Cognitive Behavioral Therapy Or Cbt
A model of therapy known as CBT for insomnia can help people manage their thoughts and feelings about sleep and sleeping while changing their behavior.
CBT for insomnia can treat people with severe sleep deprivation get better sleep. It can help a person:
- understand their insomnia
- talk through emotions that play a role in insomnia
- make healthful changes that reduce insomnia
CBT may be particularly helpful for those facing anxiety or depression.
Remedies For Insomnia During Pregnancy
Whether youre currently pregnant or expecting, its good to know how to best deal with insomnia during pregnancy.
In most cases, you cant fix it 100%, but you can minimize the effects and sleep better during pregnancy.
Note that if you ever develop severe insomnia pregnancy, get help from a doctor, as its more likely to affect your child.
Research into insomnia treatment for pregnant women is still ongoing, but here are your main options.
Gestational Sleep Disordered Breathing
Sleep disordered breathing refers to breathing alterations during sleep, ranging from simple snoring to complete cessation of breathing with airflow interruptions lasting at least 10 seconds, usually accompanied by oxygen desaturation and fragmented sleep. Hypopneas, instead, are defined as airflow interruptions 10 seconds with a 50% reduction in airflow and a 3% desaturation. The severity of SDB is usually expressed in terms of apnea and hypopnea index .
Snoring is drastically increased in pregnant women, mainly due to the estrogenic effect on the nasal mucosa. Loud snoring in the third trimester has an estimated prevalence between 14-45%. RERAs, even in the absence of clear apneas, may be responsible for significant sleep fragmentation and increased sympathetic activation, leading to hypertension in the context of upper airway resistance syndrome .
Habitual snoring was independently predictive of both hypertension and small-for-gestational-age infants in a logistic regression analysis controlling for weight, age, and smoking. Habitual snoring during early pregnancy also proved to be a risk factor for glucose intolerance, as well as for GDM.
In a high-risk pregnancy population with high BMI and one or more comorbid risk factors among chronic hypertension, pre-GDM, prior pre-eclampsia, or twin gestation, 30% of women in early, and 47% in late pregnancy met criteria for OSA .
GDM: Gestational Diabetes Mellitus; OSA: Obstructive Sleep Apnea, PSG: Polysomnography.
Improve Your Sleep Hygiene
Sleep hygiene refers to good habits that will improve the quality of sleep you get each night. While everyone should practice good sleep hygiene, its especially important during pregnancy.
Healthy sleep hygiene habits include the following:
- Only sleep in your bed rather than anywhere
- Go to bed and wake up at consistent times each day
- Keep the bedroom dark and cool
- Ensure your bed is comfortable
- Do not use screens or electronics in bed, such as phones or the TV
- If you cant drift off to sleep, get up for 15 minutes and relax before trying again
Tips To Improve Postpartum Sleep And Treat Insomnia
Although measures to treat insomnia depend on the persons health and medical history , people can experience a reduction in symptoms by using cognitive behavioral therapy for sleeplessness . This therapy is usually provided by licensed health professionals. It involves the identification of problematic or incorrect thoughts and beliefs regarding sleep and their replacement with healthier attitudes. Cognitive-behavioral therapy can include the following:
Our newsletter contains the most recent information on sleep
- Sleep educationPeople with sleep problems and insomnia can gain a better understanding of how sleep works. A sleep diary can help you become more aware of your sleep patterns.
- Hygiene during sleepSleep hygiene is a term that refers to the practice of improving sleep. This includes a nighttime routine that encourages sleepfulness and a healthy sleeping environment. Sleep hygiene includes the temperature of your bedroom, light levels, caffeine, alcohol, meal times, exercise, and even lighting.
- Stimulus controlPeople can have anxiety about sleeping after experiencing nighttime disturbances or insomnia. This needs to be addressed in order to get better sleep.
Stimulus control emphasizes the importance of using a bed only for sleep and sex. It also stresses the importance getting out of bed on nights that are difficult to fall asleep.
Will Insomnia Continue After Pregnancy
To wrap up, lets think ahead a bit.
Lets say youre unable to get a great handle on your sleep issues during your pregnancy. Will you still have insomnia after pregnancy?
