SLEEP DURING PREGNANCY

Say no to smoking and alcohol
Not only can nicotine and alcohol harm your baby, but both can make it difficult to get to sleep.

Cut down on caffeine
Cut down on caffeinated substances such as tea, coffee, soda, and chocolate (too much of which aren't safe, anyway), and avoid them entirely in the afternoon and evening.

Make your bedroom a sleep sanctuary
Since you may feel warmer than usual when you're pregnant, keep your room on the cool side. Block out light and noise, too — they can wake you from a light sleep.

Exercise three to four hours before you go to bed
While exercise is great for your mental and physical health during pregnancy, it can make drifting off difficult if your body doesn't have time to unwind after a workout. Some studies also show that exercising too close to bedtime can cut down on deep sleep.

Take naps
A 30- to 60-minute snooze during the day will improve alertness, sharpen memory, and generally reduce the symptoms of fatigue. A study by the National Sleep Foundation found that more than half of pregnant women take at least one nap during the work week, while 60 percent take at least one weekend nap. Keep in mind, though, that napping too late in the day (or for too long) could disrupt a good night's sleep.

Establish a regular, relaxing bedtime routine
Have dinner at a leisurely pace; afterwards, do something quiet such as reading or taking a bath.

Stick to a sleep schedule
Try to regulate your sleep / wake schedule by going to bed and getting up at the same time every day and night.

Use your bed only for sleep and sex
If you're in the habit of paying bills or watching TV in bed, stop. Reserve your bed for enjoyable activities, like sleep, sex, and maybe a little light reading.

Leave your worries at the bedroom door
If you keep a 'worry list' — of questions, concerns, or things to do — finish making your list at least an hour before bedtime, and don't start tackling it until morning. Keeping a notepad next to your bed can help relieve middle-of-the-night anxieties, but if writing down your thoughts makes them seem even more pressing, stick to an evening worry list.

If you can't sleep, get out of bed
If you're still awake after 20 or 30 minutes, get up and go into another room. Listen to soothing music or read a magazine. When you feel drowsy, go back to bed.

Practice relaxation techniques
See our sleep aids chart to learn about sleep-inducing techniques such as guided imagery, deep breathing, or progressive muscle relaxation.

Snack before bedtime to ward off nausea
If you're troubled by nausea (common during the first trimester), keep your stomach full by eating frequent bland snacks such as crackers, especially before bedtime.

Avoid heavy meals and spicy foods before bedtime
Spicy foods such as chili or acidic foods such as tomatoes in any form can cause heartburn and indigestion. So can eating a big meal too close to bedtime. Instead, eat lighter meals earlier — give yourself two to three hours to digest your food.

Drink less in the late afternoon and evening
While it's important to drink plenty of fluids when you're pregnant, drinking more in the morning and less in the late afternoon and evening will help you cut down on bathroom breaks during the night.

Sleep on your left side
If you aren't doing it already, train yourself to sleep on your left side. This position helps blood and nutrients flow to the fetus and uterus and helps your kidneys eliminate waste and fluids. Plus, getting used to this position now will help you sleep better when your belly is bulging.

If you can't sleep, don't worry
If you wake up at night, don't fret! Interrupted sleep during pregnancy is perfectly natural. Although sleeping through the night may seem impossible right now, eventually you'll establish a sleep routine that works for you.

Is sleep a distant memory now that you're pregnant? Considering that nausea, heartburn, and a constant need to pee may now be a daily fact of life, it's no wonder that whatever sleep you get feels hard won. In fact, almost all women have trouble sleeping at some point during pregnancy. But knowing that countless other pregnant women are also wide awake doesn't provide much comfort when you're staring at the ceiling at 3 a.m. Read on to find out what kind of slumber you can expect during your first trimester and why. And don't forget to visit our sleep disturbances and coping strategies area to learn how to make the most of your pregnancy zzzs


