Oct 24, 2024 – Here’s something sure to keep a pregnant woman up at night: A recent study revealed that lack of sleep during pregnancy may impact the baby’s development, leading to delays in learning and social behavior.
The research builds on a substantial body of evidence – and scary headlines – linking poor sleep during pregnancy to bad outcomes for both Mom and Baby.
Good to know. Unless you’re a pregnant woman who can’t sleep.
“It's really unhelpful to be bombarded with messaging that the person is hurting their health” – or their baby’s, said Natalie Solomon, PsyD, a psychologist and behavioral sleep medicine specialist at Stanford Medicine, with a focus on sleep and reproductive health. (As it happens, she’s also eight months pregnant.)
Pregnant women already have plenty of reasons why they might struggle to get a full night’s sleep – from getting up in the night to use the bathroom to physical changes that can make finding a comfy position hard. Adding that psychological pressure doesn’t help.
“Trying to make yourself sleep is like trying to get out of quicksand,” said Solomon. “The harder you struggle, the more you get stuck.”
Dealing With Anxiety and Insomnia
If those recent headlines are keeping you up, there are evidence-backed strategies you can try, Solomon said.
Solomon likes progressive muscle relaxation, when you tense each muscle group – starting at your feet and working your way up your body – for a few seconds while breathing in, then relax your muscles as you breathe out. In randomized trials, this technique has been shown to significantly reduce pregnant women’s anxiety and insomnia. You can also try guided imagery (imagining yourself in a peaceful setting) or square breathing, when you breathe in for a count of four, hold for four, exhale for four, and hold for four.
Another trick: Setting aside dedicated worrying time during the day. This really works, Solomon said. Having dedicated worry time means you’re less likely to worry during the rest of the day (and night).
But if you’re really struggling, don’t be afraid to seek professional help.
“If sleep problems are causing significant distress, we recommend consulting with a local sleep center or specialist in maternal-fetal medicine,” said Peng Zhu, PhD, a professor of maternal, child, and adolescent health at Anhui Medical University in China, and co-author of the recent study on Mom’s sleep and Baby’s development.
Your doctor may be able to refer you to a perinatal therapist or other mental health professional who can provide cognitive behavioral therapy for insomnia (CBT-I), a type of behavior change therapy designed to help with insomnia. Research shows that CBT-I can greatly reduce insomnia among pregnant women.
Depending on the situation, a doctor might advise taking Benadryl as a sleep aid, if the benefits outweigh the risks, Zhu said. But talk to your doctor first.
‘Sleep Opportunity’ or Physical Discomfort
What if something besides anxiety has you short on sleep? Chances are, it’s one of two things, Solomon said.
Some people simply lack “sleep opportunity,” meaning they just don’t have enough time to clock their eight hours. If that’s you, recruit a family member or friend to help with childcare, chores, or whatever you need, Solomon said. Hate asking? Remind yourself: You’re doing this so your body can nurture your growing fetus, Solomon said. (It might also help to know that women have, throughout history, relied on help and care from their community to deliver a healthy baby – in other words, you’re not meant to do this alone.)
You could also consider hiring a doula, a trained professional who provides care for you (the expecting parent) before, during, and/or after childbirth. A doula can help with household tasks, childcare, or any other support you need. You can find one through DONA International, a doula certifying organization.
On the other hand, maybe you have time but just can’t get comfortable, a common challenge especially toward the end of gestation.
The American Pregnancy Association recommends sleeping on your side – particularly your left side, promoting good circulation and increasing nutrients and blood flow to the placenta. The key for many pregnant people: Get creative with pillows. Back pain? Put a pillow between your legs and/or under your belly. Heartburn? Prop your upper body up with pillows. A pregnancy pillow can help you stay comfortably on your side. If you must sleep on your belly, consider a blow-up pillow with a cutout.
What Else Can You Do?
For insomnia in general, common advice is to avoid napping during the day. But for pregnant people, naps can be crucial, Solomon said. Just keep them short – set a timer for 20 to 30 minutes – and get them in before 6 p.m., she said.
Another technique to try is delaying your bedtime. “It sounds counterintuitive, but temporarily spending less time in bed can increase a person’s appetite for sleep,” Solomon said. “By the time you go to bed, you really feel sleepy.”
Limiting liquid intake two hours before bed can help prevent nighttime bathroom trips. Drink if you’re thirsty, but be mindful of the amount.
Most important: Realize that sleep struggles in pregnancy are common, and grant yourself some grace.
“Remember there are parts of sleep that are in our control and parts out of our control, and efforts to force sleep in pregnancy tend to backfire,” Solomon said. “The best thing a person can do is protect time for rest and know that some sleep disruption is actually normal.”