One study that looked at this topic found :
Although women slept fewer hours at night after delivery compared to during late pregnancy, and reported more nights with nighttime awakenings, their self-reported insomnia scores improved, and the prevalence of insomnia according to the DSM-IV criteria decreased.
Essentially, youll still probably sleep less , but youll have higher quality sleep. When it comes to sleep, quality is more important than quantity in most cases.
See our detailed guide to insomnia after having a baby for more details.
SummaryWhile youll still be a bit tired and fatigued on a regular basis, you likely wont have the same stress and anxiety from during pregnancy.
Treatment For Sleep Problems During Pregnancy
There are a number of ways to reduce sleep problems while pregnant. Principal strategies include adjustments to sleeping position and sleep hygiene habits. In conjunction with good sleep hygiene, managing pregnancy-related sleep disorders is key to getting better sleep while pregnant.
Certain therapies have proven effective for treating sleep disorders, such as a continuous positive airway pressure device for OSA, antacids for GERD, or vitamin and mineral supplements for RLS and other conditions. Although there are many theories, the reason for leg cramps and RLS during pregnancy remains unclear. Suggested therapies include vitamin supplementation, heat therapy, and massage but there is no consensus about what is the best treatment.
As certain substances may pose a risk to the developing fetus, pregnant women should always consult with their doctor before taking any medication or herbal remedies to help with sleep.
Insomnia During Pregnancy In Different Trimester
- First Trimester: The first trimester of pregnancy involves numerous changes that affect the body of the women. Some of these can develop after conception and some can be undermined sleep in pregnancy, resulting symptoms of Insomnia.
- 10 week pregnancy: A 10 week pregnant woman spends her time, mostly in sleeping, but with frequent naps throughout the day and longer sleep duration at night. This is because of frequent awakening and the amount of sleep decreases. During this period, women complain that they are not getting proper sleep. However, in second semester, this condition tends to improve.
- 12 week pregnancy: A woman who is 12 weeks pregnant experiences tiredness and sleepiness at the day time. However, generally sleepiness affects 37.5 percent pregnant women at six to seven weeks. The main reason for this is increasing levels of the progesterone, which is a hormone that leads to increased fragmentation of sleep. The other reasons disrupt sleep are back pain, increased appetite, morning sickness, anxiety and breast tenderness. Certainly, it is correct to say that these health issues would disturb the sleeping ability of the women, causing Insomnia.
Certainly, getting appropriate sleep is not very easy while you are pregnant due to numerous reasons, but a restless mind and body is unhealthy for both baby and mother. Though, there are many side effects of lack of sleep and for that getting assistance of a good physician is a good decision.
Getting Help For Insomnia
If you have insomnia, no matter the reason, you should seek help to sleep better. For temporary relief, the use of over-the-counter or prescription sleeping medications may be used, but these are not recommended to be used beyond a few weeks. For more persistent difficulties, other treatment options may be pursued.
Cognitive-behavioral therapy for insomnia is an attractive option to fix the condition without needing to rely on sleeping pills, which may not be safe to use during pregnancy. This education program teaches you a set of skills that will help you to sleep better for the rest of your life, no matter the cause of insomnia.
If trouble sleeping persists, seek evaluation by a board-certified sleep physician. If needed, a sleep study can be arranged to identify other causes of the disturbance, including the presence of sleep apnea. Contributions from stress, anxiety, pain, and other issues can be sorted out.
Fortunately, if a sleep disorder is contributing to insomnia, effective treatment may quickly resolve the condition. And if you think you may be pregnant, you should simply take a home pregnancy test or see your doctor to be certain.
You can use our Doctor Discussion Guide below to start a conversation with a healthcare professional about the right treatment approach for you.
Insomnia Doctor Discussion Guide
What Causes Urine Infections In Pregnancy
Urinary tract infections , or cystitis are as unpleasant as they are common. They are more prevalent in pregnancy because the urinary tract becomes dilated, increasing the chance of bacteria entering the area.
Talking on behalf of Patient.Info, Dr Sarah Jarvis MBE explains that UTIs such as cystits lead to burning, stinging, needing to wee more often, low tummy pain, and sometimes a fever or feeling generally unwell. Other symptoms include back pain, bad-smelling urine and feeling sick.
