Summary of this article
Insomnia in early pregnancy is mainly due to hormonal imbalance. In mid-pregnancy, some pregnant women experience insomnia due to fetal movements when lying down, back pain, or frequent urination. In late pregnancy, edema, limpness, and other symptoms may be caused by lack of exercise. The way to cope with insomnia and sleep disorders varies from person to person, but the most important thing is to avoid stress. It is best to try to relax by soaking in warm water and doing light exercise such as walking or maternity yoga.
- Introduction
- Causes of insomnia during pregnancy
- For a better maternity life
- How to deal with insomnia during pregnancy
- Fetal health risks learned through NIPT (New Prenatal Testing)
The cause of sleepiness and wakefulness in early pregnancy is body temperature
Early pregnancy symptoms are closely related to increases in estrogen and progesterone. Both are important hormones for maintaining pregnancy, but it is said that changes in the hormone balance between estrogen and progesterone can cause insomnia during pregnancy.
There is a deep connection between sleep and body temperature. At night, the human body’s metabolism slows down, and body temperature drops accordingly. This is said to be to prevent the brain from overheating due to morning and afternoon activity, and even if you are unable to sleep and stay up late, your body temperature will be slightly lower.
Progesterone is a hormone that causes sleepiness. Progesterone is likely the cause of abnormal sleepiness before menstruation. However, because progesterone has the effect of raising body temperature (high temperature phase), it affects the ability to fall asleep at night. For these reasons, pregnancy often leads to sleepiness during the day and a lack of drop in body temperature at night, making it difficult to fall asleep and causing insomnia. Some pregnant women also experience insomnia due to night sweats.
Progesterone is a hormone that not only makes you sleepy, but also causes premenstrual syndrome (PMS). Irritability and anxiety during early pregnancy are also known to cause sleep disorders. Of course, many pregnant women are unable to sleep because they are worried about the health of their baby.
In addition to the changes in body temperature and mental effects caused by hormonal balance, morning sickness and frequent urination due to pressure on the bladder caused by the enlarging uterus are said to lead to sleep disorders.
Second trimester (14 weeks 0 days to 27 weeks 6 days)
- Fetal movement
- Frequent urination
- Anxiety (fear of miscarriage or premature birth)
The fifth to seventh month of pregnancy is said to be the stable period, but many pregnant women experience insomnia as they wake up in the middle of the night due to shortness of breath caused by their growing stomach, changes in sleeping posture, or back pain.
Also, the middle of pregnancy is when fetal movements begin, so while you may not notice them during the day, when you lie down and quietly you may become bothered by them and be unable to sleep.
During pregnancy, as the fetus grows, more blood needs to be sent to the uterus. This increases the amount of blood, which is said to be about 1.4 to 1.5 times that of before pregnancy. To maintain the balance of bodily fluids, blood is filtered by the kidneys, and excess water is excreted as urine, so it can be said that frequent urination is likely to occur during pregnancy. During the second trimester, the amount of blood passing through the kidneys is at its highest, leading to frequent urination.
In addition, the enlarged uterus puts pressure on the bladder, making it difficult to empty all of the urine, which can make you feel like you have residual urine.
These are some of the obstacles to getting good quality sleep.
Also, as the amount of blood increases, the mucous membranes swell, which can cause nasal congestion and make it difficult for pregnant women to sleep.
The second trimester of pregnancy is said to be a time when both the fetus and the pregnant woman are mentally stable. However, many pregnant women who have been diagnosed with threatened miscarriage or premature labor suffer from sleep disorders caused by anxiety, or insomnia due to the stress of having their daytime activities restricted.
