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Sleep During the Third Trimester

Waking up at night? Having trouble falling asleep? Join the club. Most pregnant women have sleep problems in their third trimesters, waking three to five times a night on average. But don't despair -- there are strategies that can help you have a restful night. Read on for more tips on getting a good night's sleep during pregnancy. Sweet dreams!

Desperately seeking a comfy sleeping position

Feeling like you have a watermelon strapped to your stomach can make it tough to find a comfortable position to sleep in. Try lying on your left side with your knees bent. Tuck one pillow under your tummy and another between your legs, or snuggle up alongside a body pillow. (Lying on your left provides better blood flow to your baby, too.) If you're still wrestling with the bed covers, resting upright in a recliner may do the trick. With a little creativity -- and a lot of pillows -- you can probably get comfy, so try not to lose any sleep over it.

Reducing bathroom breaks

Now that your baby is getting bigger and putting more pressure on your bladder, the bathroom may become your second home. To avoid too many late-night trips to the toilet, limit your fluid intake in the evening (without cutting back on the amount of liquid you drink for the day), and empty your bladder completely each time you pee. Cutting out caffeine -- coffee, tea, and cola -- can also help.

Beware: Third-trimester sleep snatchers

Your ability to get a decent night's sleep may be interrupted by third-trimester sleep stealers like leg cramps, snoring, heartburn, restless legs syndrome, and insomnia. Here's a list of common pregnancy complaints and what you can do to eliminate these sleep snatchers:

Cramps. To avoid waking up with painful leg cramps -- usually in your calf muscles -- do a few leg stretches before you retire for the night. Regular exercise may help keep cramps at bay. If you do get one, apply heat or massage to the affected area.

Sometimes sleeping under heavy covers can make cramps worse, perhaps by restricting movement or by weighing down on your body. Try not to load up on blankets if you can help it.

Snoring. Around 30 percent of women snore while they're pregnant because of increased swelling in their nasal passages. This may not be music to your (or your partner's) ears, and can prevent you from getting as much shut-eye as you'd like. This annoyance will probably go away once you have your baby, but for now, try propping up your head with an extra pillow. If loud snoring and severe daytime sleepiness are a concern, talk with your health-care practitioner because this could be a sign of a more serious condition called sleep apnea.

In severe cases, certain medications can be used to reduce snoring, but don't take any over-the-counter medications for congestion without talking it over with your doctor.

Heartburn. Another common pregnancy complaint actually has nothing to do with your heart, despite its name. If you want to avoid getting woken up with this unpleasant burning sensation in your throat and chest, steer clear of spicy, fried, or acidic foods if they give you trouble. Eat small meals and chew your food slowly. Avoid eating or drinking within a few hours of bedtime. Elevating the head of your bed by a few inches may also help.

Restless Legs Syndrome (RLS). As many as 26 percent of pregnant women develop a condition in their third trimester called restless legs syndrome. As its name suggests, this ailment causes an uncontrollable urge to move the legs, usually in response to an unpleasant or odd feeling in the legs. Unfortunately, these sensations often occur during the night and can make it tough to fall or stay asleep. Moving the affected leg can stop the symptoms, but the irritation returns once your limb is still again.

Avoiding caffeine and taking a folic acid supplement may help. (Pregnant women should be getting 600 to 800 micrograms of folic acid per day.) Make sure you are getting enough iron as well. One study revealed that iron plays a central role in causing restless leg syndrome. Sleeping under heavy covers worsens restless leg syndrome as it does cramps, so avoid heavy blankets and comforters if you have this problem.

Unfortunately, the prescription medication that can relieve the twitching and discomfort is not advisable during pregnancy, but these curious symptoms usually go away once you give birth.

Insomnia. Most pregnant women suffer from insomnia during their pregnancy -- more often than not in their third trimester when size, back pain, heartburn, bathroom breaks, anxiety, and anticipation can all conspire to make it nearly impossible to fall -- or stay -- asleep. And chances are, you're not the only one tossing and turning in the wee hours of the morning. Growing babies are often busy at night, too. And their nocturnal maneuvers, such as kicking feet or bending elbows, may keep you from sleeping soundly.

If falling asleep is the problem, a warm bath, soothing massage, or gentle stretching exercises, even a glass of hot water may help you feel sleepy and ready for bed. Relaxation techniques taught in your childbirth classes may also help, as can calming music.

If waking up in the middle of the night is the problem, get out of bed and read a book, write in your journal, or drink a small glass of warm milk. Then when you start to nod off, try slipping between the sheets again. If all else fails, think of these sleepless nights as preparation for when your baby arrives.

References

Santiago, JR, Nolledo MS, Kinzler W, Santiago TV. Sleep and Sleep Disorders in Pregnancy. Annals of Internal Medicine; 134:396-408

American Pregnancy Association. Sleeping Positions During Pregnancy. http://www.americanpregnancy.org/pregnancyhealth/sleepingpositions.html

Mayo Clinic. The third trimester: Amazement and anticipation. http://www.mayoclinic.com/

National Sleep Foundation. Women & Sleep. http://www.sleepfoundation.org/publications/women.cfm

Swedish Medical Center. Pregnancy and Sleep: A Contradiction in Terms? http://www.swedish.org/17294.cfm

American Academy of OtolaryngologyHead and Neck Surgery. Snoring: Not Funny, Not Hopeless. http://www.entnet.org/healthinfo/snoring/snoring.cfm

Michaelson,PG, et al. Popular Snore Aids: Do They Work? Otolaryngoly Head Neck Surgery. 130(6):649-58.

Franklin, K. et al. Snoring, Pregnancy-Induced Hypertension and Growth Retardation of the Fetus. Chest. 117:137-141.

Pregnancy.org. Sleep Apnea and Snoring. http://pregnancyorg.healthology.com/pregnancyorg/16315.htm

National Heartburn Alliance. General Questions. http://www.heartburnalliance.org/section2/index_textonly.jsp#general

Restless Legs Syndrome Foundation. Living with Restless Legs Syndrome (brochure).http://www.rls.org/pdf/LwRLS_English.pdf

March of Dimes. Frequently Asked Questions About Folic Acid. http://www.marchofdimes.com/professionals/690_1403.asp

National Sleep Foundation. Women & Sleep. http://www.sleepfoundation.org/hottopics/index.

National Sleep Foundation. Pregnancy and Sleep. http://www.sleepfoundation.org/site/

Restless Leg Syndrome: Pathophysiology and the role of iron and folate. Patrick, LR. Alternative Medicine Review. Volume 12, Number 2.

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