Sleep, glorious sleep!

In Utah we just started daylight saving time. For many this means spring is right around the corner and we welcome the extra sunlight which is a natural mood elevator and good source of vitamin D. Of course this also means some adjustment in our body's biorhythm and in pregnancy sleep is already a challenge. Either we just can't get enough of it and require a daily nap as well as 9 or 10 hours at night, or we can't find a comfortable position, have insomnia or wake frequently.

Click on the post title or here to see a good sleeping video from About.com

Sleep patterns can vary significantly from person to person but it is generally accepted that adults require 7 to 8 hours at night in order to function optimally during the day. In pregnancy you might need a lot more. Pregnancy can also bring other complications that interfere with needed rest.

Sleeping difficulties

• Obviously the growing baby can make it hard to find a comfortable sleep position and even shifting in bed can be a challenge, especially in later pregnancy.
• Pregnant women need to urinate more frequently because of the increased blood volume of pregnancy. With the extra fluid being filtered, kidneys must work harder. Along with this some women find the increased heart rate interferes with sleep and may cause worry. A 10-20 beat/minute increase is common.
• Some women feel short of breath resulting from the decreased space and pressure against the diaphragm. You also have increased oxygen needs and you may notice you breathe faster or deeper.
• Acid reflux is common in pregnancy, when the digestive system slows and the resulting heartburn can disrupt your rest. (there are acceptable meds for this so talk to your doctor)
  
• Constipation is also common (also relating to slowed digestion) and of course any discomfort can interfere with sleep. Make sure you are getting some exercise, drinking plenty of water, and eating foods with high fiber content. If this is not enough discuss use of additional fiber or mild laxatives with your health care provider.
  
• Aches and pains are frequent in pregnancy. This is often due to the extra weight you carry. Most doctors recommend acetaminophen.
  
• Some women have different sleep cycles with different dreaming patterns.
• Stress and worry can also get in the way.

These causes are all normal but if you feel your symptoms are excessive, talk to your doctor about possible additional sleep aids.

Sleep positions

Many women worry excessively about their sleep position because they have been told they should not sleep on their backs. They try a new position but find they have reverted during the night. Peg Plumbo, CNM at iVillage.com states, "expecting moms should sleep and rest in whatever position they are most comfortable" She goes on to explain that there are a few exceptions, relating to high risk pregnancies (preeclampsia, preterm labor or placental insufficiency. These conditions necessitate bedrest and it that case a side-lying position would be best.). It is also not recommended you lie on your back during labor since the uterus against the aorta can aggravate already compromised blood flow at that time.

When worrying about back sleeping, keep in mind you are not likely to spend the entire night there anyway between tossing, turning and trips to the bathroom. You can even sleep on your tummy until it becomes uncomfortable. Peg says, "the female body is uniquely prepared for such positions and they will not put the baby in jeopardy." That said, there is a position that is actually good for you in pregnancy. If you can do it, the left side-lying position with knees bent is optimal for blood flow. Unless you have a particular need for the left side due to complications, either side can be quite beneficial. The reason the left is preferred is because the liver is on the right. Even if you weren't pregnant, this would be the "best" position for sleep.

You can become quite comfortable on your side with extra pillows. I recommend four pillows for every pregnant woman. One to be tucked in behind her back (partner can help with this and it will support her so she can relax in the position). A second one for her head (duh!), the third to be placed between the knees (this helps keep the legs aligned and prevents hip pain) and the fourth is for the side-lying mom to hug, allowing the upper arm to have support. You'll be amazed how this can help. You may get so comfortable you have to force yourself up for that bathroom break.

Keep in mind that your mattress should be firm enough to support you well. Even with all these measures you still may need naps during the day.

Kidshealth.org gives the following recommendations to help your sleep success:

• Avoid caffeinated drinks as much as possible. If you do use them, avoid from afternoon on.
• Try not to go to bed on a full stomach or after lots of fluid taken late at night (the bladder problem). Be sure you get adequate fluid and nutrition earlier in the day, however. If you are feeling nauseated, eat a few crackers.
• Try to follow a routine sleep and wake time.
• If you get a leg cramp, press your feet hard against the wall or stand on the leg. Don't point your toe. If it is sore, use heat at first, then switch to ice. Be sure you get enough calcium in your diet. If you don't eat dairy, talk to your doctor about taking a supplement.
  
• Learn relaxation exercises, like Yoga, to help you unwind. Exercise should be approved by your doctor.
• Enrolling in a childbirth or parenting class may help decrease stress and anxiety. Sometimes fears about these things keep you awake

If you do find yourself tossing and turning, find a relaxing activity such as a book (not a thriller) or TV, music or puzzles to help make you drowsy. If you need additional sleep aids, you should talk to your doctor. Click this post title to read more.