Sleep Quality in Postpartum Women

Sleep quality in women has been linked to changes in hormone levels because of the menstrual cycle, pregnancy, postpartum recovery, and menopause and to the stress of shouldering multiple roles in the transitional stages immediately after childbirth. Postpartum women are significantly more likely to experience sleep disturbances than either pregnant women or women in general, with most reporting exhaustion during the first 3 postpartum months.

The postpartum period is an especially stressful and sensitive time for mothers because they are focused on incorporating a new member into the family structure and integrating the new role of motherhood into existing responsibilities. Sleep deprivation or sleep disturbances are thus commonly expressed concerns. Sleep is commonly disturbed during pregnancy and following childbirth.

Types of Changes

Even individuals who have been ‘healthy sleepers’ prior to pregnancy will notice a change in their sleep patterns during pregnancy. There are many physiological, psychological and lifestyle changes that occur during this period.

• Pain or discomfort while trying to sleep, and more frequent night-time toilet visits are common.
• Many women experience symptoms of insomnia, whilst some develop restless leg syndrome and/or sleep apnea. Pregnancy requires adaptation to an ever-changing body and unfamiliar sleep patterns.
• As pregnancy progresses, complaints of sleep disruption become more prevalent and sleep quality deteriorates significantly.
• The most common sleep difficulties during pregnancy are frequent night wakening, difficulty falling asleep and waking too early. In fact, the vast majority of women (92%) report restless sleeping. As a result, particularly if labor onset is at night or labor continues overnight, many women begin motherhood sleep deprived.

New mothers

Sleep disturbances are common to all new mothers. The sleep patterns of new mothers are characterized by shorter sleep durations at night resulting in daytime fatigue. This is particularly marked for first time mothers, who have lower sleep efficiency, spend more time in bed and have a greater wake after sleep onset during pregnancy than multiparous mothers. These mothers also have fewer sleep episodes in the early postpartum period and generally poorer sleep quality than their multiparous counterparts. The high rates of sleep disturbance amongst new mothers is not surprising given the many physical, lifestyle, psychological and emotional changes that occur following childbirth.

Sleep disruption

During the first few days after childbirth, the breasts begin to produce milk, which is new and often uncomfortable. Genital, pelvic and back pain is also common after childbirth, which is known to further disturb sleep. In addition to the physical changes, lifestyle changes and parenting responsibilities also contribute to the potential for sleep disruption.

Tips to Improve Sleep for New Moms

1. Talk about your sleep needs

Do it early, before you bring baby home. “Once you become pregnant, discuss your ability to handle sleep deprivation with your partner.” You may want to think about getting help such as night nurse or babysitter.

2. Use the hospital nursery

It’s there for a reason does not feel guilty. “This is your time to recuperate from birth.” “Let a trained professional take care of your baby for the night or two that you are in the hospital.”

3. Just say no to added responsibility

If you feel guilty about spending less time with your oldest child, you may want to volunteer to go on a trip with his class or take him for a special excursion to the museum. Think twice. “Do not take on any extra responsibilities when you have a newborn at home.”

4. Sleep when your baby sleeps

Any experienced baby nurse will tell you that the key to staving off postpartum sleep deprivation is to sleep when your baby sleeps. “If your baby takes a nap, put everything aside and take a nap too.”

“Everything can wait except the baby.”

It is very tempting to try and do chores, wash dishes, do laundry and clean floors when your baby is asleep. But accept that your house is dirty and messy and go to sleep because once baby is up, you have to be up too.

5. Say yes to help

Accept any help that you can get. “Many people are resistant, but whether it is a family member, friend, or babysitter, accept help, so you can get a few hours of sleep.” “People think of sleep as a luxury, but it is a medical requirement.

“When you do get to nap, avoid television, radio, and looking at your clock so you don’t focus on how much time you have left.” A cool, dark environment is also optimal for napping.

6. Don’t worry that you won’t hear your baby cry

“A baby is a natural alarm clock and mothers tend to be attuned to their baby’s crying”. If you are concerned that you won’t hear your baby or if the nursery is far away from your bedroom, buy a monitor and keep it near you. Remember that your baby is safe, and if he cries for a few minutes before you hear him, he will be OK.

7. Outsource tasks

If your baby takes a bottle, ask your partner to take on some of the feedings. If you’re breastfeeding, “Consider pumping and giving someone else a turn to feed.” Try to divide up all your household responsibilities as best you can.

9. Don’t ignore the baby blues

Sleep loss can lead to mood changes, and new moms are at risk for baby blues or the more serious postpartum depression. If you are experiencing some of these symptoms, talk to your doctor to address them. Mood changes may be made worse by sleep deprivation.

10. Rule out underlying sleep disorders

“Short naps should revive you somewhat, but if you don’t feel like they do, see a professional as there may be an underlying sleep disorder that can be treated.” Sleep disorders like sleep apnea pauses in breathing while you sleep are very common among people who gain weight, and may develop due to the weight gain of pregnancy. A sleep study, in which you are monitored while asleep, can identify sleep apnea. Treatments are available.

Relax, mama

Speaking of relaxation, it’s a good idea to get familiar with a few relaxation techniques that can help ease your anxiety when you’re in bed trying to sleep.

Some of the belly breathing relaxation techniques are:

• Place one hand on your stomach and the other on your chest.
• Take a deep breath through your nose into your belly.
• You should feel the hand on your stomach rise, while the one on your chest should stay still.
• Breathe in, hold the breath, and then slowly exhale through your mouth, feeling your stomach fall back down.
• Do this for as long as you need to return to a calm state or until you fall asleep.