Abstract
Pregnancy is a time of extensive physiologic, physical, and hormonal changes. These changes can significantly disrupt a woman’s sleep and can result in symptoms of daytime sleepiness and fatigue. Understanding how sleep is altered during pregnancy and recognizing sleep disorders that commonly develop during pregnancy may enable healthcare professionals to identify and treat sleep problems. Sleep is vital to the health and well-being of pregnant women. By counseling women on strategies to optimize sleep, healthcare professionals may improve the quality of nighttime sleep and reduce daytime sleepiness and fatigue.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Carsten ME (1998) Endocrinology of pregnancy and parturition. In: Hacker NF, Moore JG (eds) Essentials of obstetrics and gynecology. W.B. Saunders, Philadelphia, PA, pp 76–84
Manber R, Armitage R (1999) Sex, steroids, and sleep: a review. Sleep 22:540–555
Lancel M, Faulhaber J, Holsboer F, Rupprecht R (1996) Progesterone induces changes in sleep comparable to those of agonistic GABAA receptor modulators. Am J Physiol 271:E763–E772
Lee KA (1998) Alterations in sleep during pregnancy and postpartum: a review of 30 years of research. Sleep Med Rev 2:231–242
Colvin GB, Whitmoyer DI, Lisk RD, Walter DO, Sawyer CH (1968) Changes in sleep-wakefulness in female rats during circadian and estrous cycles. Brain Res 7:173–181
Kleinlogel H (1983) The female rat’s sleep during oestrous cycle. Neuropsycho-biology 10:228–237
Branchey M, Branchey L, Nadler RD (1971) Effects of estrogen and progesterone on sleep patterns of female rats. Physiol Behav 6:743–746
Marbry RL (1986) Rhinitis of pregnancy. South Med J 79:965–971
Hedman C, Pohjasvaara T, Tolonen U, Suhonen-Malm AS, Myllyla VV (2002) Effects of pregnancy on mother’s sleep. Sleep Med 3:37–42
Suzuki S, Dennerstein L, Greenwood KM, Armstrong SM, Satohisa E (1994) Sleeping patterns during pregnancy in Japanese women. J Psychosom Obstet Gynaecol 15:19–26
Mindell JA, Jacobson BJ (2000) Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs 29:590–597
Baratte-Beebe KR, Lee K (1999) Sources of midsleep awakenings in childbearing women. Clin Nurs Res 8:386–397
Schweiger MS (1972) Sleep disturbance in pregnancy. A subjective survey. Am J Obstet Gynecol 114:879–882
Hertz G, Fast A, Feinsilver SH, Albertario CL, Shulman H, Fein AM (1992) Sleep in normal late pregnancy. Sleep 15:246–251
Driver HS, Shapiro CM (1992) A longitudinal study of sleep stages in young women during pregnancy and postpartum. Sleep 15:449–453
Lee KA, Zaffke ME, McEnany G (2000) Parity and sleep patterns during and after pregnancy. Obstet Gynecol 95:14–18
Brunner DP, Munch M, Biedermann K, Huch R, Huch A, Borbeley AA (1994) Changes in sleep and sleep electroencephalogram during pregnancy. Sleep 17:576–582
Santiago JR, Nolledo MS, Kinzler W, Santiago TV (2001) Sleep and sleep disorders in pregnancy. Ann Intern Med 134:396–408
National Sleep Foundation (2007) Women and sleep poll. National Sleep Foundation, Washington, DC
Lee KA (2007) Sleep and pregnancy/postpartum. J Perinat Neonatal Nurs 21:91
Karacan I, Heine W, Agnew HW, Williams RL, Webb WB, Ross JJ (1968) Characteristics of sleep patterns during late pregnancy and the postpartum periods. Am J Obstet Gynecol 101:579–586.
