Study Shows No Reprieve From Sleep Problems During Pregnancy

Pregnancy can be a magical time for many women, but it also can be a sleepless one. New research by a sleep expert at The Children’s Hospital of Philadelphia shows that a high prevalence of a spectrum of sleep problems occurs across all months of pregnancy, and that napping during the day should be considered the norm for moms-to-be.

“Past studies only considered sleep and pregnancy at one point in time or trimester,” said the study’s author Jodi Mindell, PhD, a psychologist and associate director of the Sleep Center at CHOP. “We looked at what were the most common sleep issues by month of pregnancy, and now that we know that information, we can start developing interventions.”

Dr. Mindell collected data from an online questionnaire that 2,427 pregnant women accessed via a popular pregnancy website over a four-day period in April 2014. Upon analyzing the data, Dr. Mindell found that almost all the study participants reported that they frequently woke up at night throughout pregnancy. These sleep disruptions were due mainly to their increased need to urinate and difficulty finding a comfortable sleep position.

Overall, three out of four women reported having poor sleep quality, which could contribute to the lack of energy and increased fatigue most women experienced throughout pregnancy. Eighty percent of the study’s participants took naps during the day.

Pregnant women also reported a high prevalence of sleep disorders. One out of five women had symptoms of sleep-disordered breathing, such as snoring and sleep apnea. One out of four women had restless leg syndrome symptoms.

“What I was struck by was how sleep problems really do not change across pregnancy,” Dr. Mindell said. “There are some symptoms that change; for example, being uncomfortable increases by the time you are seven or eight months pregnant. But for sleep quality, we didn’t see any change at any point in time. There is no ‘second-trimester honeymoon’ that people always talk about. These data give the message that we need to take sleep issues seriously in pregnant women and not discount them by saying they’re short-lived or the baby’s coming.”

In fact, sleep problems during pregnancy may have lasting effects even after delivery, especially in terms of their association with post-partum depression, Dr. Mindell pointed out. She encouraged healthcare practitioners to ask every pregnant woman about her sleep during prenatal visits to screen for sleep disturbances and then consider nonpharmacologic solutions, if needed.

“One out of 10 women were taking a sleep medication in the past month, so it appears that women are treating themselves, and they may not be using the most appropriate treatment,” Dr. Mindell said. “That is concerning.”

The next step is for researchers to study safer ways to help women improve their sleep during pregnancy, Dr. Mindell said. For example, cognitive-behavioral therapy has been shown to alleviate insomnia, and it could teach pregnant women how to deal with worries about the baby or labor that may be keeping them awake.

The current study was published online in Sleep Medicine, and the project was supported by Johnson & Johnson Consumer & Personal ProductsWorldwide, a division of Johnson & Johnson Consumer Companies Inc.