The impact of pregnancy on sleepSleep disruption during pregnancy One of the most common experiences that women encounter during pregnancy is the disruption of sleeping patterns. The general causative factor that results in this disruption are dreams that are usually associated with the developing fetus in their womb. Despite its high prevalence among pregnant women, this experience is regarded as a typical feature of pregnancy and thus does not require any kind of scientific investigation, more so any therapeutic regimen to address this condition (Owens 97). In order to fully understand the pathophysiology of sleep disturbance during pregnancy, it is important to describe the activity of sleep. The term sleep pertains to a circadian activity that is mainly controlled by biologic and environmental factors, such as temperature, hormones and sunlight. Sleep can be subdivided into 5 stages based on the depth of the activity and the movement of the eyes. The first two stages are considered as light sleep, while the subsequent two stages are part of deep sleep.
Approximately 90 minutes after an individual has fallen asleep, he enters into a sleep stage that is known as rapid eye movement (REM) sleep. During one evening, an individual will go through several cycles of the light and deep sleep, with a significant decrease in the occurrence of deep sleep as the individual goes through the rest of the evening. Consequently, the frequency of rapid eye movement increases as a person progresses through the night. Several factors can influence the quality of sleep of an individual. Age has been established to affect the extent of deep and light sleep.
The absence of sunlight in the evening can also influence an individual to feel sleepy. In the case of pregnancy, there are reports that describe the architecture of sleep, based on this unique physiological condition.Impact of pregnancy on sleepSleep among pregnant women has been reported to vary based on the stage of gestation, wherein women in their later trimesters are observed to undergo a marked decrease in the amount of deep sleep, yet still retaining the same frequency in rapid eye movement. Quantification of the duration of sleep stages showed that pregnant women spend approximately 55% of their evenings in light sleep, 20% in deep sleep and 25% in REM sleep.Several hypotheses have been presented to explain the occurrence of sleep disruption during pregnancy.
One theory is that sleep is disrupted due to the pregnant woman’s anticipation of the arrival of the baby. Another theory presents that the disruption in sleep is a sign of impending depression, which is commonly regarded as postpartum depression. Regardless of the actual mechanism behind the occurrence of sleep disruption, its incidence affects the general condition of the pregnant woman.
There is currently a discrepancy in the effect of pregnancy on sleeping patterns, as different results were observed by independent investigations. One observation describes that the duration of sleep was longer during the first trimester of pregnancy and shortened as the pregnancy progressed to the second and third trimesters. On the other hand, another observation described the opposite, wherein sleep was extended during pregnancy. Despite this disparity in the trend of sleep disruption, it is still evident that pregnancy itself influences the amount and quality of sleep of an individual.
Impact on waking functioning Sleep disruption during pregnancy results in several effects on a woman. The greatest impact of the fragmentation of sleep would be on the quality of life of the individual, as she would feel continuously exhausted through several months of sleep disruption. The pregnant woman would have extreme moods at different times of the day, which in turn could affect her relationship with her husband, relatives and even co-workers.
Sleep disruption can also affect the quality of work she would deliver at the workplace. The lack of sleep can also indirectly affect her job, as her performance would then be suboptimal, due to the difficulty in focusing on the assigned tasks at the workplace. One misconception that a pregnant woman derives from such experience of sleep disruption is that her body is coping with the impending responsibility of taking care of the baby soon after delivery. The pregnant woman would usually accept this physiologic change and thus attempt to live with such significant change in her life, even before the delivery of the baby. It should be understood that the disruption of sleep is an enigmatic occurrence during pregnancy that still needs to be investigated. One factor that further complicates the issue of sleep disruption during pregnancy is the capacity of a woman to respond to this change in circadian rhythm (Edwards 81). For some pregnant women, sleep disruption is a minor change in their lives and they continue to perform their daily tasks, yet this time with a little more effort on their part. On the other hand, there are some pregnant women who suffer from such change in sleeping patterns, thus making this circadian change a catastrophic event during their pregnancy.