Disturbance No. 1: A sudden need to nap
Early on in your pregnancy, you'll start feeling very sleepy during the day. This sudden craving for naps is caused by elevated levels of progesterone, a female hormone that helps regulate your reproductive cycle but that also has a sedative effect. The flood of this natural chemical can make a normal day at work seem as taxing as running a marathon; you may be so worn out that you think you're coming down with the flu.
Though progesterone makes you feel drowsy, it can also disrupt your sleep at night, leading to even more fatigue during the day. Unfortunately, there's no real way around this problem other than to rest as much as you can — even if you can't fall asleep. Remember, too, that the hours you spend in bed rarely equal the hours you actually sleep, so grab a quick catnap whenever the urge strikes you.



Disturbance No. 2: Trouble getting comfy
Your newly tender breasts may make it hard for you to find a comfortable sleeping position, especially if you're used to sleeping on your stomach. Your first trimester is the perfect time to start training yourself to sleep on your left side to improve the flow of blood and nutrients to your fetus and uterus and to help your kidneys get rid of waste and fluids. The sooner you get used to this position, the better you'll be able to sleep when your belly is bulging.

Disturbance No. 3: A constant need to pee
Another sleep stealer is your growing uterus, which puts pressure on your bladder and sends you scrambling for the bathroom more frequently than you thought humanly possible. If you're sick of doing the bathroom scuttle, drink plenty of fluids during the day but cut down in the late afternoon and evening.

Take heart: This, too, shall pass

If you feel caught in a vicious cycle of wakefulness at night and exhaustion during the day, you're not alone. More than half of pregnant women take at least one nap during the work week, while 60 percent take at least one weekend nap. Bottom line: Expect your first trimester to be tiring, and listen to your body when it tells you to slow down or rest.

Your body's adjusting to its sudden hormonal and physical changes, and you can sleep more peacefully as a result — barring a few leg cramps, crazy dreams, and bouts of congestion, that is. Yet at the same time your sleep is improving, your sudden energy renewal may mean you don't want or need the extra shut-eye. Read on to find out what kind of slumber you can expect during your second trimester and why. And don't forget to visit our sleep disturbances and coping strategies area to learn how to make the most of your pregnancy zzzs.

Your exhaustion lifts
Chances are you're sleeping better now than you have in months. That's because your progesterone flood has tapered to a steady drizzle. Although your hormone levels are still rising, it's happening more slowly now, so you feel more rested than you did during the first trimester.

You're making fewer trips to the bathroom
More good news: Your baby is now positioned above your bladder, so you won't be scurrying for the bathroom as often as you have been. Morning sickness has probably passed, too. Hey, your second trimester isn't called the honeymoon phase for nothing!

Why you should enjoy it while you can
While you're feeling and sleeping better, start exercising regularly — a strategy that will boost your mental and physical health, as well as help you sleep better at night. Keep in mind, however, that the quality of your slumber, as well as the amount of time you actually sleep, still won't be as good as it was before you were pregnant.

As the so-called honeymoon phase of your pregnancy ends, so do your nights of slumber. In fact, studies show the quality of sleep in the third trimester is worse than ever before (once your baby is born, however, you may think back to this time rather fondly). Knowing that countless other pregnant women also are staring wide-eyed at the ceiling won't bring you much comfort. Read on to find out what kind of slumber you can expect during your third trimester and why. And don't forget to visit our sleep disturbances and coping strategies area to learn how to make the most of your pregnancy zzzs.


Why you can't get comfortable
From here on in, sleep becomes a hazy memory. Your belly is simply too big to allow you to lie down comfortably. If sleeping on your left side with pillows wedged between your legs and behind your back doesn't help, head for a comfy recliner instead. As your belly reaches watermelon proportions, you may sleep better propped up.

