Can pregnancy cause insomnia?

Pregnancy causes physical changes such as repositioning of the abdominal and thorax organs to accommodate the growing uterus, physiologic changes such as changing levels of hormone secretion and oxygen intake and psychological change as the excitement and anxiety of pregnancy and impending motherhood are experienced. All of these changes combined with the difficulty of finding a comfortable sleeping position in the second half of pregnancy can lead to difficulty sleeping.

Many women have difficulty sleeping during pregnancy. When you are pregnant the uterus presses on the bladder so there are often more trips to the bathroom during the night. Many women have trouble getting back to sleep when they are woken up during the night. Indigestion, leg cramps and many of the other common discomforts of pregnancy may make it harder for that good night’s uninterrupted sleep as we know it. Take heart. This is mother nature giving on the job training for learning how to sleep for several hours at a time, get up and go back to sleep. I tell my patients that this actually helps mom to get ready to be up and down with her new baby and learn to try for a nap during the day. Drinking warm milk or a sleepy time herbal tea, warm baths and decreased stimulation before bed can help you drift off for your first stint of sleep during the night. Decreasing the stress in your life and getting massages and emotional support for all your physical changes will also help. Make sure to discuss your sleep concerns with your midwife or ob/gyn.

When it comes to sleeping during pregnancy, you just can't impose your will on your body. A few causes of insomnia during pregnancy include back pain, heartburn, anxiety and vivid dreams, just to name a few. However, there are some little things that will make you more comfortable. Some suggestions:

• Try multiple pillows, which will pull the baby away from your diaphragm.
• Don't drink water after 6 p.m. to reduce bathroom use—and no caffeine either. (Make sure you get your 2 quarts a day before that.)
• Quiet the pain (through acetaminophen) so that you can get the restorative sleep you need.
• Try a small glass of warm skim milk, but not after 6 p.m. The lactose stimulates insulin, which helps proteins enter the brain and help people fall asleep.
• Create a dark and quiet environment in the bedroom, using the bed for sleep and sex only (and not for work or surfing the web).
• Ratchet up the air conditioner; it's easier to sleep in a cooler environment.

In addition to cognitive behavioral therapy (CBT), there are other alternative therapies for sleep disorders, including:

• Meditation
• Yoga
• Light therapy; where you expose yourself to bright light in the morning and avoid light in the evening
• Melatonin; which is effective in regulating the body's internal clock (Ask your doctor before taking any supplements.)
• Yoga; which builds your strength, flexibility and balance, as well as incorporates breathing exercises that have been shown to improve sleep
• Biofeedback devices; which help patients learn to control bodily functions like heart rate and temperature
• Exercise; doing so four to five hours before bed raises your body temperature above normal, and as your body temperature starts to fall a few hours later, that triggers your body to get ready for sleep.