Polysomnographic features of sleep disruption during pregnancy Polysomnographic investigations among pregnant women showed that the disruption in the sleeping patterns is mainly due to obstructive sleep apnea. A progressive monitoring of sleep apnea was conducted among women from pregnancy to post partum pregnancy and this showed that there was a significant decrease in the frequency of sleep apnea immediately after delivery of the baby. There is an inverse correlation between sleep apnea during pregnancy and the condition of the baby upon birth, wherein the occurrence of sleep apnea commonly results in lower scores. Moreover, the occurrence of sleep apnea during pregnancy is also associated with an increased risk that the pregnant woman would develop hypertension. Polysomnographic studies have also shown that pregnant women who experienced fragmented sleeping patterns were more at risk of developing pre-eclampsia during their pregnancy (Sloan 75). The main mechanism behind this increase in susceptibility was the dysfunctional activity of the endothelial cells of the blood vessels, due to the increased secretion of stimulants that are associated with the loss in sleep.
There would also be a disruption of the hemodynamic activities of both the mother and the developing fetus, thus decreasing the cardiac output that transmits essential oxygen to the fetus. The concentration of carbon dioxide was also decreased in the bloodstream, thus increasing the energy requirement for cardiac output.Behavior and/or therapeutic recommendations for sleep disruption during pregnancy Sleep disruption during pregnancy is often characterized by recurrent leg movement, which can in turn be treated with dopamine or its chemical analog. The medication would increase the production of neurotransmitters between neural synapses, thus resulting in a calming effect on the pregnant woman. It is also possible to administer codeine to a pregnant woman who is suffering from sleep fragmentation. It is however better to provide this medication only during the first trimester of the pregnancy.
Unfortunately, there is not much information on the safety of administering codeine during pregnancy thus it is best to discuss the possible effects on the mother and child before prescribing this medication. Advice on the decrease in intake of caffeine-containing beverages may also be suggested to a pregnant woman who is experiencing difficulty in sleeping. Massaging the legs of the pregnant woman can also increase the circulation of blood to these lower extremities, resulting in a relaxation of the individual and ultimately, sleep.
It is also advisable to suggest that the pregnant woman use stockings that are made of supportive material such as nylon, as these stockings may provide additional structural substrate for the legs and enhance circulation of the blood to the extremities of the body. In case the pregnant woman is doubtful of taking any medications during pregnancy, it may also be advised that she refrain from taking afternoon naps so that by bedtime, she could immediately fall asleep from the entire day’s activities. It is also possible to prescribe sleeping aid medications in order to assist a pregnant woman to sleep for the entire night. One example of a sleeping aid is dimenhydrinate is a weak sedative that could be administered to pregnant women for induction of sleep.Personal reflections Pregnancy is a physiologic process that involves the development of the fetus within the reproductive system of a woman. Despite its normal pathway towards producing a healthy baby, the sleeping patterns of a pregnant woman may be disrupted, resulting in a deteriorating of the quality of life of this individual. It is of utmost interest to know that what has been long perceived as a common feature of pregnancy is actually a negative feature that could result in a wide range of effects on both mother and child. Based on the readings performed, it is quite alarming to discover that the usually ignored sleeplessness associated with pregnancy can even result in the development of depression in the mother.
Sleep disruption can also result in hypertension, which could also affect the fetus. It is important to detect and to address the occurrence of sleep disruption among pregnant women because any untoward and more severe effects take place during the pregnancy or even post partum. The results obtained from polysomnographic investigations have provided essential information on precise effects of sleep disruption on a pregnant woman.Works CitedEdwards, N.
and Sullivan, C.E. “Sleep-disordered Breathing in Pregnancy.
” Sleep Medicine Clinics 3(2008): 81-95.Owens, J.A. “Socio-cultural Considerations and Sleep Practices in the Pediatric Population.” Sleep Medicine Clinics 3(2008): 97-107.Sloan, E.
P. “Sleep Disruption During Pregnancy.” Sleep Medicine Clinics 3(2008): 73-80.