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Managing Sleep During Pregnancy

Facts ------ 3976293

Sleep problems during pregnancy are generally caused by hormonal and other physiological changes that occur to support you and your baby during pregnancy as well as physical changes that take place as your baby grows.

    • Feeling sleepier during the day, trouble falling asleep even when you are really tired, less restful sleep and waking up more frequently for no apparent reason can all be due to changing levels of pregnancy hormones.
    • Difficulty getting comfortable as well as restless legs, feeling short of breath and heart-burn are all due to your body changing shape and your growing baby pressing on your organs and nerves.
    • Waking up during the night to go to the toilet is also due to pregnancy hormones and your baby pressing on your bladder.

Tips

Being more tired than usual can be part of being pregnant, but there are things you can do to manage how tired you feel.

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Plan sleep

    • Sleep is something we take for granted, that is, until problems are encountered. 
    • Give sleep higher priority now that you are pregnant. Decide how much sleep you need to function well and plan your day around achieving this.
    • Set and maintain a regular bedtime to help stabilise your body clock. Constant variation in bedtime and sleep duration affects ability to fall asleep and the quality of sleep.
    • If your sleep at night is regularly interrupted by toilet visits or other children, plan a regular nap during the day to make up for it. A power nap can do wonders even if it is only 10-15 minutes. However, if possible nap for no longer than 30-45 minutes and no later than 4.00 pm. This way your night time sleep will not be affected and you won’t wake up feeling too drowsy.
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Create a Regular Bedtime Routine

  • A regular bedtime and routines to relax and prepare for you for sleep may improve the duration and quality of your sleep.  Routines to relax you before bed may include:
    • Stretching your muscles  (external) gently to relax any muscle tension you may have.
    • Breathing exercises (external) by inhaling in through the nose and releasing out through the mouth.
    • Take a warm shower one or two hours before bed, as your body cools down you will feel sleepy.
    • Using a small drop of lavender oil mixed with olive oil to either rub into your skin or put into the bath. Lavender is known to promote sleep.
    • Sitting calmly and drinking a small cup of non-caffeinated herbal tea (e.g. chamomile) to help you relax.
    • Replacing activities like watching TV and using other electronic gadgets (laptop, mobile, tablet computer etc.) with more restful pastimes e.g. Knitting/crocheting, reading a book etc.
  • You can also use these techniques when you are having difficulty sleeping or wake up in the middle of the night. Here are some more tips on getting to sleep and sleep hygiene (external).
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Get Comfortable

  • Being comfortable is important to falling asleep and staying asleep but can be a problem with the physical changes in late pregnancy.
    • Sleep on your left side. This reduces back ache and improves blood flow to your uterus so that nutrient delivery and waste removal for your baby is more efficient.
    • Use pillows as supports to wedge behind your back, between your knees and under your belly.
    • Allow plenty of room to spread out and move your limbs during sleep.
    • Pay attention to temperature regulation. Your metabolic rate rises during pregnancy making you feel warmer so you may need less blankets and clothing even in winter.
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Minimise Nausea

  • Nausea associated with ‘morning sickness’ during pregnancy can wake you from sleep in the morning or keep you awake at night.
    • If nausea strikes when you are trying to sleep, keep some dry crackers close to your bed for a snack. Even if you really don’t feel like you can eat anything – it can help settle your stomach.
    • Getting hungry can trigger nausea so make sure you have snack before bed if you find you are nauseous during the night.
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Reduce Heart Burn

    • ‘Heart burn’ or reflux of food and acid from your stomach is due to the pressure of your expanding uterus on your stomach as well as relaxation of the sphincter that closes off the opening of your throat to your stomach in response to higher levels of progesterone hormones in pregnancy. Lying down to sleep after eating can make it worse.
    • Try to:
      • Eat upright and stay semi-upright (head and shoulders at ≥ 40° angle) for at least 1 hour after meals
      • Eat smaller portions more frequently. More about healthy eating and portion size
      • Avoid foods that induce heart-burn (spicy, fatty/ fried, caffeine) and
      • Avoid drinking too much fluid with meals – drink between meals instead as this will avoid your stomach getting too full
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Reduce Toilet Trips At Night

    • Although it only takes a few minutes, frequent waking to visit the toilet at night can reduce the quality of your sleep. Even worse, you may not fall back to sleep, leaving you feeling less rested the following day.
      • Try to drink fluids throughout the day but taper off before bed time
      • Empty your bladder just before bed
      • Avoid caffeine- containing drinks (tea, coffee, cola, energy drinks) before bed
      • Avoid salty foods that stimulate thirst, these increase your fluid intake and increase your urine production
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Keep a Healthy Weight

    • Maintaining a healthy weight makes it easier to get comfortable in bed and reduces the risk of snoring, sleep apnoea (external) and therefore the risk of chronic sleep deprivation.
    • Other pregnancy health-related issues such as gestational diabetes, pre-eclampsia (high blood pressure) and oedema (fluid retention) can also affect the quality of your sleep and are minimised by maintaining a healthy weight.
    • See the pregnancy weight gain calculator to estimate your healthy weight gain in pregnancy and the weight, nutrition and activity sections for facts and tips to help maintain a healthy weight.
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Boost Your Energy

  • Your diet and keeping active can affect how energetic you feel during the day and how well you sleep at night.
    • Try to:
      • Choose healthy foods with a low glycaemic index which will give you longer-lasting energy. More about healthy eating
      • Spread your food intake across three small meals and two or three snacks throughout the day to maintain your blood sugar levels and to keep you feeling energetic. More about Nutrition.
      • Exercise regularly. This will improve your sleep quality by increasing your need to sleep, relieving stress, anxiety and body aches. Aim for at least 30 minutes daily. If you are finding it difficult to fit in a 30 minute time slot, do shorter bouts of physical activity for 10 or 15 minutes. It all adds up. Being active when you have a moment is better than doing nothing at all. More about keeping active.
      • It is best to exercise at least two hours before bed time as moderate physical activity right before bedtime can negatively affect your sleep.
    • If you are still tired after a good amount of regular sleep, see your doctor about other possible causes (e.g. low iron).
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Other Useful Links

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More on Pregnancy

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