5 Questions About Pregnancy and Sleep

Pregnancy is a time of increased sleep needs and—ironically—increased sleep problems. You might have heard the quip that sleep difficulties now are nature’s way of helping inoculate you against the sleep deprivation you’re likely to encounter once your little one arrives, but we reject the notion that you’re doomed to poor sleep for 40 weeks. Maximizing your rest is highly important right now, and if you have questions about how best to accomplish that, we have answers. Well, we have answers to these top 5 “sleeping for two” questions:

1. I’m in my first trimester, and the other day, I fell asleep at my desk! It was only for a few minutes and no one noticed, but I’m so embarrassed. I’ve never been a napper. How can I remedy this problem?

Maybe you were never a napper before, but pregnancy changes just about everything, so why not that, too? Early in pregnancy, in particular, the struggle (to stay awake) is real. And for good reason; the work your body is doing to nurture the new life inside it has been likened to running a marathon everyday. Meanwhile, hormonal changes and a more-frequent need to pee may be disturbing your nighttime sleep, so you may benefit from catching up in the daytime. If you have the space, the privacy, and the type of job that allows for a short snooze every now and then, by all means, take advantage. Just keep naps short—20 minutes seem to be ideal—so you don’t hinder your ability to fall asleep at night. If you don’t have a desk to lay your head on or a door to close, consider a brief shut-eye in your car instead of a coffee break. Or, lay down for 20 minutes when you get home to recharge for the rest of the evening. You deserve it. 











2. I never in my life got heartburn, but now I can't even think about lying down in bed without feeling that burning pain in my chest. What's wrong?

One thing we know for sure is that your heartburn is not a sign that you’ll have a baby with a full head of hair, as the charming but false old wives’ tale tells us. Heartburn is caused by a weakening of the ring of muscle called the esophageal sphincter that normally keeps your stomach contents where they should be. When that occurs, food and stomach acid can back up and you’ll feel the burn. Why now if you’ve never had it before? Pregnancy-related heartburn (also called gastroesophageal reflux disease or GERD) is likely caused by increased levels of pregnancy hormones that relax muscles including the esophageal sphincter. Increasing weight can also exacerbate the problem. GERD is surprisingly common in pregnancy—up to 50% of pregnant women experience it.

If heartburn is interfering with your sleep, consider lifestyle modifications as a first line of defense: Don’t eat heavy, greasy, fried or acidic or spicy foods, which tend worsen heartburn, and don’t eat too close to bedtime. Speaking of your bed, elevating the head of it can help you rest easier. If it’s truly bothersome, or isn’t helped by changes in diet or other habits, talk to your doctor about over-the-counter meds that are considered safe throughout pregnancy.

3. Before I got pregnant, if I had a headache or was sore from working out, I’d take some Tylenol and it would also help me relax and sleep. Is that no longer safe for me?

If you’re asking, it’s likely you’ve seen or read news fairly recently about a study linking pregnant women’s acetaminophen (Tylenol) use with evidence of language delays in toddlers. The study getting all the ink, published in the journal European Psychiatry, concerned an observed delay in spoken language among a cohort of Swedish women’s children at about 30 months of age. It’s worth pointing out that the study showed a correlation between acetaminophen use and language delay; they did not prove a causal link between the two. And it should be stated that the researchers themselves aren’t calling for pregnant women to swear off the pain reliever. They note that these results should be replicated in further studies—and that the children studied should be followed up on—before any recommendations are made. On the other hand, there have been other studies in recent years linking Tylenol use to problems such as ADHD and autism in children. But on the other other hand, in all studies of this kind, the moms took a fair amount of the pain reliever; this is not a case of popping a tablet for the occasional headache so you can sleep, but more consistent, regular use.

The bottom line is that you should speak to your doctor or healthcare provider and ask his or her advice about any drug or remedy—prescription or OTC—that you take while pregnant. Consider how often you need Tylenol. If you are achy from a workout, a warm bath or shower may help. If you can’t sleep, consider other forms of sleep hygiene, like drinking warm milk or eating a small, carbohydrate-rich snack, which may help you drop off. But if you have a fever—which has the potential to be harmful to your baby—definitely talk to your doctor about taking acetaminophen, because in some cases a fever may be far more provably harmful to your baby than a couple of Tylenol.

4. I'm having the craziest dreams lately. I wake up to pee (of course) and I can’t even believe the things I dreamed. Is it pregnancy related?

Maybe. Wild, right? Many pregnant women report far more active, crazy, vivid dreams than they recall having beforehand. The subjects can sound like the headlines on supermarket tabloids: “I Gave Birth to an Alien Baby!” “Recall” may be the operative word here. Some experts speculate that the explanation for vivid pregnancy dreams (or nightmares) may be as simple as this: Pregnant women wake up more often during the night for various reasons, and if woken during the phase of sleep associated with dreaming, you may just remember the dream more clearly in the moment than if you’d stayed asleep till morning.

Anxiety and worry over the impending event can also make some women have more turbulent and memorable dreams. As for the content of your dreams, who knows? If you believe that dreams reflect your subconscious or are a way to work through problems or events in your waking life, then dreams about labor and delivery or visions of your baby to be seem like a natural fit. If you’re curious and if your dreams are particularly entertaining or confounding, consider keeping a dream journal. Hey, your child may someday find it interesting reading!

5. I keep going to sleep on my left side, but wake up on my back. Help!

It's no doubt that you’ve internalized the advice that it’s best, after the first trimester, to snooze on your left side, which allows for unimpeded blood flow to your uterus. (If not the left side, then at least a side is better than flat on your back, and of course stomach sleeping simply becomes impossible after a certain point.) If you want to increase your chances of staying put and remaining comfy on your side, consider a body pillow or two to prop yourself in the best position. But if you wake up on your back, don’t worry—you’re not putting your baby in danger. Just make an effort (as best you can as you get bigger!) to resettle yourself on your side.

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