Insomnia in pregnancy

Between the changing body, the mind processing the new situation and hormones working at full speed , experiencing insomnia during pregnancy is far from uncommon. This, however, does not mean that it happens to all future mothers, or that we have to accept it passively.

So let’s get to know this disorder better, especially typical of the first and third trimester , to discover its potential causes and to see how it can be solved or mitigated.

Why you sleep badly in the first trimester

Sleep disturbances in pregnancy start right in the first trimester .

One of the culprits is progesterone, a very important steroid hormone in this phase which, however, brings with it side effects that are difficult to reconcile with good restful sleep: reduction of the REM phase, breast tenderness, frequent urge to urinate, gastric acidity, increased of body temperature, just to name a few.

If we add to this a great daytime drowsiness, always linked to the increase in progesterone, and the consequent need to nap during the day, it is easy to understand how frequent it is, in this period, to spend restless nights and sleepy days, often feeling tired and confused.

Sleepiness (less common) in the second trimester

The second trimester of pregnancy is usually the quietest on all fronts, including sleep. But it can equally happen that you continue to sleep badly, for example if on an emotional level you are not yet completely at peace with the new situation, or if you have a tendency to think too much, projecting yourself forward, worrying about the birth, wondering if you will be able to be a good parent.

Anxieties and fears, which already peeked out in the first months, may not have calmed down yet. However, the causes of insomnia in this phase of pregnancy can also be physical, such as the very first fetal movements, the belly that begins to grow forcing you to change position in bed, the urge to urinate that continues.

Finally, while it is true that progesterone levels stabilize in the second trimester , the stress hormone cortisol could make itself felt .

Troubled sleep and a bump in the third trimester

If the second trimester can give insomnia a break, the third trimester presents some new problems for those who are experiencing intermittent and unrefreshing sleep during pregnancy.

The size of the belly, in this phase, can greatly hinder the achievement of a comfortable position for sleeping, while at the hormonal level the release of oxytocin , which will be so important in the birth phase, can make one more irritable.

Then there are the baby’s movements, more and more clearly perceptible, the increase in gastric reflux, as well as the potential increase in worries and thoughts as the time of delivery approaches.

Pillows, light dinners and warm milk

The solutions to reduce the problem of insomnia during pregnancy are different and should be harmonized with the cause, or causes, from which it is caused.

If the problem is merely “positional”, a pillow for pregnant women can help, as can practicing sleeping on your side .

Naps during the day are fine, but should be limited to no later than sixteen, just as dinner should be a little late, so that you go to bed without feeling heavy. But be careful, read yes, but hungry no: a small snack before falling asleep can be granted, perhaps avoiding sugars, which are unnecessarily energetic and immediately released. Classic hot milk is also fine, both for the relaxing ritual of sipping a steaming drink and for its tryptophan content, which promotes sleep.

The bedtime ritual

Speaking of rituals, you can try to fight insomnia by creating a small pre-sleep routine: no TV, computer or device at least an hour before turning off the light, relaxing music in the background, a novel to leaf through or a couloring book on which to empty your mind.

In this way they are created as the “end credits” of the day, which gently help to transition from the day full of thoughts and commitments to a night of silence and rest.

For those who want to try to help themselves with herbs, it is important to ask the doctor’s advice first, even if it is a simple herbal tea: linden, lemon balm, passionflower are typical phytotherapeutic remedies that promote sleep, each acting in a specific and different way from the others, and which in various formats (from infusions to tablets) can help in case of agitation and prolonged insomnia, but should not be taken without first consulting.

Become like water

It may seem excessively new age advice , but it is not a wrong approach to accept some situations without forcing them, acting like water that meekly follows the bed of the river.

Just as it is good to allow yourself, especially at the beginning of pregnancy, small daytime naps to satisfy the need for refreshment that the body legitimately makes present, you can accept finding yourself awake at night and, instead of trying to try to sleep at all costs maybe try reading a book, engage in an undemanding and pleasant activity, get up and take a short walk around the house.

Who knows, by freeing the mind from the need to do the opposite of what one is experiencing, relaxation and sleep won’t come by themselves. It’s worth a try.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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