7 Corresponding to this period of increased sleepiness, women surveyed about their sleep habits during pregnancy reported an average increase of 0.7 hours of sleep duration during the first trimester, compared to the pre-pregnancy period. In human pregnancy, hypersomnolence is a common complaint during the first trimester.

In an animal model, total sleep time increases during pregnancy, with an early but transient increase in REM duration, a sustained increase in NREM sleep over the course of pregnancy, and increased diurnal sleep during late gestation. 4 However, increased REM sleep has been observed in human studies of peri-menopausal women receiving estrogen replacement therapy, 5 making it difficult to understand the specific effects of estrogen on sleep during human pregnancy. In animal studies, estrogen selectively suppresses REM sleep 3 an effect possibly due to increased brainstem nor-epinephrine turnover. 2 Progesterone metabolites impact brain gamma amino butyric acid-A(GABA-A) receptors 2 which are thought to drive these sleep changes. Estrogen reduces the amount of Rapid Eye Movement (REM) sleep. In animal studies, progesterone administration has been observed to have sedating effects, to reduce wakefulness, shorten the latency and increase the duration of non-rapid eye movement (NREM) sleep. Women during first trimester take day time naps in part due to fatigue. At 36 weeks progesterone levels are 10 times greater than peak menstrual cycle levels. Levels of progesterone rise throughout pregnancy. Sleep problems and changes in sleep patterns start during the first trimester of pregnancy 1 most likely influenced by the rapid changes in reproductive hormone levels. This review is intended to provide practitioners with an understanding of sleep changes in pregnancy and guide them in rational approaches to their management. A recent study at University of California, San Francisco found that women who slept less than 6 hours per night were more likely to have longer labor and were 4.5 times more likely to have a cesarean section.īoth non-pharmacological and pharmacological interventions may alleviate sleep disturbances. Sleep disturbances affect health and quality of life and may also negatively influence obstetric outcomes. After child birth it becomes even harder for new mothers to have a good night’s sleep.

Poor quality sleep is not only a core feature of prenatal, intra-natal and postpartum depression, but also a risk factor for mood disturbances in pregnancy. Frequent trips to the bathroom, nausea and vomiting, pregnancy related discomfort like back pain, fetal movements and gastro-esophageal reflux can also impair the quality of sleep.Īnxiety during pregnancy may be further amplified by concerns about labor, delivery and its outcome. Sleep duration and quality related changes in pregnancy may be due to many proposed and interrelated mechanism like hormonal, physiologic, metabolic, psychological and posture related changes.įor example during first trimester, a rise in progesterone levels may cause excessive day time sleepiness, decreased muscle tone, increased risk of sleep apnea, snoring and sleep interruptions. Additionally, 15% of pregnant or recently pregnant women reported one weekday nap and 60% women reported at least one weekend nap. A US National Sleep Foundation’s Women and Sleep Survey in 1998 found 78% of women reported disturbed sleep during pregnancy and 15% of women developed Restless Legs Syndrome (RLS) during 3 rd trimester of pregnancy. Sleep disturbances are common in pregnancy.

Insomnia pregnancy