Your bladder is under pressure -- again
Remember your first trimester, when you felt as if you spent more time in the bathroom than out of it? Well, that feeling is back. This time you can thank your growing baby, who's putting pressure on your bladder. Reduce your number of nighttime bathroom breaks by cutting back on fluids in the late afternoon and evening, and by completely emptying your bladder on every trip to the toilet. (Hint: Leaning forward when you pee will help.)

Heartburn and other sleep stealers
Don't be surprised if heartburn, leg cramps, restless leg syndrome, and snoring — not to mention your baby's kicking and squirming — keep you awake at night. Studies show that women in their third trimester have fewer periods of deep sleep and wake up more often during the night. In short, the quality of your sleep is heading toward an all-time low.

A preview of things to come

Though you can ease or avoid some of these problems (see sleep disturbances and how to cope with them for more details), you will have to endure some sleepless nights. Think of this time as a dress rehearsal for life after your baby is born!
On the bright side, now's a great time to start learning about babies' sleep habits, so everyone can start getting a good night's sleep as soon as possible. So if you find yourself wide awake at 3 a.m., check out our Baby Sleep area and our article, Plan ahead now for better sleep later.

Pillows
You can use pillows to support your belly and back in bed, and they can mean the difference between a sleepless night and a peaceful slumber. Tucking a pillow between your legs supports your lower back and may make side-sleeping (your best option as pregnancy advances) more comfortable. Maternity pillows abound, but regular pillows work fine, too.
* Single or dual pregnancy wedge
Wedge-shaped pillows support your belly when you lie on your side. You can also use it to prop yourself up to a semi-recline when you're lying on your back. The dual pregnancy wedge is two pillows (attached with adjustable Velcro tabs) that provide simultaneous support in front and in back.

* Full-length body pillow
Body pillows are at least 5 feet long and are designed to support the back and cradle the belly.

* Sleeping Bean
Support your belly and your back by wrapping yourself around this column-shaped pillow. It's makes a good nursing pillow later, and you can use a smaller Sleeping Bean as a bolster or bumper to protect your baby in his crib. Available from Bean Products (800 / 726-8365).



Foods
What you eat — and when you eat it — can affect the quality of your sleep. Click here for more about foods that can make or break your night.
Warm milk
Drinking a glass of warm milk before bedtime is a time-tested way to bring on sleep. Experts believe the amino acid l-Tryptophan (found in milk and other foods such as turkey and eggs) makes eyelids heavy by raising the level of a chemical in the brain called serotonin. Others suggest the somnambulant effects of warm milk may be all in your head. But if it helps you snooze, does it really matter?

Breads and pasta
Some experts believe foods high in carbohydrates such as bread and pasta can promote sleep, so make your late-night snack a carb-packed bagel or a piece of toast. Note: If you suffer from heartburn or indigestion, your symptoms may get worse after you carbo-load.

Protein-packed snacks
If bad dreams, headaches, or full-body sweats are disturbing your sleep, you could be suffering from low blood sugar. Just before bed, munch a high-protein snack such as an egg, some peanut butter, or a slice of turkey on bread to keep your blood sugar up during the night.

Relaxation techniques
If you're tense, anxious, or overtired, sleep can seem as hard to grab as own shadow. Try these simple, time-tested techniques to help calm your mind, relax your muscles, and put sleep within your grasp.

Yoga and stretching
In addition to helping you relax, yoga and stretching have the added benefit of keeping you toned and flexible during pregnancy. Many gyms, health clubs, and YMCAs offer yoga and stretch classes; some are designed specifically for pregnant women. Or you can create your own stretch routine with simple moves for your neck and shoulders, calves and hamstrings, and back and waist. Although you don't want to work up a sweat too close to bedtime (see Exercise, below), gently stretching your muscles during the day and before bedtime can make falling asleep a little easier.

Massage
Getting a massage relaxes tense or tired muscles. If you visit a professional masseuse, make sure he or she has experience working with pregnant women and uses a table and pillow designed for that purpose. Hiring a masseuse can be expensive, but a foot, hand, or neck massage at home from your generous partner is a perfect way to wind down before bed.

