I'm often asked by pregnant patients and their partners what they can do to help them get better sleep. Oftentimes, they are physically uncomfortable in the back and hips and cannot seem to find a comfortable sleeping position. Other times hand numbness/tingling/discomfort is the culprit, and nasal congestion and shortness of breath can also be reasons for difficulty resting. Finally, a very common source of insomnia for both pregnant and non-pregnant patients is stress and anxiety.
The most common sleep aid I recommend is a "body pillow" to provide support for the full length of the body while sleeping on either the left or right side (after 16 weeks it's a no-no to sleep on one's back in pregnancy). Other smaller pillows may also be useful to support the enlarging abdomen or to place in the lumbar area. If the bed is just not comfortable to sleep in at some point, it may be necessary to find another place in the house that's more comfortable--the guest room bed, the couch, the recliner, etc. I always say "whatever works".
For those with hand discomfort, wrist braces can be purchased at a pharmacy that carries medical supplies and adjusted to keep the hand(s) at a neutral position during sleep, decreasing compression on the nerves. Avoiding hi sodium/salty foods is also useful in reducing fluid retention and nerve compression in the wrists as well.
For those with nasal congestion, using saline nasal spray and/or a humidifier can be helpful, and many of my patients with chronic sinus congestion swear by the "Neti Pot" irrigation techniques. We only recommend nasal decongestants for short term (i.e. 3 days or less) management of upper respiratory tract infections, as they are stimulants to the cardiovascular system, and can actually worsen insomnia as well.
Shortness of breath is a very common symptom in advancing pregnancy, in part due to the compression of the diaphragm from below as well as to other physiologic changes in pregnancy. Proper positioning and posture can help, as well as elimination of common allergens such as pet dander (no sleeping with Fido!), mold/dust (break out the vacuum, Dad!), and appropriate prescription medications for those who suffer with asthma. Of course, we always recommend avoiding smoking in pregnancy and exposure to second hand smoke.
Stress and anxiety are very common, especially with the excitement of impending birth and changes to family structure, financial concerns, relationship issues, and so on. This is particularly true if you are carrying a high risk pregnancy that has caused you to be on bedrest or to modify your work hours. There are also lots of patients who were anxious people long before they conceived a pregnancy. Doing what you can to control the sources of stress in your life is an obvious (though not always easy) fix. Avoiding stimulants such as caffeine, exercising close to bedtime, too much screentime (TV, computer, smartphone, etc) close to bedtime, and so on can be very effective. Sometimes sleep aids are recommended short term such as diphenhydramine, Ambien, etc., but we like to clear the system prior to the onset of labor of any sedative medications that may hang around longer in baby than in mom. Finally for those who are clinically depressed/anxious, certain prescription medications may be recommended to avoid the consequences of those conditions in pregnancy, including insomnia.
Finally, one of the most frequent complaints I get from pregnant women is that they have to urinate all the time, including during the night. Clearly avoiding over-drinking prior to bedtime can help, and as long as your urine is a light yellow color you don't have to worry about being dehydrated. If there is burning with frequent urination, a urine culture should be done to rule-out infection.
Sometimes I look at a little insomnia as God's way of getting us ready for the true sleep deprivation yet to come after baby's arrival, but getting as much sleep as you can before baby is a gift to yourself. Happy dreams!
The most common sleep aid I recommend is a "body pillow" to provide support for the full length of the body while sleeping on either the left or right side (after 16 weeks it's a no-no to sleep on one's back in pregnancy). Other smaller pillows may also be useful to support the enlarging abdomen or to place in the lumbar area. If the bed is just not comfortable to sleep in at some point, it may be necessary to find another place in the house that's more comfortable--the guest room bed, the couch, the recliner, etc. I always say "whatever works".
For those with hand discomfort, wrist braces can be purchased at a pharmacy that carries medical supplies and adjusted to keep the hand(s) at a neutral position during sleep, decreasing compression on the nerves. Avoiding hi sodium/salty foods is also useful in reducing fluid retention and nerve compression in the wrists as well.
For those with nasal congestion, using saline nasal spray and/or a humidifier can be helpful, and many of my patients with chronic sinus congestion swear by the "Neti Pot" irrigation techniques. We only recommend nasal decongestants for short term (i.e. 3 days or less) management of upper respiratory tract infections, as they are stimulants to the cardiovascular system, and can actually worsen insomnia as well.
Shortness of breath is a very common symptom in advancing pregnancy, in part due to the compression of the diaphragm from below as well as to other physiologic changes in pregnancy. Proper positioning and posture can help, as well as elimination of common allergens such as pet dander (no sleeping with Fido!), mold/dust (break out the vacuum, Dad!), and appropriate prescription medications for those who suffer with asthma. Of course, we always recommend avoiding smoking in pregnancy and exposure to second hand smoke.
Stress and anxiety are very common, especially with the excitement of impending birth and changes to family structure, financial concerns, relationship issues, and so on. This is particularly true if you are carrying a high risk pregnancy that has caused you to be on bedrest or to modify your work hours. There are also lots of patients who were anxious people long before they conceived a pregnancy. Doing what you can to control the sources of stress in your life is an obvious (though not always easy) fix. Avoiding stimulants such as caffeine, exercising close to bedtime, too much screentime (TV, computer, smartphone, etc) close to bedtime, and so on can be very effective. Sometimes sleep aids are recommended short term such as diphenhydramine, Ambien, etc., but we like to clear the system prior to the onset of labor of any sedative medications that may hang around longer in baby than in mom. Finally for those who are clinically depressed/anxious, certain prescription medications may be recommended to avoid the consequences of those conditions in pregnancy, including insomnia.
Finally, one of the most frequent complaints I get from pregnant women is that they have to urinate all the time, including during the night. Clearly avoiding over-drinking prior to bedtime can help, and as long as your urine is a light yellow color you don't have to worry about being dehydrated. If there is burning with frequent urination, a urine culture should be done to rule-out infection.
Sometimes I look at a little insomnia as God's way of getting us ready for the true sleep deprivation yet to come after baby's arrival, but getting as much sleep as you can before baby is a gift to yourself. Happy dreams!
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