Maternal Mental Health Awareness Week 2022

Getting quality sleep during pregnancy and during postpartum is very important for both mother and baby. However, women often experience sleep disturbances and worsening sleep quality throughout pregnancy and after the baby is born.

Sleep problems for mothers begin as early as pregnancy and there is evidence that sleep structure never quite returns to pre- pregnancy levels after birth.

Daytime sleepiness and fatigue are very common during the first trimester and may even be the first sign of pregnancy.

Nausea and vomiting, leg cramps, joint pain, back pain, uncomfortable or unusual sleeping position, nasal congestion, temperature problems, anxiety and worries and nightmares are other problems that arise during pregnant women sleep.

Mothers who report very poor or drastically decreasing sleep quality during pregnancy 13are more likely to develop postpartum depression.

Prioritising quality sleep during pregnancy may, for that reason, be especially important for women who already have another risk factor for postpartum §depression.

In addition to pregnancy sleep aids such as specialised pillows or eye masks, the following habits may help to improve overall sleep quality and support insomnia:

Keep a cool, dark, quiet bedroom and limit the bed to sleeping and intimacy
Prioritise sleep and stick to a regular bedtime, scheduling naps earlier in the day so they don’t interfere with nighttime sleep
Read a book, take a bath, or indulge in another calming activity in preparation for bedtime
Use a nightlight to make it easier to get back to sleep after bathroom breaks
Avoid caffeine, spicy foods, and heavy meals too close to bedtime to reduce the risk of reflux
Avoid taking technology into the bedroom, and turn off screens at least an hour before bedtime
Create a nice and relaxing environment to sleep
Get regular exercise and natural day light exposure early in the day
Drink plenty of water throughout the day, but reduce liquid intake before bed to reduce nighttime bathroom breaks
If you can’t sleep, get out of bed and do something else relaxing until you feel sleepy
Write down thoughts in a journal, or seek help from your partner, friends, doctor, or childbirth classes if you’re feeling anxious or worried
Process feelings and keep a journal/worry worksheet
Use sleeping aids like specialised pillows or a mattress topper for comfort and support – posture can be crucial in maximising sleep length and quality, especially during the third trimester of pregnancy.
Taking the time to rest and promote relaxation are also important aspects in promoting healthy habits and reducing anxiety levels.

The sudden shifts in hormone levels, accumulated fatigue from pregnancy, and the caring for a new baby can have a big impact on new mother sleep, and it’s common for mothers to experience a dip in energy and mood during the first few weeks after giving birth.

The so-called ‘baby blues’ are quite common but for approximately one in eight women1 , these negative feelings become a persistent condition known as postpartum depression2.

While there are many factors contributing to this, sleep deprivation can exacerbate symptoms of postpartum depression and the relationship between the two can be symbiotic and have similar roots, such as stress, anxiety and shifts on hormone levels. The 2019 coronavirus disease pandemic (COVID-19) required strict confinement measures that impacted the world population’s daily life. This brought new challenges to pregnancy and the postpartum period for mothers, their families and healthcare providers. Recent studies also revealed higher rates of postpartum depression and insomnia compared with pre-pandemic studies.

Prioritising, planning and scheduling rest and sleep will support not only mothers recovery, connection with newborn, physical and mental health, but also the newborn sleep and the rest of the family.

Even if no significant sleep disturbance was identified during pregnancy, the challenges of dealing with a newborn, postpartum mood disorders and other aspects that might affect women after delivery can trigger sleeping difficulties during this period.

Therefore, it is important to try to optimise sleep during the postpartum period, which might include:

Rearranging the sleep schedule: Many newborns have erratic sleep schedules. Sleeping when their baby sleeps, both at night and during naps, can help mothers acclimatise to their little one’s sleep schedule and get an adequate amount of sleep themselves. However, it is important to allow enough sleep pressure to be accumulated during daytime to avoid circadian rhythm disorders.
Share the workload: Mothers who raise their child with a partner or extended family can alternate responsibilities for taking care of their infant. This may cultivate more time to sleep.
Go for a morning walk: Exposure to natural sunlight can realign the circadian rhythm, which is normally calibrated with the rise and fall of the sun. Moderate exercise can also help with sleep the following night.
Don’t consume alcohol: drinking can actually decrease sleep quality. Although alcohol has sedative properties and can induce faster sleep onset, people often experience sleep fragmentation later in the night.
Have a healthy diet

While measures to improve sleep and treat insomnia depend on a person’s health and medical history, people may experience a reduction of symptoms through cognitive behavioural therapy for insomnia (CBT-I). This type of therapy has no recognized side effects and can be used by pregnant and new mothers.

The American Academy of Sleep Medicine (AASM) recommends multi-component CBT-I for treatment of acute and chronic Insomnia.

When to See a Doctor

You should communicate to your doctor any negative feelings or problems sleeping, even if you believe they are just a normal part of being a new mother.

Sleep is an essential part of prenatal and postnatal care. If you’re struggling to sleep well, you’re not alone. Please reach out to us.