Tips & tricks to help improve your sleep experience in pregnancy
Early in pregnancy, it is perfectly fine to sleep or lay on your back for a prolonged period in pregnancy. However, as the pregnancy progresses some women may find it difficult to sleep on their backs for a couple reasons.
A hormone called Relaxin is released in pregnancy to help aid in softening the fibrocartilage found between the pelvic bones. This hormone makes the tissue more stretchy and allows the baby to more easily pass through the birth canal. The main tissue type that this hormone acts on is also found between the bones in the spine and knee joints, which is why some pregnant women experience pain in those places as well. Good news is that these aches and pains of pregnancy resolve once the baby comes out.
Why does this happen? As the weight of the fluid, placenta and baby increase, the uterus may compress a large vein that returns blood, nutrients and oxygen to the maternal heart and brain. If you experience symptoms of lightheadedness, dizziness, pre-syncope, or nausea while lying on your back, don’t be alarmed, these symptoms will easily resolve within a few minutes with application of cold wash clothes and by lying on your left side. If you never experience these symptoms while laying on your back in pregnancy and you desire to lay on your back while sleeping for comfort, do not worry…some women tolerate back sleeping up until the day of delivery. Do not worry yourself about what you do subconsciously if you wake up flat on your back. Obviously, you cannot control how you move in your sleep. If you like to sleep on your back, then I would recommend placing a small pillow under the bend of your knees to decrease pressure on low back and under your right low back/hip for a small tilt if possible.
Ideally, side sleeping on full left or full right side relieves added pressure on the low back and added pressure on the large vein we spoke about earlier.
(Pillow #1) Underneath your head
(Pillow #2) Behind your back
(Pillow #3) Underneath your baby bump to support the weight of the baby and decrease strain on the opposing round ligament
(Pillow #4) Between knees/legs
The same pregnancy sleep support can be accomplished with a combination of normal pillows and pregnancy pillow.
Anything that you can do to decrease daily pains of pregnancy, will help improve your sleep (i.e. proper daytime and sleep ergonomics, daily stretching, good oral hydration, warm showers/heating pads, pregnancy support band, Tylenol as needed. The over-the-counter shower stool/bench is worth every penny. Pregnancy pain maintenance is important! You will notice when you don’t treat yourself to the nightly regimen because YOU WILL FEEL IT.
Safety of sleep medications and human research studies are limited in pregnancy. However, there are some therapies that are definitely safe in pregnancy and that have helped many women. If you have an underlying psychiatric disorder and are already taking medications for other conditions that affect your sleep please talk to your doctor at Premier OBGYN to discuss the risks and benefits of those specific medications.
Benadryl or Unisom-sleep are both safe medications in pregnancy to help with sleep. Osteopathic manipulative treatment (OMT) can help to balance the parasympathetic and sympathetic nervous systems and improve pregnant women’s sleep. OMT services are offered and available at Premier OBGYN. Please schedule an appointment with Dr. Gibby in our office, if you are interested in OMT to help treat pain or sleep issues in pregnancy. These treatments when done regularly can change your quality of life tremendously, especially when expecting. Similarly, massage can help with sleep. Regular pregnancy-appropriate exercise provides endorphins that relieve stress and inadvertently improve sleep in pregnancy. Therapy and guidance counseling can also be helpful as needed to reduce stress and improve sleep.
Many pregnant ladies will admit to waking up in the middle of the night to urinate. If your bladder is truly waking you up at night, then I would highly recommend wearing daily compression stockings. How will wearing compression stockings improve sleep you ask?! Often times, especially toward the end of pregnancy, women will retain fluid in their legs during the day due to compression of the lower extremity veins from the weight of the baby along with sitting and walking upright. Then when a pregnant lady lays down at night and elevates her legs up to the level of her heart, all the fluid that was pooling in her legs, returns to her kidneys and then bladder and then her bladder wakes her up. If you use compression stockings during the day, It will not only improve foot and leg pain, but will also keep the fluid from pooling in the legs and will allow the kidneys to process the fluid and expel it during the day instead. Limiting nighttime fluids can also help. Take caution to not get dehydrated and to drink plenty of fluid during the day. According to the American College of OB/GYN, during pregnancy you should drink 8-12 cups (64-96 oz) of water daily.