Poor sleep in pregnant mothers linked to preterm deliveries

A new study in the November issue of the journal SLEEP linked poor sleep in early and late pregnancy with an increased risk of preterm birth.

Researchers found that women who reported sleep disruptions during the first and third trimesters faced significant risks of delivering prematurely. Even after income levels and medical risks were factored in, the connection still remained. There was no association between quality of sleep in the second trimester and preterm births. Sleep appears to improve in the second trimester but there is no clear reason why.

The study’s authors suggested that inflammation may be the culprit. Growing evidence points to inflammation having a role in triggering the childbirth process early. Sleep disturbances are associated with exaggerated inflammatory responses. The authors also said a combination of sleep disruption and stress could lead to premature delivery.

The good news is that sleep disorders during pregnancy are easily diagnosed. An assessment of a woman’s sleep quality may help identify risk earlier, giving doctors time to step in. If sleep disruptions are occurring, they could be reduced through behavioral modification.

Restless Legs in Pregnancy Predict Later RLS

A sleep disorder that may appear during pregnancy could be the sign of things to come later in life. Nearly a quarter of women who experience restless leg syndrome while pregnant may have chronic symptoms when they are older. Short-term symptoms may also reappear in future pregnancies.

People with restless leg syndrome have the strong urge to move their legs, paired with a sensation of burning, prickling, itching or tingling. These symptoms tend to flare up at night, making it difficult to sleep. Older adults tend to get restless leg syndrome, as the symptoms progress with age.

A recent study about restless leg syndrome involved about 200 women. Only 74 reported restless leg syndrome during pregnancy. Six and a half years later, the women responded to questions about later symptoms, pregnancies and other diseases.

Results show 18 of the 74 women who had restless leg syndrome during pregnancy saw the symptoms reappear. Compared to women who did not have the disorder during pregnancy, the group was four times more likely to have the condition again. About 60 percent of the women who had restless leg syndrome reported the symptoms again in future pregnancies.

The study appears to have one notable shortcoming due to the nature of restless leg syndrome. The condition is difficult to diagnose, so researchers had to rely on the patients self-diagnosis of the symptoms.

While you can take medication to reduce the symptoms of restless leg syndrome, changing your lifestyle may be just as effective. Start exercising and reduce your intake of caffeine, alcohol and tobacco to help restless legs syndrome. The AASM also reports activities like walking, soaking in a hot tub and massaging the legs may help when symptoms flare up.

Image by jamelah e.

Irregular Sleep in Early Pregnancy Linked to Hypertension Later

Adopt healthy sleep habits early in pregnancy and your body will thank you later. Research shows too much or too little sleep during near the beginning of pregnancy can lead to hypertension and potentially serious complications during the third trimester.

Women who sleep about nine hours night have significantly lower systolic and diastolic blood pressure compared to pregnant women with unhealthy sleep habits, researchers at the University of Washington report.

Abnormal sleep duration is also associated with preeclampsia, a condition linked to pregnancy induced hypertension and excess protein in urine. Preeclampsia can lead to serious or fatal complications if left untreated.

The study published in the October 2010 issue of the journal SLEEP measured the blood pressure of more than 1,200 healthy, pregnant women immediately after childbirth. During early pregnancy, each answered the question, “since becoming pregnant, how many hours per night do you sleep?”

About 1 in 5 women said they slept nine hours per night - the normal sleep duration for pregnant women. More than half the women slept seven to eight hours per night. About 14 percent of women slept less than six hours, and around 10 percent of women slept 10 hours or more.

Short sleepers and long sleepers had an average systolic blood pressure of 118.05 mm Hg and 118.90 mm Hg, respectively. Healthy sleeping pregnant women had much lower average blood pressure, at 114 mm Hg. The National Heart, Lung, and Blood Institute reports a systolic blood pressure reading of 140 mm Hg or more is considered high.

Short sleepers also had a 10 times higher preeclampsia rate. Overall, about 6.3 percent of study participants were diagnosed with preeclampsia or pregnancy induced-hypertension.

Sleep patterns tend to change throughout pregnancy due to shifting hormone levels. Pregnant women tend to sleep longer than normal adults.

Read more about Sleep & Pregnancy at Sleepeducation.com.

Photo by Bethykae

Pregnant smoking linked to childhood sleep problems

A new study gives soon-to-be moms another reason to butt out. Doctors across several U.S. cities combined efforts to look at how using various substances during pregnancy affected children’s sleep.

Alcohol, cocaine, marijuana and opiates had no noticeable effects, but pregnant mothers who used nicotine products tended to have children with sleep problems.

Researchers regularly checked up on a group of 808 children throughout the first 12 years of their lives.

The authors did not reveal the exact percentage of children with sleep problems. Instead of counting the number of individuals who had sleep problems they created a scoring system to account for the combined conditions, including insomnia, sleepwalking, sleep talking.

After adjusting for external factors, like socioeconomic status, the authors discovered children exposed to nicotine scored highest. Children whose mothers smoked tended to have sleep problems from birth all the way to their 12th birthday.

One of the authors of the study told Reuters Health the findings should not be misinterpreted, all prenatal substance abuse is harmful. Smoking is unique because it happens so frequently.

She said researchers couldn’t find out the exact effects of nicotine during pregnancy because many of the mothers in the study used multiple substances while pregnant.

Perhaps not coincidentally, a past study found young boys with sleep problems were more likely to start smoking at an early age.