How can urine infections in pregnancy be treated?Antibiotics may be needed, especially if you have blood in your urine, have a high fever, if the symptoms go on for more than two days, and particularly if the pain spreads to your loins, says Dr Jarvis. If youre pregnant its especially important that you seek treatment.
To avoid getting a UTI drink lots of water; go for a wee as soon as you feel the need, and after sex; wipe your bottom from front to back; dont use perfumed products on your genitals; and wear breathable fabrics.
When Does Insomnia During Pregnancy Occur
In general, the further along you get, the worse the insomnia is . Most women find that third trimester insomnia is the worst.
The chart below from a study shows the amount of sleep women had at different check-in points during labor. You can see a steady downward trend.
While many women do start to get insomnia during early pregnancy , one study found that the risk of insomnia was 2.03 times higher for those in the third trimester than those in the first and second trimesters .
At 39 weeks , up to 73.5% of women will have some degree of insomnia , with the most common difficulty reported being maintaining sleep .
The main cause of this is that your body secretes more oxytocin shortly before labor .
SummaryWhile its not always linear, insomnia typically continues to get worse during late pregnancy. Theres more stress, chance of depression, and hormonal changes the nearer you are to labor.
When Does Insomnia During Pregnancy Start
It’s normal to have trouble sleeping at any point during pregnancy, but many expectant women experience insomnia starting in the second to third trimesters, as other pregnancy symptoms increase, and a burgeoning baby belly makes it harder than ever to get comfortable in bed.
Still, first trimester woes can force you from your cozy bed and disturb precious sleep too, including morning sickness, which can happen any time of the day or night, and a constant need to pee. But if youre worried that a case of insomnia may harm your baby, rest assured it wont. So do your best not to fret and sometimes, just letting go of these feelings is all it takes to help you sleep.
Strange Dreams During Pregnancy
You may have strange dreams or nightmares about the baby, and about labour and birth. This is normal.
Talking about them with your partner or midwife can help. Remember, just because you dream something, it does not mean it’s going to happen. Relaxation and breathing techniques may be helpful in reducing any anxiety you might be feeling.
What Is Restless Legs In Pregnancy
Restless Legs Syndrome is classed as both a neurological and sleep disorder. It creates an urge to move around to stop odd sensations. Regardless of its name, RLS affects other parts of the body as well as the legs.
According to the charity RLS-UK, the condition affects up to 25 per cent of pregnant women, especially during the third trimester, and often disappears shortly after the birth. Women who already have RLS may find it gets worse during pregnancy.
What causes restless legs in pregnancy?The causes of restless legs in pregnancy are unknown but could be as a result of a folate or iron deficiency, or hormonal or circulatory changes. A low red blood cell count raises a womans risk, as does a family history of the condition, or having suffered from it before or during a previous pregnancy.
How can restless legs in pregnancy be treated?RLS-UK recommends that you ask your doctor or midwife about trying supplements such as iron, magnesium, vitamin B12, or folate. Its important to speak to a health professional before taking over the counter medications or supplements.
The charity also advises that some women may find it helpful to stretch their legs, get a massage, use hot or cold packs, take a warm bath , or practice relaxation techniques. Maybe your partner will massage or rub your legs until you fall asleep. Try to be active during the day and avoid smoking and drinking, which may not only harm your baby but make the condition worse.
How Do You Know If You Have Insomnia
The simplest way to self-diagnose insomnia if you cant see a doctor is to assess yourself on The Pittsburgh Sleep Quality Index .
Its a short and simple test that measures the quality of your sleep, and has shown to be reliable for pregnant women .
Heres a free online Pittsburgh Sleep Quality Index calculator that you can fill out.
At the end, youll get your final PSQI global score.
If your score is greater than 5, youre a poor sleeper.
If your score is higher than 5, you might have insomnia . The higher your score, the more likely it is that you suffer from it and should seek help .
Keep Track Of Your Sleep
One of the most common, and effective, sleep hygiene strategies is to set a regular sleep schedule. This suggestion is particularly true for setting a regular wake-up time, as there is no reason to crawl into bed if you dont feel sleepy.
Maintaining your standard wake time can serve as a hard reset of your biological rhythms. Your body will get used to waking up and falling asleep at a certain time making mornings much easier. Your sleep and wake cycles are controlled by hormones and those particular hormones love a good routine.
Another method of improving sleep is tracking it. We know from weight-loss and smoking-cessation research that simply keeping track of a behaviour leads humans to adjust it.
Start by keeping a record of your sleep using a paper sleep-journal or an app. The point of tracking is to notice patterns so that you can begin to use what you learn to adjust your behaviours to improve sleep.
How Soon Can You Tell Youre Pregnant
If youre anxious to find out if doing the deed did its job, theres a good chance youll find yourself looking for any unusual early pregnancy signs.
While one of the most common first signs of pregnancy is a missed period, that wont actually occur until youre around 4 weeks pregnant. Some women, myself included, show weird pregnancy symptoms before a missed period has time to happen.
For example, when I was pregnant with our first daughter, I suddenly noticed I could barely stay awake during the day.
As someone who doesnt usually nap, this shouldve been a big ol flag.
In addition to fatigue, there are some other side effects you could experience during the two-week wait after ovulation, such as:
Prevalence And Associated Risk Factors Of Insomnia Among Pregnant Women In China
In Chinese pregnant women, about a fifth of women met strict clinical diagnosis of insomnia.
Insomnia were significantly associated with partner influence, depression, daytime sleepiness, somatic discomfort and the late gestation.
Further explorations are warranted to develop optimal psychosocial and physical interventions to reduce insomnia in pregnant women.
Increased Sense Of Smell
Another sign of early pregnancy is an increased sense of smell. I have a friend that started smelling odd things like burning dust on a lightbulb. She thought it was so strange too smell such a thing, and even asked her husband if he could smell it too. He couldnt. Turns out she was pregnant!
Increased sense of smell is definitely one of the funnier early signs of pregnancy.
Unusual Behaviour From Other People
Yep as surprising as this may be, your first inkling of pregnancy might be other people noticing something different about you! ‘My toddler daughter became obsessed with my belly and started wanting to lie her face on it at nap time and bedtime, says Petra A Mum Reviews. Same goes for Kate, who blogs at Family Fever; My toddler became super-clingy!
Different Factors Affecting Sleep In Pregnancy
Changes in sleep during pregnancy reflect alterations of several modified body-mind aspects including anatomical, physiological, hormonal and psychological factors. Increased weight and uterine volume comprise the most significant anatomical changes; uterine volume affects diaphragm elevation, leading to respiratory impairment. Body repositioning difficulties affect both sleep continuity and initiation. Primary physiological factors include cardio-respiratory changes such as increased pulse rate, blood pressure, and respiratory frequency, with an augmented alveolar/arterial oxygen gradient. Sympathetic activity, which is partially mediated by hormonal changes, is also increased during pregnancy, as are cardiac load and ejection fraction. All of these changes contribute to the fatigue and exhaustion endured by the expecting mother.
Pregnancy-related physiological changes include slower digestion due to the increase of gastric-emptying time, as well as constipation and gastroesophageal reflux. The latter, in fact, represent common problems in later pregnancy, affecting over 75% of pregnant women in some populations. Nocturnal micturition, which is linked to increased overnight sodium excretion, may also affect sleep fragmentation.
Is Insomnia Harmful During Pregnancy
A lost night of sleep during pregnancy here and there isnt usually a big concern, but continued or chronic inadequate sleep has been linked to gestational diabetes, stress and depression. Insomnia and frequent snoring also have been linked to an increased risk of giving birth to a baby thats too large or too small for its age, and sleep issues late in pregnancy have been linked to a longer labor and a greater need for a cesarean section.
Best Sleeping Positions For Pregnancy
Sleeping on the left side with the legs slightly curled is considered the best sleeping position in pregnancy. This position facilitates blood flow to the heart, kidneys, and uterus, and improves the delivery of oxygen and nutrients to the fetus. Although not as optimal as the left side, sleeping on the right side during pregnancy is also acceptable.