Hoppenbrouwers T, Ugartechea JC, Combs D, Hodgman JE, Harper RM, Sternman MB (1978) Studies of maternal-fetal interaction during the last trimester of pregnancy; ontogenesis of the basic rest-activity cycle. Exp Neurol 61:136–153
Coble PA, Reynolds CF, Kupfer DJ, Houck PR, Day NL, Giles DE (1994) Childbearing in women with and without a history of affective disorder. II. Electroencephalographic sleep. Compr Psychiatry 35:215–224
Wolfson AR, Lee KA (2005) Pregnancy and the postpartum period. In: Kryger MH, Roth T, Dement WC (eds) Principles and practices of sleep medicine. Elsevier Saunders, Philadelphia, PA, pp 1278–1286
Orr WC, Heading R, Johnson LF, Kryger M (2004) Sleep and its relationship to gastro-oesophageal reflux. Aliment Pharmacol Ther 9:39–46
Wolfson AR, Crowley SJ, Anwer U, Bassett JL (2003) Changes in sleep patterns and depressive symptoms in first-time mothers: last trimester to 1-year postpartum. Behav Sleep Med 1:54–67
Van Thiel DH, Gavaler JS, Joshi SN, Sara RK, Stremple J (1977) Heartburn of pregnancy. Gastroenterology 72:666–668
Gupta MA, Schork MJ, Gay C (1992) Nocturnal leg cramps of pregnancy: a prospective study of clinical features. Sleep Res 21:294
Lee KA, Zaffke ME, Baratte-Beebe K (2001) Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med 10:335–341
Suzuki K, Ohida T, Sone R (2003) The prevalence of restless legs syndrome among pregnant women in Japan and the relationship between restless legs syndrome and sleep problems. Sleep 26:673–677
Nikkola E, Ekblad U, Ekholm E, Mikola H, Polo O (1996) Sleep in multiple pregnancy: breathing patterns, oxygenation, and periodic leg movements. Am J Obstet Gynecol 174:1622–1625
Allen R, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisir J (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4:101–119
Earley CJ (2003) Clinical practice. Restless legs syndrome. N Engl J Med 348:2103–2109
Pien GW, Schwab RJ (2004) Sleep disorders during pregnancy. Sleep 27:1405–1417
Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Casetta I, Mollica G, Ferini-Strambi L, Granieri E (2004) Restless legs syndrome and pregnancy. Neurology 63:1065–1069
Aul EA, Davis BJ, Rodnitzky RL (1998) The importance of formal serum iron studies in the assessment of restless legs syndrome. Neurology 51:912
Sun ER, Chen CA, Ho G, Earley CJ, Allen RP (1998) Iron and the restless legs syndrome. Sleep 21:371–377
O’Keefe ST, Gavin K, Lavan JN (1994) Iron status and restless legs syndrome in the elderly. Age Ageing 23:200
Boetz MI, Lambert B (1977) Folate deficiency and restless legs syndrome in pregnancy. N Engl J Med 297:670
Hening WA, Allen RP, Earley CJ, Picchietti DL, Silber MH (2004) An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 27:560–583
Pritchett AM, Morrison JF, Edwards WD, Edwards WD, Schaff HV, Connolly HM, Espinosa RE (2002) Valvular heart disease in patients taking pergolide. Mayo Clin Proc 77:1280–1286
Montplaisir J, Allen RP, Walters AS, Ferini-Strambi L (2005) Restless legs syndrome and periodic limb movements during sleep. In: Kryger MH, Roth T, Dement WC (eds) Principles and Practices of Sleep Medicine. Elsevier Saunders, Philadelphia, PA, pp 839–52
Phillips B, Kryger MH (2005) Management of obstructive sleep apnea-hypopnea syndrome: overview. In: Kryger MH, Roth T, Dement WC (eds) Principles and practices of sleep medicine. Elsevier Saunders, Philadelphia, PA, pp 1109–1121
American Academy of Sleep Medicine (2005) The international classification of sleep disorders, 2nd ed: diagnostic & coding manual. American Academy of Sleep Medicine, Westchester, IL
Elkus R, Popovich J (1992) Respiratory physiology in pregnancy. Clin Chest Med 13:555–565
Lapinsky SE, Kruczynski K, Slutsky A (1995) Critical care in the pregnant patient. J Respir Crit Care Med 152:427–455
Popovic RM, White DP (1998) Upper airway muscle activity in normal women: influences of hormonal status. J Appl Physiol 84:1055–1062
Brownell LG, West P, Kryger MH (1986) Breathing during sleep in normal pregnant women. Am Rev Respir Dis 133:38–41
Itasaka Y, Miyazaki S, Ishikawa K, Togawa K (2000) The influence of sleep position and obesity of sleep apnea. Psychiatry Clin Neurosci 54:340–341
