According to holistic sleep coach and paediatric nurse Lyndsey Hookway, pregnancy insomnia is a thing. Find out why pregnancy affects sleep and seven easy tips you can do to help you get the sleep you need
‘Your baby isn’t here yet, so rest, take it easy and enjoy the sleep while you can’… What other patronising things have you heard since announcing your baby bump to the world?
‘Disturbed sleep is good practice for when the baby arrives’? Or my favourite – the voice of impending doom, ‘Enjoy the sleep while you can!’
Sometimes, unsolicited advice about sleep and pregnancy can be remarkably unhelpful. The voices of doom and the patronising comments are unhelpful, because if you are struggling now, you need support, not scaremongering.
It isn’t as simple as before and after the baby. You don’t necessarily sleep one way in pregnancy, and then all of a sudden another way after birth. This is an unhelpful concept on a number of levels.
Firstly, while some people sleep well during their pregnancy, many do not. Whether you are currently gliding through pregnancy and finding the voices of doom unnerving, or you are struggling already and being told to be grateful because sleep deprivation is coming, neither of these scenarios are particularly helpful or positive.
Secondly, if we attribute all fatigue to the birth of a baby, it can make us focus on the baby, rather than take a holistic view.
while some people sleep well during their pregnancy, many do not
Sleep is rarely something that only affects one person – it is a family affair. But on a practical level, if we turn our focus to modifying infant sleep, this can set us up to fail as well, because infants do wake at night, and this is normal. Modifying a behaviour that is entirely normal is fundamentally difficult.
Finally, on a pragmatic level, it is a lot easier to modify adult sleep than infant sleep, so we could be more constructive if we focus on improving the sleep of adults rather than infants.
Why might pregnancy affect sleep?
There are a number of reasons pregnancy might affect sleep, (I must stress though, that some people sail through pregnancy without a bother).
Whether you struggle with sleep or not in pregnancy, the changes your body makes to accommodate a growing baby and keep them safe are awesome.
Many people struggle with early pregnancy fatigue. That crushing tiredness that seems alleviated by sleep, as well as nausea which can hit any time of the day.
Some struggle with anemia, which can cause insomnia, fatigue and restless legs. You are growing an entire person, that’s a big deal for your body. Take a moment to pat yourself on the back, or bump, or wherever you can reach.
Many people experience mood changes, anxiety, and excitement. Pregnancy is a time of huge mental, relational and physical adaptation.
Whether you are busy imagining the future, planning a house move, or composing your announcement to your manager, it can leave you lying awake at night.
Pregnancy is a time of huge mental, relational and physical adaptation
Pregnancy is a particularly anxious time for some people, if it has been a long time coming, hard to achieve or you have suffered previous losses.
Being grateful for the pregnancy you have doesn’t mean you aren’t sad about the ones you’ve lost, and that’s before we get to the murky concept of feeling guilty for finding pregnancy hard because ‘at least you’re pregnant’…
When you do get to sleep, a few people may have problems with breathlessness, snoring and sleep disordered breathing, and nearly everyone will get up in the night to use the bathroom.
There is physically less space for your lungs, bladder and other important body parts, so it’s no surprise that when you are growing an entire new human, it will probably affect most organ systems.
Body clock disruption
Finally, pregnancy causes some pretty amazing changes to your circadian rhythm (body clock). Your circadian rhythm adapts to keep your unborn baby safe, and your placenta makes more melatonin than your brain.
Some of the changes that take place may affect your sleep temporarily. Amazingly, melatonin seems to have a vital role preventing certain inflammatory mediated conditions such as pre-eclampsia and preterm labour. It also helps to manage the immune system changes in pregnancy.
It is therefore unsurprising that there are some profound changes to your circadian rhythm as an adaptation to pregnancy.
Top sleep tips in pregnancy
There is not always much you can do about some of the pregnancy sleep changes, so you might need to first adjust your expectations of what a ‘good nights’ sleep’ looks like.
Managing expectations can prevent us from feeling cheated out of sleep.
#1 Accept that sleep changes are inevitable
Acceptance is positive. Accept that your body is working hard and changes to sleep are inevitable. Don’t fight your body – if you can, listen to what it’s trying to tell you.
That might mean an earlier night, or a nap after work. It might mean not flying round organizing the nursery and cleaning up.
#2 Get comfortable
You may also want to consider whether there is anything practical you can do. Sometimes it helps to use pillows to support your back, bump and legs.
Lying on your left side is often recommended as it helps with heartburn and increases the blood flow to your bump.
#3 Limit caffeine
You should always drink plenty of water, but perhaps limit caffeine and reduce your drinks in the evening so that you don’t need to get up to use the bathroom every 2 hours!
#4 Improve sleep hygiene
Next, is there anything you could do to improve your own sleep hygiene? Try reducing screen use, having a calming bedtime routine, making sure your bedroom is cool and comfortable, and invest in some black-out blinds.
#5 Don’t clock watch
One tip that often works is to avoid the temptation to look at the clock when you wake up in the night. It can be anxiety-provoking and demoralizing to see what time it is, and may prevent you from returning to sleep.
#6 Look after your health
Looking after yourself by eating as well as you can, trying some gentle exercise if it’s safe and possible, and making sure you take your pregnancy multivitamins are all simple tips to help yourself.
But as well as your physical health, try to care for your heart, mind and soul too. If anything doesn’t feel right with your body or mind, please ask for help from your doctor, midwife or a counselling service.
#7 Ease your mind by having a plan
Finally, while all this is about you, it’s fairly obvious that something big is happening – in the form of someone small. You can begin to make plans for how you will manage with your newborn.
Making a birth preferences plan is a great idea, but it’s just as important to make a getting-through-the-first-few-weeks plan. Not everything in life can be predicted, but I can guarantee you will need support.
Pregnancy can be tiring for sure, and finding hacks to cope is important
Would your budget stretch to a postnatal doula? A cleaner? Could you organize for friends to bring round meals? Can you and your partner have a practical discussion about how you will manage at night? Will the baby be sleeping in your bed, a co-sleeper crib, or a cot? How can you share the load?
Making a realistic plan not only focuses the mind, but also allows for honest conversations with yourself and others about the big changes.
Pregnancy can be tiring for sure, and finding hacks to cope is important, but you also need sensible and achievable ways to cope with the first few weeks after birth.
Good luck with the rest of your pregnancy, and your baby!
Lyndsey Hookway is a PhD candidate at Swansea University, an experienced paediatric nurse, children’s public health nurse, International Board Certified Lactation Consultant, Holistic Sleep Coach and birth trauma recovery practitioner.
The cofounder and clinical director of the Holistic Sleep Coaching program, Lyndsey regularly teaches internationally.
In 2019 she set up the Breastfeeding the Brave project. She is a respected international speaker, teacher, and published author, and she regularly speaks out against the dominant sleep training culture, as well as advocating for the rights of families to receive expert and respectful support.