Sleepiness in pregnancy: why it occurs, and how to manage it

An increase in sleep during pregnancy, especially in the first trimester, is usually perfectly natural. Let’s see why it occurs and when it can indicate the existence of a problem.

Sleep and pregnancy

Sleep is a state of physical and mental rest. Sleepiness is a state of torpor characterized by the need to sleep and the consequent difficulty staying awake.

Sleepiness is not only a classic symptom of the initial months of pregnancy, it is also one of its earliest indicators. In fact, it can happen that you find yourself sleepy and in need of a nap before even discovering that you are pregnant.

This perfectly physiological state is explained by various natural causes, first of all by the work of hormones , which from the moment of conception begin to activate themselves to prepare the body for gestation and which bring with them inevitable side effects, including sleep.

Progesterone and sweet sleep

Among the hormones responsible for drowsiness in pregnancy, progesterone stands out . This steroid hormone, produced by the adrenal glands and corpus luteum in the luteal phase of the menstrual cycle and then “collapsing” in production with the arrival of menstruation, continues to be produced throughout pregnancy.

Among its numerous, very important functions in this period, there is the relaxation of the uterine wall and the inhibition of ovulations. And several studies associate the increased, constant production of progesterone with the great drowsiness that women feel in the first three months of pregnancy .

Vasodilation and iron deficiency

Another consequence of hormonal action on the pregnant woman’s body is the decrease in pressure on the walls of blood vessels.

This results in a loss of tone of the walls and in a dilation of the vessels, with consequent lowering of blood pressure and, again, a sense of tiredness, if not exhaustion.

To reinforce this picture of asthenia is added the possible lack of iron which, although more frequent in late pregnancy, can present itself from the beginning and bring with it increased drowsiness.

Disturbed sleep and mental fatigue

Sometimes we are surprised by our daytime sleepiness believing that we sleep well at night, when in reality we are not, but we are not aware of it. And this is even more true during pregnancy, when the duration of the REM phase tends to decrease , i.e. that of authentic and deep rest, and sleep is lighter, disturbed and intermittent.

If we add to this the fact that, even in the case of wanted and desired pregnancies, a little psychological and emotional adjustment is needed to fully enter the new dimension of future mother, it is understandable how a certain mental fatigue can peep out and manifest itself, again once, with the need to “turn off the brain” more often, indulging in naps.

How to manage sleepiness

Sleepiness during pregnancy should be managed in the simplest and most natural way: indulging it. It may seem counterintuitive in an era of multitasking, but this is not the time to be dynamic and performing: the body, which is currently working for two and is requiring resources, nourishment and energy, sends precise messages that it is smart to listen to .

Indulging the need for sleep then becomes a way of respecting oneself and one’s body, and preparing a serene environment for the unborn child, as rested and balanced as possible, inside the belly as once it was born.

In general, it’s perfectly fine to allow yourself small naps during the day, even treating yourself to many small breaks of even just 15 minutes, while it is better to avoid long daytime sleeps, also to avoid sleepless nights.

When sleep indicates that something is wrong

As we said, drowsiness is quite normal in pregnancy and typical of the first trimester , and in part of the third , but sometimes, if excessive or if it appears in more advanced stages, it can be a sign that something is wrong.

In case of extreme tiredness it could be, as mentioned, anemia , to be rebalanced with an iron supplement to be agreed with the doctor.

Significant daytime sleepiness can also signal that you have obstructive sleep apnea , a condition that can occur during pregnancy and is best monitored as it may predispose you to other conditions such as preeclampsia and gestational diabetes . In general, it is best to seek medical advice if sleepiness appears excessive and constant.

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, Maternicity.com.

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