O’Connor C, Thornley KS, Hanly PJ (2000) Gender differences in the polysomnographic features of obstructive sleep apnea. Am J Respir Crit Care Med 161:1465–1472
Peppard PE, Young T, Palta M, Dempsey J, Skatrud J (2000) Longitudinal study of moderate weight change and sleep-disordered breathing. JAMA 284:3015–3021
Krieger J (2007) Respiratory physiology: breathing in normal subjects. In: Kryger MH, Roth T, Dement WC (eds) Principles and practices of sleep medicine. Elsevier Saunders, Philadelphia, PA, pp 232–244
Schutte S, DelConte A, Gross A, Segal J, Cater J, Bustraan S, Doghramji K, Youakim J (1995) Self-reported snoring and sleep in high risk pregnancies. Sleep Res 24:342
Franklin KA, Holmgren PA, Jonsson F, Poromaa N, Stenlund H, Svanborg E (2000) Snoring, pregnancy-induced hypertension, and growth retardation of the fetus. Chest 117:137–141
Maasilta P, Bachour A, Teramo K, Polo O, Laitinen LA (2001) Sleep-related disordered breathing during pregnancy in obese women. Chest 120:1448–1454
Guilleminault C, Tilkian A, Dement WC (1976) The sleep apnea syndromes. Annu Rev Med 27:465–484
Pien GS, Fife D, Pack AI, Nkwuo E, Schwab RJ (2005) Changes in symptoms of sleep-disordered breathing during pregnancy. Sleep 28:1299–1305
Sahin FK, Koken G, Cosar E, Saylan F, Fidan F, Yilmazer M, Unlu M (2008) Obstructive sleep apnea in pregnancy and fetal outcome. Int J Gynaecol Obstet 100:141–146
Joel-Cohen SJ, Schoenfeld A (1978) Fetal response to periodic sleep apnea: a new syndrome in obstetrics. Eur J Obstet Gynecol Reprod Biol 8:77–81
Schoenfeld A, Ovadia Y, Neri A, Freedman S (1989) Obstructive sleep apnea (OSA) – implication in maternal-fetal medicine. A hypothesis. Med Hypotheses 30:51–54
Schutte S, Del Conte A, Doghramji K, Gallagher K, Gallagher E, Oliver R, Rose C, Breuninger W, De Los Santos L, Youakim J (1994) Snoring during pregnancy and its impact on fetal outcome. Sleep Res 23:325
Loube DI, Poceta JS, Morales MC, Peacock MD, Mitler MM (1996) Self-reported snoring in pregnancy. Association with fetal outcome. Chest 109:885–889
Guilleminault C, Querra-Salva M, Chowdhuri S, Poyares D (2000) Normal pregnancy, daytime sleeping, snoring, and blood pressure. Sleep Med 1:289–297
Koken G, Sahin FK, Cosar E, Saylan F, Yilmaz N, Altuntas I, Fidan F, Unlu M, Yilmazer M (2007) Oxidative stress markers in pregnant women who snore and fetal outcome: a case control study. Acta Obstet Gynecol Scand 86:1317–1321
Guilleminault C, Kreutzer M, Chang JL (2004) Pregnancy, sleep disordered breathing and treatment with nasal continuous positive airway pressure. Sleep Med 5:43–51
Lewis DF, Chesson AL, Edwards MS, Weeks JW, Adair CD (1998) Obstructive sleep apnea during pregnancy resulting in pulmonary hypertension. South Med J 91:761–762
Partinen M, Hublin C (2005) Epidemiology of sleep disorders. In: Kryger MH, Roth T, Dement WC (eds) Principles and practices of sleep medicine. Elsevier Saunders, Philadelphia, PA, pp 626–647
Shepard JW, Olsen KD (1990) Uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. Mayo Clin Proc 65:1260–1267
Lee KA, Gay CL (2004) Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol 6:2041–2046
Wilkie G, Shapiro CM (1992) Sleep deprivation and the postnatal blues. J Psychosom Res 36:309–316
Verster JC, de Weert AM, Bijtjes SI, Aarab M, van Oosterwijck AW, Eijken EJ, Verbaten MN, Volkerts ER (2003) Driving ability after acute and sub-chronic administration of levocetirizine and diphenhydramine: a randomized, double-blind, placebo-controlled trial. Psychopharmacology (Berl) 169:84–90
Mansfield L, Mendoza C, Flores J, Meeves SG (2003) Effects of fexofenadine, diphenhydramine, and placebo on performance of the test of variables of attention (TOVA). Ann Allergy Asthma Immunol 90:554–559
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Ward, B.A. (2010). Insomnia During Pregnancy. In: Attarian, H., Schuman, C. (eds) Clinical Handbook of Insomnia. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-042-7_8
Download citation
DOI: https://doi.org/10.1007/978-1-60327-042-7_8
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-60327-033-5
Online ISBN: 978-1-60327-042-7
eBook Packages: MedicineMedicine (R0)