The ABCs of getting ZZZs while pregnant
Friends sometimes joke with expectant moms that they should get plenty of sleep now, because they might not get much rest after the baby arrives. Easier said than done, many moms-to-be reply.
“This is something a lot of patients talk to me a lot about during pregnancy,” said Maddy Sommers McNary, a certified nurse midwife who sees patients in the maternity department at Cape Cod Hospital and Cape Cod Hospital OB/GYN. “Sleep during pregnancy is a very common thing to have trouble with for a variety of reasons. It’s hard to get comfortable. There can be changes in the joints and pressure from the baby. All of these things can make it really challenging to get comfortable enough to sleep.”
Body position is one of the keys to getting a good night’s sleep, she said. The best position, especially as pregnancy advances, is on either side. “Some people say left side is best,” she said. “I say either side is fine, however you can get comfortable.”
Pregnancy pillows help many women become more comfortable, she said.
“There are many styles of pregnancy pillows, from ones that wrap all the way around to ones that are more wedges with a band in between. Find one that's comfortable for you. You usually want back support and a little bit of support underneath the belly as well, especially as pregnancy advances. That can be done with either a bed pillow, a folded blanket or a specialized pregnancy pillow. The other thing that can help with hip and low back pain is sleeping with a standard bed pillow between the knees. That helps relax the joints.”
Things to Be Aware Of
Sommers McNary advises against women sleeping directly on their back. For some people, if they’re back sleepers prior to pregnancy, this can be particularly challenging, she said. “I usually tell patients if you wake up on your back, it’s fine. Just roll and sleep on your side.” The goal is to avoid extensive periods of time sleeping on one's back.
“Sleeping on your back can cause compression of a major vessel that runs next to the spine. As the uterus rises throughout the pregnancy, that weight can shift onto that vessel and it can cause a drop in blood pressure,” she said.
One study found a small increased risk of stillbirth associated with women who had slept on their backs consistently, she added.
“If your blood pressure is dropping and you’re not perfusing well, then you’re not pumping blood through the placenta to the baby very well. There could be a drop in the baby’s oxygen, which would be a risky thing. We say better to be safe than sorry. If you wake up on your back, just turn onto your side and adjust your pillows, with one behind you so that if you do roll onto your back, you don't roll all the way flat.” In fact, most women after 20 weeks will find it uncomfortable to be on their backs and will naturally change position.
General sleep hygiene practices apply more than ever during pregnancy, and this includes avoiding screens at night.
“I know it’s so hard,” Sommers McNary said. “Everyone’s on their phones all the time, but it’s best to avoid screens before bed and establish a consistent bedtime routine that includes a wind down, whether that’s drinking a cup of herbal tea, taking a warm shower or reading a book – something that is going to help your body know it is time to slow down.”
If you’re having trouble with sleep, discuss it with your doctor or your midwife, she advised. Good sleep hygiene is always her first area of focus for moms, but there are medications that can be prescribed after a good bedtime routine has been established, she said.