Late pregnancy (from 28 weeks)
- Palpitations
- Shortness of breath
- Swelling (edema)
- Fetal movement
- Body pain such as back pain
- Restless legs syndrome
- Itchy skin
- Cramps
- Anxiety (anxiety about childbirth, anxiety after childbirth)
- Frequent urination
Blood volume increases during pregnancy. In the later stages of pregnancy, the amount of blood being sent to the heart and the heart rate increase to about 30-50% of what it is when not pregnant, so palpitations occur even when sleeping, and it is not uncommon to feel short of breath. It is also said that anemia is more likely to occur during pregnancy, and anemia can also cause palpitations. In the later stages of pregnancy, as the fetus grows, the belly becomes larger and many pregnant women become less active. As a result, it is said that blood flow becomes poorer and swelling (edema) is more likely to occur in the body.
Skin discomfort and itching during pregnancy
There are many cases of “restless legs syndrome” during pregnancy, which is characterized by an uncomfortable tingling sensation in the lower legs. Although the exact cause of restless legs syndrome has not been elucidated, it is said that symptoms tend to appear at night while sleeping, leading to sleep disorders.
Unlike restless legs syndrome, which can occur in both sexes, symptoms that occur only during pregnancy include “pruritic papules of pregnancy (PUPPP)” and “herpes gestationis.” Both conditions cause intense itching that can disrupt sleep and lead to sleep disorders. Itching can be controlled with oral medications and topical ointments, so it is important to see a doctor promptly if you experience these symptoms.
Cramps that occur during the middle and late stages of pregnancy
Many pregnant women experience cramps from the middle to late stages of pregnancy. “Cramps” refer to the calf muscles. They occur when the calf muscles spasm and contract abnormally, causing leg cramps. Cramps can also occur while sleeping, and some pregnant women wake up suddenly in pain.
Cramps are said to be caused by poor circulation in the lower limbs due to lack of exercise, or a lack of calcium or magnesium. However, from around the 28th to 31st week of pregnancy, your belly will bulge out and you may have trouble seeing your feet. If you are hesitant to go for a walk, you can just tap your feet indoors. Make sure to do light exercise and eat a nutritionally balanced diet.
Maternity highs and blues
Maternity high and maternity blues are said to be the emotional ups and downs that are unique to pregnant women.
Maternity high is the act of imposing your high on others due to the joy of being pregnant. Examples include explaining how wonderful pregnancy is without considering the other person’s feelings or situation, or showing ultrasound pictures even though they were not asked. Note that maternity high is not a medical term.
On the other hand, maternity blues is a medical term that can also be found in psychiatric dictionaries. It is said that changes in hormone balance also have an effect, and symptoms include anxiety and depression during pregnancy, fear of childbirth, irritability, and other emotions that cannot be controlled.
It is not uncommon for mental and physical discomfort that stabilized during the middle of pregnancy to reappear in the later stages of pregnancy. It is also said that maternity blues can occur even after giving birth, and in some cases can progress to postpartum depression. If you experience any mental or physical discomfort during or after giving birth, it is important to consult with your family, partner, or doctor.
For a better maternity life
During pregnancy, many pregnant women will feel various anxieties due to hormonal imbalances and sudden changes in their bodies. Many also suffer from morning sickness, frequent urination, and sleep disorders due to worries about the health of their baby.
“I can’t sleep at night,” “I’m not getting enough sleep because of the baby’s movements,” “I can’t even go back to sleep because of frequent urination,” are some of the concerns we receive from pregnant women. However, it is said that sleep disorders themselves rarely have any effect on the fetus, such as causing miscarriage or premature birth.
How to deal with insomnia during pregnancy
How to deal with insomnia and sleep disorders during pregnancy varies from person to person, but the most important thing is to avoid accumulating stress. Feelings of irritability and anxiety are likely to be caused by hormonal imbalance, so it’s a good idea to try to relax. Below are some specific measures and ways to deal with insomnia during pregnancy.
Take a bath in lukewarm water
When your body temperature rises after taking a bath, it becomes easier to fall asleep as your body temperature drops.
Water that is too hot stimulates the sympathetic nervous system, so try to bathe in lukewarm water between 38°C and 40°C. Although this varies from person to person, it is effective to take a bath about an hour and a half before your planned bedtime.
Also, long baths during pregnancy can be hard on the body, so try to limit your time to 10 minutes.
