such as hyperthyroidism, could contribute to insomnia during pregnancy.

But while this may be uncomfortable for the mothers and can cause them to suffer from fatigue the morning after, Dr Buchanan said that lack of sleep generally is not dangerous to the baby.

“Apart from daytime drowsiness, lack of sleep increases the risk of poor coordination causing falls, increases the risk of accidents since some women have to drive tired, or even with handling everyday chores around the house things may fall and break. There is also the possibility of poor concentration, frustration, depression and a poor quality of life for as long as insomnia lasts,” Dr Buchanan shared.

To increase the chances of resting better, Dr Buchanan said that there are a number of treatment strategies that a pregnant woman can explore, most common being behavioural changes. She shares of the techniques below:

• Behavioural changes such as limiting the use of cellphones and tablets prior to bedtime can help, as the blue light that they emit can increase insomnia.

• Relaxation techniques before bedtime, a massage or a warm bath can increase the chances of falling asleep and staying asleep.

• Use of pillows in the bed such as those wedged behind the back to allow the woman to sleep on the left side. A pillow between the legs helps to support the lower back and limbs and eases discomfort in bed. Propping up the head with two to three pillows helps to ease heartburn and allow for a more comfortable sleep.

• Drinking chamomile tea or warm milk prior to bedtime also helps. Warm milk helps to release tryptophan and this is a sleep aid.

• Limiting coffee and other caffeinated beverages can aid with insomnia.

• Antihistamines such as DPH and medications for vomiting, for example Dimenhydrinate, are safe at all stages of pregnancy and can help with sleep. However, Dr Buchanan warns that these can lead to daytime drowsiness and increase the risk of accidents from falls or motor vehicle accidents. But she quickly pointed out that once taken in the hours before sleep their effects generally wear off in six to eight hours.

•At times underlying mental problems such as anxiety or depression may be causing insomnia and medical attention with a therapist will be needed.

“Most times simple lifestyle changes are usually successful in treating insomnia. However, if these are not working, the best thing to do is see your obstetrician to get assistance to get you back on track with adequate sleep,” Dr Buchanan advised.