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Sleep And Pregnancy: What To Expect From Each Trimester

Sadly, sleepless nights can start way before the baby arrives.

13/07/2016 8:52 AM AEST | Updated July 15, 2016 12:57
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'You're kicking NOW!? You have to be kidding me...'

You'd think that as a reward for being a walking, talking incubator of human life for nine months, nature would give you a bit of a break when it came to sleep.

Sadly, that's just not the way life works. Even though your sleep patterns are about to be forever disrupted by the arrival of your little one, sleepless nights can actually start way before you give birth, even as early as your first trimester.

So what can you expect between the sheets (sleeping-wise, people. Haven't you had enough!?) during the 40-odd weeks of pregnancy?

"The trajectory for most people in terms of sleep is that it's not great in the first trimester, improves a little bit in the second trimester, and then gets worse again in the third trimester," sleep psychologist Liora Kempler of Integrated Sleep Health told The Huffington Post Australia. "It's interesting because the same symptoms don't tend to effect women all the way through, but at different times during their pregnancy."

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First trimester

Things to watch out for: Vivid dreams, nausea, feelings of anxiety or apprehension, extreme fatigue.

"During the first trimester, vivid dreams are really common," Kempler said. "Nausea is also a big cause of poor sleep, and a lot of women find that feelings of apprehension, excitement or anxiety could be keeping them up as well. If it's not a planned pregnancy, there could be relationship changes which also could add to that."

While there's not much you can do for the vivid dreams, if you're finding 'morning' sickness is keeping you awake, Kempler suggests seeing if a full stomach helps to ease the nausea.

"A lot of people find keeping their tummy full actually helps," she told HuffPost Australia. "If that's the case for you, try having a snack before bed, or putting a snack by the bed so you have it on hand when you wake up."

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Your first trimester could see you napping like nobody's business.

On the opposite end of the spectrum, your issue might not be waking up too much, but trying to stay awake at all.

"People might find they are extremely tired in the first trimester," Kempler said. "They may find they are going to bed a lot earlier than they usually would or are finding it difficult to get out of bed in the morning.

"Luckily enough, the best way to manage that is to actually give in and get more sleep. So go to bed earlier or sleep in later, if you can. Though if it's your second or third child, you might find you're getting up at 5am anyway.

"The other thing that's a really good idea to do, if an earlier bed time is not an option, is to nap."

Second trimester

Things to watch out for: A growing belly and fetal movement may start to impact sleep towards the end of the second trimester, but really, this is the time where you should be able to enjoy fairly normal sleep patterns. Our advice: enjoy it while you can!

"For most people, things ease up a little bit and return to normal during the second trimester," Kempler said.

"There could be some physical discomfort due to getting a tummy or an increase in urination frequency, but for the majority of people, this won't really become problem until later in the pregnancy."

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You may have a belly, but sleeping in your second trimester should be fairly easy going. Also, it will involve you wearing a full face of make-up and dressed in an all-white ensemble because, obviously.

Third trimester

Things to watch out for: fetal movement, urinary frequency, cramping, restless legs syndrome, snoring, shortage of breath, general discomfort.

"In your third trimester, you'll most likely find your sleep becomes more and more fragmented," Kempler said. "You'll wake more frequently as your pregnancy progresses. You could even look at it as a way of getting prepared for your baby."

Snoring

"As you get bigger, snoring can become more common, and in some cases it can lead to obstructive sleep apnea," Kempler said. "If that's the case, and depending on the severity, it should be treated accordingly. Some women may find they need a CPAP machine."

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You might want to invest in some fancy pregnancy pillows.

Restless Legs Syndrome

"Restless legs syndrome is different to cramping and the two should not be confused," Kempler said.

"Rather than that feeling of cramp-y pain, it's more like a tingly sensation in the legs that gets worse as the day progresses. You may find it's difficult to sit still or you have this urge to move -- it's the only thing that will release it.

"In some cases [restless legs syndrome] is due to not having enough iron and this can be managed with supplements. However, talk to your doctor about it and don't attempt to manage it on your own."

Cramping

"We're all familiar with what a cramp feels like, and unfortunately these can crop up -- leg cramps in particular -- during the third trimester," Kempler said.

"The best way to manage cramps is to have a warm shower and a bit of a massage before bed. Unfortunately there aren't really many amazing options that are out of the ordinary."

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Feeling uncomfortable? Try lying on your left-hand side.

Urinary frequency

"As you get bigger, you'll find you don't have a lot of space for your bladder," Kempler said. "So many women will find themselves getting up to go to the bathroom multiple times a night.

"If you're not accustomed to it, returning to sleep for some people can be an issue, because they start thinking about things.

"As much as possible, try to get up, go to the bathroom and return to bed as quickly as you can so you don't wake up fully. Alternatively, keep a notepad next to your bed and jot down your thoughts for the next day so they're not on your mind.

"Some people might use a breathing exercise to calm themselves, or even walking through your day very slowly can be boring enough to put you to sleep.

"Often it's not the waking, but the returning to sleep that can be the big difficulty."

Keeping women awake:

  • 83 percent of pregnant women will report needing to urinate as a reason they are having trouble sleeping.
  • Almost 80 percent will find it's being in an uncomfortable position that keeps them awake.
  • Almost half find it's their thoughts keeping them up.
  • Fetal movement will keep almost 40 percent of women awake.

'Sleep patterns and sleep disturbances across pregnancy' - Jodi A. Mindell.

Fetal movement

"This can happen in the second trimester as well, but it's more likely to become an issue in the third," Kempler said. "Fetal movement can definitely keep people awake at night, and it's not really fair. because they're not even born yet and they are already waking you up. So cheeky!

"I say to most people, if the baby is kicking, the best way to see it is to think, 'my baby is healthy inside me so I can go to sleep relaxed', because there's nothing you can really do.

"Even more annoyingly, often they will wake up as you are going to bed. This is partly due to the fact they tend to be rocked to sleep by your movement during the day, partly because they don't yet have a circadian rhythm, and partly because it's easier to notice when you're lying still."

What to do

Firstly, it's important to note that no matter how tired you are or how few hours' sleep you are getting a night, this is not the time to start popping sleeping pills.

"I definitely wouldn't be seeking out any pharmaceutical assistance when it comes to sleep," Kempler said. "Sleep medication is not advised during pregnancy, though alternative methods of supporting sleep might be utilised. Seek professional advice if you are really having trouble: don't try and treat it yourself."

Zoran Zeremski
Get used to yawning: it's going to be a sleepless couple of months!

Also, when it comes to sleeping issues, the quicker you can get on top of things, the better.

"If it's the beginning of your pregnancy and you are having insomnia symptoms, it's worth seeking help straight away because it tends to worsen before it improves," Kempler advised.

"If the sleep difficulty is related to a medical problem such as restless leg syndrome, approach your GP and in some cases, particularly with sleep apnea, seeing a sleep physician is best.

"If the sleep difficulty is psychological, for example, feeling alert in bed, thinking in bed or having difficulty returning to sleep after a night wake, the best treatment will be from a psychologist who specialises in sleep disorders."

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