‘What is sleep??’, you might ask jokingly since about 70% pregnant women do report difficulty in getting enough sleep. But, as you know, good sleep of 7-9 hours is really needed. New research suggests that women who don't get enough sleep during pregnancy may have higher risks of developing pregnancy complications like diabetes and blood pressure.

It was found that pregnant women who slept less than 6 hours in their third trimester pregnancy were 4.5 times more likely to have prolonged labour and around 5 times more likely to have caesarean deliveries.

Dealing with sleepiness in early pregnancy

Feeling sleepy in the very early stages of pregnancy is normal. It is caused by increased levels of progesterone, increased blood volume to support developing placenta. In fact, some women report unexplained fatigue as the very first symptom of pregnancy.

The best ways:

• Take daily afternoon naps.
• Drink 8-10 glasses of water.
• Deep breathing & yoga. 
• Avoid junk food.
• Wear loose clothing made of natural fibres. If you wear synthetic clothes, they will make you sweat more and you will feel more tired.

Causes of Sleep Issues in Pregnancy and Remedies

1. Issue: Needing to pee more frequently.

Reasons: 

• Double blood in body means more fluid for your kidneys to process. 
• Relaxin hormone causing ligaments to soften and loosen. This includes the ligaments of the urethra lowering ability to hold urine.
• Pressure of growing uterus on bladder.
• Body absorbing more fluid in your legs during sleep.

Remedies: 

• Do Pelvic floor exercises (Kegel exercises) to strengthen the muscles of the pelvis and urethra and support the bladder.  
• Lean forward while peeing to empty bladder fully.
• Don’t have fluids 1 hour before bedtime.

2. Issue: Stress

Reasons: Anxieties about pregnancy and/or labour

Remedies:

• Sleep only in your bed. Don’t use the bed as a working place.
• Keep sleep timings consistent.
• Keep the bedroom dark and cool.
• You can put some drops of calming essential oils like lavender on your pillow.
• Do not use screens in bed, such as phones or television.
• Get up if you cannot sleep after 15 to 30 minutes.
• Join Yoga classes to build physical and mental strength for labour.
• Before sleeping, have a glass of warm milk add a tbsp of nutmeg, and ghee.  
• If you wake up in the night, try talking to the baby and breathing exercises.  
• Meditate - Try Yog Nidra exercise. It helps to enter deep relaxation.
• Massage your feet using cow’s ghee. 
• Put 2-3 drops of cow’s ghee in each nostril before sleeping. 
• Take a glass of warm milk and add some Nutmeg (jayfal), Cardamom (elaichi) and dried Ginger (adrak) to it and consume it.
• Take Rosewater (gulab jal), add one drop of ghee and rinse the eyes with that water at bedtime.
• Grind some fried Cumin (jeera) seeds to a fine powder and mix them with the pulp of a ripe Banana. Eat this at night.
• Include berries in the diet: Melatonin is a hormone that regulates sleep. Berries have the capacity to increase melatonin production in the body. Any berries ranging from gooseberries to strawberries intake in the day can help regulate sleep.

3. Issue: Aches and Pains

Reasons: Changing body posture, stress on joints

Remedies:

• Do daily Abhyanga with warm coconut oil.
• Join trimester-relevant yoga classes.
• What else? - daily massage with lavender oil helps to sleep better. Specially around back and legs.
• Gentle joint rotations followed by long and deep rounds of Nadi shodhan (8-9 rounds) just before going to sleep.
• After Nadi shodhan listening to Yog nidra will help remove the stiffness from the various parts of the body and relax better.

What are the right sleeping positions for each trimester in pregnancy?

78% of women have more trouble sleeping when pregnant and the extra weight can intensify and sleep deprivation can worsen. Some strategies can help pregnant women get better sleep. Let’s look at sleeping positions to try or avoid and discuss sleep aids that are safe to use during pregnancy.

First 14 weeks

‍It is safe for a woman to sleep in whatever position she feels comfortable in, whether this is on her back, side, or stomach. The womb has not grown large enough to interfere with sleep. However, hormonal changes, night time hunger, nausea, and other pregnancy symptoms may make sleep more difficult.

14-20 weeks

‍During these weeks women should avoid sleeping on the stomach or prone position. She can sleep on either the right or left side and on the back. As the womb size is growing significantly, it can get compressed while sleeping on the stomach. 

As your belly grows, you’ll want to make sure your mattress is somewhat firm so your back doesn’t hurt. You may also want to look into pregnancy pillows. 

20-28 weeks

‍The best position to sleep is on either side, right or left. One can rest on the back for 15-20 minutes for resting the back muscles. It provides the best circulation for mum and baby.  It also places the least pressure on your veins and internal organs. 

Sleeping on your left side will increase the amount of blood and nutrients that reach the placenta and your baby. Plus good circulation helps reduce potential swelling, varicose veins in your legs and hemorrhoids.

28-40 weeks

‍One must completely avoid sleeping on back during these weeks as the weight of your the uterus can decrease the blood flow in the vena cava, the vein that carries blood from the lower part of your body to the heart which might cause lightheadedness, giddiness, nausea or even heartburn. 

Sleeping on your left side also takes the pressure off your liver and your kidneys. This helps to function properly, helps with swelling issues in your hands, ankles, and feet. Being in this position increases blood flow to the uterus without putting pressure on the liver.

You don’t have to, strictly,  sleep on the left side alone. A woman who prefers to sleep on her right side can continue to do so. There is no research showing that it is dangerous.

Using pillows between your legs while you sleep can be more comfortable and help prevent back pain. One can also put a pillow at the back to avoid rolling on the back.

Sleep can prove challenging at every stage of pregnancy. While there are no perfect solutions, various strategies can help with pregnancy-related sleep difficulties.