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Sleep in Pregnancy

the effects of pregnancy may have on your sleep

As your body changes throughout the course of your pregnancy, hormonal changes and physical discomforts can affect the quality of your sleep. During each trimester you will experience differences in sleep patterns, and it is important to recognize how these may change.

Is it safe to sleep on my back during pregnancy?

Early in the pregnancy, sleeping on your back is safe. In the third trimester (starting around 28 weeks), it is not recommended that you lie flat on your back for a prolonged period of time because the weight of your uterus presses on the major vein in your back. When you are sleeping, it is hard to control your position. If you wake up on your back, you probably awakened because your body was telling you to shift position. Some people wake up feeling dizzy, short of breath, or with heart palpitations. These symptoms should resolve quickly if you shift to either side. As your pregnancy progresses, try to sleep on one side or the other, or use a cushion to ensure that you are not completely flat on your back to avoid nighttime awakenings and ensure proper blood flow to your baby.

Is it safe to sleep on my stomach during pregnancy?

There is no problem with sleeping on your stomach in early pregnancy, as the uterus is protected by your pubic bone. As the pregnancy progresses, sleeping on your stomach will become uncomfortable, which is the cue to stop.

What about sleeping on my side during pregnancy?

Sleeping on your side will promote good blood flow to your baby. You may also want to consider bending one or both of your knees and elevating your head slightly.

Is it safe to use sleeping medications during pregnancy?

Some prescription sleep aids can be used in pregnancy but should be discussed with your OB provider before starting. These medications can be habit forming, and in general, are used sparingly in pregnancy. There are overthe- counter sleep aids that are safe to use during pregnancy, including Benadryl, Tylenol PM, and Unisom. These medications should be taken according to the directions on the package and should be discussed with your provider.

PREGNANCY SLEEP TIPS

  • Drink plenty of fluids during the day but cut down in the evening before bedtime to minimize getting up at night
  • If approved by your physician or care team, exercise in the morning can give you energy during the day, help you to stay fit and improve circulation, and reduce nighttime leg cramps
  • Maintain a consistent sleep routine. If you establish a soothing and comforting evening routine you’ll be able to relax and get to sleep more easily. Try a cup of caffeine-free tea or hot milk, reading, or taking a warm shower
  • Try stretching before bed to help ease muscle cramps
  • Keep heartburn at bay. See page 7 for tips.
  • Nap during the day. If you’re not getting enough rest at night, take a nap to reduce fatigue. Find a quiet spot and relax, even if only for a half-hour.
  • Support your body. Use a special pregnancy pillow or regular pillows to support your body. Try placing a pillow under your upper back or hips, or between your knees.
  • Watch your diet. Completely eliminate caffeine if insomnia is a problem for you. If nausea is a problem, eat bland snacks throughout the day. Keeping your stomach slightly full helps keep nausea at bay.
  • Be sure you are sleeping as many hours as you need to feel rested.
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Clinical Trials

  • This study is looking at the relationship between sleep and perinatal mood disorders such as depression and anxiety. Participants will wear a wrist monitor like a fit bit for 10 days to help researchers gain information into sleep patterns during pregnancy and postpartum and will answer questionnaires about their mood.
  • Preterm birth is one of the leading causes of neonatal morbidity and mortality. One of the most significant risk factors is a history of a prior spontaneous preterm birth. Intramuscular progesterone is the only FDA approved medication for the prevention of recurrent preterm birth. Vaginal progesterone is not FDA approved for the prevention of recurrent preterm birth, but has been found to beneficial. Given the presence of trials demonstrating efficacy for both intramuscular and vaginal progesterone in the prevention of recurrent preterm birth, but limited information one being more superior to the other, we are performing a trial comparing vaginal progesterone and intramuscular progesterone for the prevention of recurrent spontaneous preterm birth in women with a history of prior spontaneous preterm birth.
  • [This study is no longer recruiting.] The SONATA Study is an FDA-approved clinical study designed to establish the safety and effectiveness of a new, investigational device to reduce heavy menstrual bleeding caused by uterine fibroids. The device, called the SONATA System, targets fibroids rather than treatment or removing the entire uterus. If effective, this device will provide an alternative to hysterectomy that is: incision-free, preserves the uterus, does not require general anesthesia and is an outpatient procedure.
  • Women with twin pregnancy who have a dilated (open) cervix detected on physical exam before 24 weeks are at increased risk for delivering their babies preterm (before 37 weeks gestation). Prematurity is associated with many complications for the babies including respiratory (breathing) problems, bleeding inside of the brain (a form of stroke), increased risk of infection, kidney, temperature and feeding problems. The primary objective of this study is to determine if physical exam indicated cerclage use reduces the incidence of spontaneous PTB in asymptomatic women with twin gestations with cervical dilation diagnosed on pelvic exam before 24 weeks of gestation.
  • Tranexamic acid was shown to significantly reduce risk of mortality when given to women with diagnosed postpartum hemorrhage in the recent Lancet WOMAN Trial.* The purpose of this study is to determine the optimal dose for using tranexamic acid to prevent postpartum hemorrhage during routine cesarean section. Women undergoing cesarean section will be eligible and must not have a history of blood clots or a known clotting condition. *http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31111-X/fulltext
  • In this study, we are developing non-invasive tools to identify early signs of abnormalities of the placental function using arterial spin labeling (ASL) based on fetal MRI. ASL is a particularly attractive method for early and safe monitoring during pregnancy given that ASL is completely non-invasive and does not require contrast agents or exposure to ionizing radiation. Our specific aim is to develop and validate placental perfusion imaging with substantially improved image quality and sensitivity to abnormalities.
  • This study is being performed at Children's National Health System. We are trying to understand how the normal fetus controls blood flow to the different parts of the body such as the lungs and brain. We will measure your baby's blood flow using the same ultrasound approach used by your obstetrician. We will test your baby's control of blood flow by measuring the responses to changes in your (the mom's), levels of oxygen and carbon dioxide. We will make these changes by asking you to breathe extra oxygen for short periods of time. If your obstetrician determines that your pregnancy is uncomplicated, you and your baby are eligible for this study.