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Why is sleep so elusive during pregnancy?

Most mothers-to-be would probably prefer to get as much sleep as possible before the baby arrives. But one of nature's dirty tricks is that just when you're most in need of rest, you can't get it because your back aches, your bladder's full, your belly's big, and your mind is teeming with a host of fears and anxieties concerning your baby's health and birth. Here are some of the reasons those zz's are playing hard to get, and some strategies that might help you:

• Constant need to urinate Your bladder's capacity has shrunk significantly because of your growing uterus. Drinking as little as possible an hour or two before bedtime may limit late-night trips to the bathroom.

• Queasiness Since nausea tends to strike an empty stomach, eat a light, high-carbohydrate snack before you go to bed and keep some crackers or rice cakes on your night table so it's easy to grab one in the morning.

• Indigestion or heartburn Avoid distending your stomach by eating small, frequent meals rather than three large ones. Eat well before bedtime, and sit up after eating. Lay off the citrus, spices, fried foods, and chocolate because they can irritate the esophagus. If none of these measures helps, it's fine to crunch an antacid tablet after meals.

• Leg cramps Many pregnant women are occasionally awakened at night by leg cramps. Try stretching your calf by flexing your foot heel first, gently massaging your leg, placing a hot water bottle on the cramped area, or getting up and walking around. Eating more calcium-rich foods may also help.

• Insomnia It's very common during pregnancy to toss and turn with excitement and anxiety as your due date approaches. Try a warm bath before bedtime and a few relaxation techniques, such as those you've learned in childbirth class. Some women find that exercising during the day helps them sleep better at night. Whatever you do, try not to get too stressed over your lack of sleep — anxiety will only compound it. Avoid looking at the clock (knowing the time won't make you feel better), close your eyes, and concentrate on your breathing. Some research suggests that willing yourself to stay awake will slide you into the land of nod in no time.

• Worrying about your baby's well-being Every parent-to-be is anxious about the many unknowns involved in having a baby. It may help to arm yourself with information. To ease your anxieties, read up and take a childbirth preparation class. Confide in your partner, too, who may be feeling the same way you are. Bringing your fears out into the open may help you exorcise them.

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