Are you hitting the couch at 6pm, too tired to get to the grocery store or to walk the dog?  For many women, pregnancy can bring a fatigue that is unlike anything they have experienced.  You feel so overwhelmingly tired and yet you can’t sleep. You are not alone; nearly 78% of women are plagued by insomnia during pregnancy.

Why am I so very tired?

 

You are working hard.

There are many physiological demands when you are growing a baby, and your body goes through many changes to compensate for this.  Blood volume increases while lung capacity adjusts.  There are increased oxygen demands from your growing baby, and some nutrients may be pulled from the maternal stores.  It is, in short, a lot of work to grow your baby.  We don’t have all the answers about why women suffer from extreme fatigue, especially in early pregnancy.  We do know that these physical changes and hormonal events are a recipe for deep exhaustion for many women.  By the second trimester this fatigue often lifts and women enjoy elevated estrogen and serotonin levels that boost mood and energy.

Sleep apnea?

It is normal for snoring to increase during pregnancy due to body changes and new sleep positions.  If your partner notices excessive snoring or times when you appear to take gasping breaths, talk with your doctor.  Not only does apnea cause fatigue but it can lead to health problems and pregnancy complications.

Disrupted sleep.

Ample periods of undisrupted sleep in all the sleep states, including REM sleep, are important to your ability to function during the day.  If you’re waking up a few times each night, you may be losing some of the restorative benefits that plenty of sleep brings.

So why can’t I sleep?

 

Physical discomforts trigger waking.

Leg cramps, needing to urinate, aching hips, and numb hands are common complaints that cause you to wake up.   Speak with your doctor or midwife about your discomforts.  Some of them can be reduced. And, you don’t want to ignore something that could be affecting your overall health.

Hormones.

We have different sleep patterns during pregnancy and other hormonal events, and there is a cumulative effect if healthy sleep gets derailed.  After several nights of disrupted sleep cortisol levels begin to rise as evening approaches.  It’s as if the body is planning on being awake and giving you a jolt of ‘stay awake’ energy.

Stress and pregnancy.

Having a baby brings many thoughts and feelings to the fore. Everything can seem frustratingly urgent.   You’re preparing for many big unknowns, from childbirth to being a parent for life, or making room in your family for one more.  No wonder your mind is racing at 3am.

Tips for improving sleep

 

So those stress hormones are climbing, but what can you do about it? There are ways to calm down this ‘fight or flight and up all night’ activity in your brain.

Exercise for mood and sleep.

Start your day with brisk walking or other repetitive exercise to boost the ‘feel good’ hormones.  Later in the day, try ‘mind clearing’ activities rather than cardio-elevating activities–gentle yoga or meditation are good choices. Cuddling, massage, relaxing meals, and sex all boost oxytocin, which helps reduce cortisol.

blog-pregnancy-fatigue-webCreate calm

The brain ‘lights up’ when given certain stimuli.   Think about how much that murder mystery on TV gets your heart racing and consider other options for your late night movie watching. Also, some conversations are not good bedtime fare.  If your brain is racing with stressful or stimulating ‘to do’s’, consider actually making a list to clear your mind but do postpone the actual problem solving. Just as you imagine giving your little one a calm bedtime routine in the months ahead, create one for yourself!

Lights out

Artificial light can confuse our circadian rhythms.  Keep lights off or very low during those trips to the bathroom in the middle of the night.  Keeping lights lower as the evening wears on can save on energy bills and help you sleep.

Napping and routine

Napping can be an important part of wellness and healthy sleep in pregnancy.  If you are having long naps (greater than 90 minutes) AND you’re not getting good sleep at night, consider timing your naps differently (not napping past 4pm, for instance) or taking shorter ‘power naps’.

If your fatigue and insomnia are not improving, or if you have concerns about your mood, it is important to reach out to your doctor or midwife.  It is estimated that 50% of women who are living with insomnia have depression or anxiety that is treatable. The biochemistry of mood disorders and sleep loss is strongly connected: losing sleep regularly stresses your brain, and mood disorders involve disturbed sleep.  Whichever came first, you deserve to get support and relief.

Sleep as a parent

Getting sleep when you have a newborn is a well known challenge. You can prioritize your sleep needs and still meet those of your baby. You know that your baby needs care and feeding around the clock, but you might notice that it’s the anticipation of your baby waking or the settling back to sleep afterward that keeps you from getting  your own Z’s.  Breastfeeding mothers can get more restorative sleep through support from partners or doulas for the late night diapering, jiggling, and other settling needs. While these don’t in themselves take that much of your time, you are often too alert to return to sleep. Knowing that someone else has their ears tuned in to your baby can help you sink deeper into good sleep. Even a few good blocks of sleep can help you come back into balance, which is an important part of self-care as a new mother.

Best wishes for a good night!

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