It may be helpful to use a few extra pillows to get comfortable sleeping on your side, especially if youre not accustomed to this sleeping position. Try tucking in a wedge pillow to support your belly, or adding a thin pillow between the knees to help relieve pressure on the lower back. Some women find it useful to hug a body pillow or place a pillow under the lower back.
As the uterus grows larger, sleeping on the back during pregnancy can cause backache and put pressure on the vena cava. The vena cava is one of the bodys principal veins, so this can interfere with blood flow and cause dizziness. While back sleeping is all right for brief stints, its best to avoid it if possible. Most pregnant women find that sleeping on the stomach is impractical once the baby bump reaches a certain size.
Signs Causes And Natural Remedies For Pregnancy Insomnia
You know some of those not-so-good things about being pregnant that no one said to you? Well, I think that pregnancy insomnia is one of the worst for all pregnant women.
No matter what you do to get more comfortable or how tired you really are, you just cant fall asleep? Or, even worse, you fall asleep but you wake up in the middle of the night and just cant drift back off? Welcome to the club.
To comfort you, you must know that you arent the only pregnant woman who is experiencing sleep deprivation. In 2007, a poll by the National Sleep Foundation showed that 30% of pregnant women and 42% of postpartum women have sleep problems.
Sleep problems and insomnia in pregnancy are something that almost every pregnant woman deals with.
Dont worry, its nothing serious and, like all other pregnancy symptoms, itll probably end after some time.
However, I know how exhausting it can be and we all definitely want to try to deal with it as soon as possible to finally get a good nights sleep.
If you are in the first trimester and you want to know more about pregnancy insomnia, signs of it, what causes it, and the most importantly, how to deal with it, continue reading below.
Abdominal Twinges Pulling Or Pinching Sensation
This is definitely a lesser known early pregnancy symptom, but not so rare. In fact, quite a few women experience some sort of unusual feelings in their tummy a few days or weeks after conception.
This is due to your uterus starting to stretch already after implantation, getting ready to let a little human grow inside of you.
It can feel like twinges, sudden localized pain, or more like a pulling of pinching sensation in your uterine or lower abdominal region. And it can happen on either side.
I have been experiencing twinges on both my left and right side, similar to where I normally have period pain.
This mom felt them from as early as 8 days post ovulation!
I was getting niggles from about 8 dpo, tested at 10 or 11 dpo simply cos I felt different.
Sleep Hygiene For Pregnant Women
Sleep hygiene is more important than ever during pregnancy. In addition to pregnancy sleep aids such as specialized pillows or eye masks, the following habits may help reduce insomnia and improve overall sleep quality:
- Keep a cool, dark, quiet bedroom and limit the bed to sleeping and sex
- Prioritize sleep and stick to a consistent bedtime, scheduling naps earlier in the day so they dont interfere with nighttime sleep
- Read a book, take a bath, or indulge in another calming activity in preparation for bedtime
- Use a nightlight to make it easier to get back to sleep after bathroom breaks
- Avoid caffeine, spicy foods, and heavy meals too close to bedtime to reduce the risk of GERD
- Avoid taking technology into the bedroom, and turn off screens at least an hour before bed
- Get regular exercise earlier in the day
- Drink plenty of water throughout the day, but reduce liquid intake before bed to reduce nighttime bathroom breaks
- If you cant sleep, get out of bed and do something else until you feel sleepy
- Write down thoughts in your journal, or seek help from your partner, friends, doctor, or childbirth classes if youre feeling stressed
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Can Pregnancy Cause Insomnia
There is an overwhelming amount of evidence that pregnancy can cause insomnia.
However, its still not perfectly clear why some women are affected more than others. For now, heres what we do know:
- Women who are more anxious and tend to worry experience more severe sleep difficulties
- Hormonal changes affect sleep related hormones like cortisol and melatonin . This is the same reason many women suffer from insomnia on their periods.
- The risk of insomnia is 2.63 times higher for women with depression syndrome
- Pregnant women often take CoQ10 supplements. Taking too much CoQ10 can cause insomnia.
All women need to deal with the hormonal changes, but if youre typically relaxed and easy going, you have a much smaller chance of developing severe sleep troubles.
SummaryInsomnia is very common to varying degrees during pregnancy. Its mainly caused by anxiety , depression, and hormonal changes.