Sleeping Well While Pregnant

Denise Wade, seven months pregnant, runs a restaurant in Big Sky, Montana, and spends hectic lunch hours as its main chef. But despite feeling tired most days, she's often unable to sleep. "I have no problem sleeping at 3 p.m. -- it's 3 a.m. that gets me," says Wade.

A survey by the National Sleep Foundation found that nearly four out of five women had trouble sleeping during pregnancy. The reasons may include an expectant woman's altered respiration, her sheer physical bulk, and hormones, which are responsible for everything from overheating to old-fashioned insomnia.

What about the cliché that this is nature's way of preparing you for more sleep deprivation after the baby's birth? "If that were the case, nature would be doing an exceptionally bad job," says Thomas Roth, Ph.D., head of the department of sleep medicine at Henry Ford Hospital, in Detroit. "The body would want to prepare by being fully rested. It doesn't get used to losing sleep." Which means that the majority of expectant women enter motherhood already tired. But, if you're pregnant or plan to be again, there are ways you can sleep better.

You're wide-awake at 3 a.m. Probable cause: Experts suspect increased levels of hormones -- especially progesterone, which can act as a stimulant (though it has sleep-inducing properties, too). Cure: Start by regulating your schedule: Go to bed and rise at the same time every day. And if you can't fall asleep? "Get up, go to a dimly lit room, and do something boring: Watch a video you've seen before, read a tough book, watch bad TV," says Ursula Anwer, M.D., a neurologist at UMass Memorial Health Care, in Worcester. "Don't do laundry or turn on all the lights."

Sleep troubles -- and solutions

You can't get comfortable. Probable cause: The sheer size of your belly makes turning over extremely difficult. Cure: You can use a mattress pad that looks like an egg carton, available at such stores as Target and Wal-Mart for about $20. Or ditch the bed. Jennifer Ward of Hampstead, Maryland, thought her bed was too flat, but her living room sofa provided just the right amount of back support. Also, Ward found it a challenge to follow her doctor's advice that she sleep on her left side to facilitate blood flow to the fetus. "I'd start out that way, but I'd end up on my back," she says. "If you find yourself on your back occasionally, you don't need to worry about it -- it isn't the end of the world. Just don't spend your whole pregnancy on your back because it could impair the baby's growth," says Renee Eger, M.D., an obstetrician with Ob-Gyn Associates, in Providence.

You have leg cramps. Probable cause: Changes in circulation because of pressure from the baby on nerves and vessels to the legs. Cure: If your doctor tells you it's okay, you can take magnesium and calcium supplements. Try stretching exercises before you go to bed, as well as a presleep leg massage. "Sometimes I was able to wake up my husband and get him to massage my legs, but usually I'd wait five or ten minutes until the pain was over," said Michelle Vetter, mom of an 8-week-old in Big Sky.

You need to pee. Constantly. Jessica Kircher of Medina, Washington, says the multiple bathroom trips that haunted her in early pregnancy have returned now that she's seven months pregnant. Probable cause: Your expanding uterus presses on your bladder, making it feel full sooner. Cure: Before she gets into bed, Kircher always goes to the bathroom. "Then before I turn out the light, I make myself get up and go again, even though I'm feeling really relaxed and ready to nod off." It also helps to stop drinking a few hours before bedtime, says Kathryn Lee, Ph.D., a professor of nursing and a sleep researcher at the University of California in San Francisco. "Avoid caffeine, which is a bladder stimulant."

You have vivid or weird dreams. Probable cause: Lighter sleep patterns. "Pregnant women simply wake up more often, and that's one of the reasons they're more aware of their dreams," says Dr. Anwer. Anxiety and hormones can play a role as well. Cure: "It isn't a bad idea to learn relaxation and breathing techniques -- either through meditation or yoga," suggests Lewis Kline, M.D., director of the Sleep Center at Western Pennsylvania Hospital, in Pittsburgh. Many moms use whatever helps them relax. For Anne Depue of Seattle, a lavender-scented bag over her eyes could lull her back into slumber.

Meals come back to haunt you. Probable cause: It's your expanding uterus pressing on your stomach, causing the contents to come back up, which brings on heartburn. Then the extra progesterone in your system slows down your digestion by relaxing the valve between the stomach and the esophagus. Cure: Skip spicy, acidic, or fatty foods. Try to eat smaller meals throughout the day and eat dinner earlier. Avoid lying down after eating, and take a walk afterward if possible. Sleeping with your head propped up with pillows offers some relief as well. If you're still uncomfortable, ask your doctor if you can take an over-the-counter remedy. Tums, Rolaids, Mylanta, Maalox, and Zantac are usually considered safe.

THE ULTIMATE CURE: The good news about pregnancy-related sleep maladies: After childbirth, they end. Of course, they're replaced with another sleep disrupter -- your newborn.