Do some light exercise during the day
Exercising during the day can improve the quality of your sleep, but pregnant women should choose lighter exercise as vigorous exercise can be hard on the body.
We recommend walking and maternity yoga.
Breathing techniques that can help combat insomnia
Yoga breathing techniques are said to have the effect of regulating the mind and body, and it has been reported that doing yoga improves the quality of sleep.
A study of pregnant women in the 6th to 10th month of pregnancy also confirmed that stress was reduced after yoga. In particular, women in the 8th month of pregnancy were found to have better sleep after yoga.
You could try attending a prenatal yoga class, or if that’s difficult, you could also research breathing techniques yourself using books or other sources.
If you choose to do yoga on your own, be sure to stick to breathing exercises as some yoga poses may be hard on your pregnant body.
Do not use the computer, smartphone, or watch TV before going to bed at night
The blue light emitted from computers, smartphones, and televisions inhibits the secretion of melatonin, a hormone that promotes sleep, which can disrupt sleep.
To ensure you get a good night’s sleep, try to avoid using your computer, smartphone, or watching TV before going to bed.
Take a short nap
Taking a long nap during the day can make it difficult to sleep at night. It can also mess up your body clock, so even if you do take a nap during the day, try to keep it short.
Is it okay to take sleeping pills?
Some sleeping pills should not be taken during pregnancy. Benzodiazepines, which are commonly used among sleeping pills, are not said to increase the risk of teratogenicity, but they have been linked to miscarriage and other problems.
However, there are sleeping pills available for you to take if your doctor deems it necessary, so if you are suffering from insomnia, don’t push yourself too hard and be sure to consult your doctor.
Can I use herbal medicines or supplements?
Chinese herbal medicines and supplements are often thought to be gentler on the body than Western medicines, but some can have an effect on the body during pregnancy, such as causing uterine contractions.
If you want to take herbal medicine or supplements, do not make your own judgment; instead, visit a hospital and be sure to consult with a doctor.
Knowing the health risks of your fetus through NIPT (new prenatal testing)
In recent years, advances in fetal diagnostic techniques have made it possible to check for chromosomal abnormalities in the fetus early in pregnancy. This makes it possible to find out at an early stage the risk of congenital disorders caused by chromosomal abnormalities, such as Down syndrome (trisomy 21) , Edwards syndrome (trisomy 18), and Patau syndrome (trisomy 13) .
At Hiro Clinic NIPT, we offer NIPT (a new type of prenatal testing) that allows screening tests from around the sixth week of pregnancy (when pregnancy is confirmed by ultrasound). NIPT is a prenatal test that can be performed by simply taking a blood sample from the mother. In addition, it is said to be a highly safe prenatal test because it does not directly invade (damage) the fetus.
NIPT is a highly accurate screening test with a sensitivity and specificity of 99.9% for Down syndrome (trisomy 21) , the most common genetic disease . Chromosomal abnormalities can cause not only congenital disorders in the fetus but also miscarriage, so it can help mothers to know and prepare for health risks during pregnancy at an early stage.
If you have any concerns about chromosomal abnormalities in the fetus or questions about NIPT, please contact Hiro Clinic NIPT . Let’s reduce one of your anxieties during pregnancy and improve insomnia and sleep disorders.
【References】
- J-stage – Women’s Sleep and Hormones Kayo Shibui
- Body Changes During Pregnancy Haywood L. Brown MD, Duke University Medical Center
- Japanese Association for Neurological Therapy – Standard Neurological Treatment: Restless Legs Syndrome (IV Secondary Restless Legs Syndrome 4. Pregnancy and RLS)
- Japan Society of Obstetrics and Gynecology – Mental Health Care Manual for Pregnant and Postpartum Women
- J-stage – Human thermoregulation and sleep Makoto Uchiyama, Ryuji Furutahata
- Japan Academy of Midwifery – The effects of maternity yoga intervention on sleep and stress in pregnant women
Article Editorial Supervisor
Dr Hiroshi Oka
NIPT specialist clinic, MD
Graduated from Keio University, School of Medicine