Deep breathing
Breathing deeply and rhythmically can ease muscle tension, lower your heart rate, and help you fall asleep faster. Lie down on the carpet or your bed with your feet shoulder-width apart. (If you're uncomfortable lying on your back, rest on your side with a pillow between your legs for support instead. In this position, you may not be able to breathe as deeply.) With your mouth closed, breathe slowly through your nose, feeling your stomach rise as you gradually fill your diaphragm and lungs with air. Hold for one second before exhaling through your nose to the count of four.

Progressive muscle relaxation
It may take you several weeks to master progressive relaxation, but once you do, it can really help you sleep. Lying on your bed or even on the floor, you can release tight muscles by first tensing and then completely relaxing them. Focus on one group of muscles at a time and alternate between your right and left side. Start by tensing and releasing your hand and forearm muscles, followed by your biceps and triceps, face and jaw, chest and shoulders, stomach, thighs, and so on until you reach your feet.

Guided imagery
Picture yourself in a quiet, relaxing scene — lying on a warm sandy beach or walking in field of wildflowers. Now imagine every detail of the scene, including the sounds, smells, tastes, and textures around you. If you can't picture a relaxing setting, use an image from a photograph or magazine and fill in the missing details. It may take some practice, but guided imagery can calm your restless or anxious mind and help you slip into a deep sleep.

Exercise
Regular exercise during pregnancy makes you healthier both physically and mentally, and it can help you sleep better, too — provided you don't exercise vigorously within four hours of bedtime. Working out too close to bedtime can rev you up and even rob you of deep sleep by interfering with your natural sleep cycle. Instead, work up a sweat in the morning, late afternoon, or early evening. To learn more about staying fit during pregnancy, see our guide to recommended exercises throughout pregnancy and safe sports during pregnancy article.

Herbal remedies

Herbal remedies come in many forms, including fresh or dried plants, pills, tinctures, and powders. Although herbs are considered natural alternatives to certain drugs, they can be equally powerful — or even toxic. Consult with your practitioner before taking any herbal remedy (even herbal tea), either on its own or in combination with other herbs or medications. Also, since the quality of herbs varies by manufacturer, ask an expert to recommend a brand name.

Chamomile
Drinking chamomile tea may help calm your jangled nerves, although there's no scientific evidence that the herb really is a mild sedative. If you're suffering from a stomach ailment such as indigestion, flatulence, gastrointestinal spasms, or inflammation of the gastrointestinal tract, chamomile may help you feel better. The FDA says it is safe for pregnant and breastfeeding women. Note: If you're allergic to ragweed or prone to hayfever, you could be allergic to chamomile, too. To find out, hold a small amount of chamomile tea in your mouth for a few seconds and then spit it out. If your mouth itches or feels strange, do not use this herb.

Lavender
Revered by aromatherapists worldwide, lavender has a soothing scent that may help you drift off to sleep. You can sprinkle a few drops of lavender oil on your pillow or add them to a warm bath with some lemon balm. However, not all lavender is tranquilizing: Spanish lavender can actually stimulate your senses.

Prescription and over-the-counter medications
Ideally you should avoid all medications during pregnancy, since certain drugs can harm your growing baby and many have not been tested at all on pregnant women. If you have a severe sleep problem or disorder, your doctor may recommend a prescription or over-the-counter drug to use during your second or third trimester; however, you should never take any medication during pregnancy without first consulting your doctor.

OTCs
Antihistamines such as Unisom and Benadryl (Diphenhydramine hydrochloride) are generally considered safe during pregnancy, although drowsiness is a side effect — not the primary effect — of the drug. Since other possible side effects include impaired alertness and dizziness, you should not drive or operate machinery after taking this medication.

Prescription medications
If you're suffering from severe insomnia or anxiety, your healthcare provider may recommend you take a prescription sleeping medication. Warning: Never drive or operate machinery after taking a drug to help you sleep.