![]() ![]() The higher levels of estrogen and progesterone are thought to contribute to insomnia and they also influence other hormones such as the cortisol-melatonin ratio. According to a cognitive model of insomnia, 17 in women who have tendency to worry or be anxious, some of the typical sleep changes in pregnancy may be expressed with a higher level of severity. 16 Why some women are more susceptible to insomnia is unclear. 9 Insomnia generally worsens right before labor because of the secretion of oxytocin, a wake promoting hormone. ![]() Sleep disturbances are more commonly associated with pre-existing and de-novo depression 13 – 15 as well as smoking. Pregnant women do not always see their sleep as being a problem 97% of 127 pregnant women surveyed reported symptoms of disrupted sleep, but only a third of them identified themselves as having a sleep disorder 11. ![]() 1, 8, 11, 12 Night waking is the most common sleep disturbance by the end of pregnancy almost all women are waking up 4, 8 and for longer periods of time 8. In the first trimester, the most common causes of poor sleep are nausea/vomiting, urinary frequency, and backache, while in the second and third trimesters the causes are fetal movements, heartburn, cramps or tingling in the legs, and shortness of breath. 9 In the last trimester of pregnancy, up to 69.9% reported difficulty in maintaining sleep, 34.8% described early morning awakenings, and 23.7% reported difficulty falling asleep. 5, 8 Up to 73.5% of women display some degree of insomnia at a median of 39 weeks, further classified as mild in 50.5%, moderate 15.7%, and severe in 3.8%. At the beginning of pregnancy, the incidence of insomnia is lower at 12.6% 7 and then increases as pregnancy progresses. 6 The rate of sleep disturbances also changes across trimesters, ranging from 13% in the first trimester, 19% in the second, and 66% in the third 1. During the first trimester, sleep increases (on average 7.4 to 8.2 h) and then decreases in the third trimester (6.6 to 7.8 h) as evidenced by surveys 4, 5 as well as polysomnography. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |