Pregnancy can pose serious challenges to
sleeping well. Poor quality and too little sleep are common during pregnancy,
when many women experience fragmented sleep and symptoms of insomnia. Even women who don’t generally experience
sleep problems find that during pregnancy they have difficulty falling asleep
and staying asleep, as well as trouble getting enough sleep.
We talk a lot about sleep issues for new mothers. But new research
suggests we should be paying more attention to the sleep health of expectant
mothers as well.
Researchers at the University of Pittsburgh Medical Center found
links between both the quality and quantity of pregnant women’s sleep and
complications at birth, including low birth weight and pre-term births. The
link between birth complications and expectant mothers’ sleep appears to be in
disruptions to normal immune system function, caused by insufficient and
Depression during pregnancy is another risk factor for birth
complications. Researchers sought to understand how poor sleep among pregnant
women might influence birth-related complications, and what, if any, role
depression might play in this relationship. Researchers included 168 pregnant
women in their study. Some were depressed and others were not. At 20 weeks and
again at 30 weeks gestation, researchers evaluated the women’s sleep and immune
system functioning. They collected information about sleep through interviews.
In order to assess the women’s immune function, researchers measured levels of
cytokine production . Cytokines are communication molecules that
are involved in regulating the body’s immune responses. The over-production of
certain cytokines is a sign of elevated levels of inflammation in the body, and
a signal that the body’s immune system is not working properly. Researchers
sleep and depression were both associated with increased risk for birth
complications, when found separately and together.
the women evaluated, those with both depression and poor sleep were at the
greatest risk for complications including pre-term birth and low birth
- At 20
weeks of pregnancy, depressed women had higher levels of cytokines than
non-depressed women. By 30 weeks, the differences in cytokine levels
between depressed and non-depressed women had disappeared. Researchers
concluded this was likely because of a natural rise in cytokine production
over the course of pregnancy.
What we’re seeing here is evidence of the complicated,
dynamic relationship among sleep, immune function, and depression. These
conditions often can be found together in both women and men. Research suggests
that these conditions can influence each other in multiple ways:
indicating that sleep plays a critical role in immune health, and that
insufficient and poor quality sleep contributes to
elevated levels of inflammation in the body.
and depression have a well-documented and complex relationship,
with sleep disruption contributing
to depressive symptoms and depression interfering with sleep.
also shows that inflammation may be a significant risk
factor for depression,
with and without the presence of sleep problems.
Understanding more about the ways sleep interacts with
immune function and depression is important in general—but it may be
particularly important for pregnant women. Women face particular challenges to
sleep during pregnancy. Fatigue is a common issue for pregnant women, and one
many women know to expect. But sleep problems and sleep disorders are also can
be more likely to occur during pregnancy. Women are more at risk for restless leg syndrome,
sleep disordered breathing,
and insomnia during pregnancy. In a
National Sleep Foundation poll, 78% of women reported experiencing more
disrupted sleep during pregnancy than when not pregnant. There are several
factors that can contribute difficulty sleeping during pregnancy, including:
- Hormonal changes. Pregnancy is a time of many hormonal shifts,
which change sleep cycles and can disrupt sleep. Rising levels of progesterone can
cause respiratory changes that disrupt sleep, as well as more sleepiness
during the day, leaving women unusually wakeful at night. Fluctuating
levels of estrogen also cause physiological changes that interfere with
- Pain and discomfort. Lower back pain, nausea, heartburn and
other physical discomforts can often interfere with sleep. Having to get
up to go to the bathroom frequently throughout the night is another common
hazard to sleep during pregnancy.
- Anxiety. Pregnancy can be a wonderful and exciting time of
life. Women also experience anxiety about the pregnancy itself as well as
about managing all the aspects of their lives alongside the impending
arrival of a new baby. Feeling
anxious can make falling asleep and staying asleep more difficult.
Sleeping well during pregnancy is a challenge – but it
doesn’t have to be impossible. For many women, it may mean taking some extra
time and paying extra attention (good ideas for pregnant women in general) in
order to protect both quantity and quality of sleep as a pregnancy progresses.
As this study shows, protecting sleep during pregnancy is not only good for a
mother’s health, but her child’s health as well.
Michael J. Breus, PhD
The Sleep Doctor®
Everything you do, you do better with a good night’s sleep™
twitter: @thesleepdoctor @sleepdrteam
Image courtesy of Victor Habbick at FreeDigitalPhotos.net