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Pregnancy, Sleep & Postpartum Mood

A new study examined the relationship between disrupted sleep and postpartum mood in mothers. The results were published today in the journal Sleep.

The study from Australia involved 44 healthy women. They all had a low risk for postpartum depression. Their ages ranged from 18 to 41 years. Sleep was measured by actigraphy for seven days during the third trimester and seven days after giving birth.

Results show that sleep deteriorated after delivery. Total sleep time at night fell from 428 minutes in the third trimester to 373 minutes after delivery. Daily nap time increased from 32 minutes to 101 minutes.

Forty-six percent of women had some deterioration of mood after delivery. But the link between objective sleep measures and mood was weak. Variables related to the subjective perception of sleep were stronger predictors of postpartum mood.

“Subjective perception of sleep shared a much stronger relationship with mood,” said lead author Bei Bei. “Women who are concerned about their sleep and/or mood should speak to health care professionals about cognitive-behavioral therapy.”

Bei said that pregnancy is a joyous and exciting time. But it also exposes women to many stressors, including disturbed sleep.

The authors reported that new moms often have a mild mood disturbance a few days after delivery. This is called the “baby blues.”

It tends to involve mood swings and tearfulness. Other symptoms such as irritability, anxiety and headaches may occur. Postpartum blues may last about a week.

Some moms may experience postpartum depression. This involves more severe mood changes that can impair daily functioning. The Office on Women’s Health reports that about 13 percent of pregnant women and new mothers have depression.

Last year a study found a hormonal link between restless legs syndrome and pregnancy.

Read more about sleep and pregnancy on SleepEducation.com. Get sleep tips for new parents from the AASM.

Child Sleep Problems May Begin in the Womb

A study in the Aug. 1 issue of the journal Sleep examined prenatal factors that are related to sleep problems in children.

The study involved 289 children born in Finland in 1998; each child was born at term from 37 to 42 weeks of gestation. Sleep was measured by actigraphy for one week when the children were 8 years of age. Parents reported sleep problems and sleep disorder symptoms.

Results link prenatal alcohol exposure to an increased risk of sleep problems in childhood.

Alcohol "exposure" was defined as a mother drinking more than one alcoholic beverage per week during pregnancy.

Children exposed to alcohol before birth were 2.5 times more likely to have a “short” sleep duration of 7.7 hours or less per night. The AASM reports that at 8 years of age children need about nine to 10 hours of nightly sleep.

Children also were 3.6 times more likely to have a low “sleep efficiency” of 77.2 percent or less if they were exposed to alcohol in the womb; sleep efficiency indicates how much of their time in bed was spent sleeping.

“Adverse fetal environment may have lifelong influences on health and behavior,” principal investigator Katri Räikkönen, PhD, told the AASM.

The CDC reports that drinking alcohol during pregnancy can cause a baby to be born with birth defects. About 1 in 12 pregnant women in the U.S. reports alcohol use.

Size at birth also was related to childhood sleep problems; lower weight and shorter length were associated with lower sleep efficiency. The authors report that small body size at birth may reflect disturbances in the fetal environment.

One finding surprised the authors: There was no link between prenatal tobacco exposure and sleep at 8 years of age.

Learn more about sleep and pregnancy on SleepEducation.com.

Mother’s Day: Restless Legs, Sleepless Moms

Every mom deserves a good night of sleep for Mother’s Day. But good sleep can be especially hard to come by for women with restless legs syndrome.

RLS involves a strong, almost irresistible urge to move your legs. This urge gets worse at night and eases in the morning. The need to move your legs increases when you lie or sit still. Temporary relief can be found by walking or moving the legs.

Often RLS also involves an uncomfortable feeling in the legs. It may be hard to describe what this feels like. It might be a burning, prickling, itching or tingling sensation.

RLS can have a severe effect on your sleep. It may prevent you from falling asleep. It also may keep you from returning to sleep if you wake up during the night.

Women are more likely than men to have RLS. It also is common during pregnancy.

There are many drugs that can help treat RLS. Mirapex and Requip are both FDA-approved for RLS. Reuters reported recently that Lyrica also may be a helpful treatment for RLS.

Last week the Dallas Morning News shared one woman’s story of what it’s like to suffer from RLS. “It's as if everything from the waist down wants to dance when everything from the waist up wants to sleep,” she says.

You can get help for RLS from an AASM-accredited sleep center near you.

A Hormonal Link Between Restless Legs & Pregnancy

A new study in the journal Sleep links restless legs syndrome in pregnant women to the hormone estradiol.

Results show that in the last trimester, pregnant women with RLS have much higher levels of estradiol than healthy controls. Estradiol is an estrogenic steroid hormone.

RLS is more common in women than in men. Symptoms often appear for the first time during pregnancy. These symptoms tend to worsen during pregnancy. Then they may improve or even disappear after delivery. The risk of developing RLS increases gradually with each pregnancy.

RLS is a sleep-related movement disorder. It involves an almost irresistible urge to move the legs at night. This urge tends to occur along with unusual feelings or sensations deep in the legs. These uncomfortable sensations often are described as a burning, tingling, prickling or jittery feeling.

RLS can severely disturb a person’s ability to sleep. Eighty percent to 90 percent of people with RLS also have periodic limb movements during sleep. These are involuntary jerking or twitching movements of the feet or legs.

Disturbed sleep is common during pregnancy. In addition to RLS, pregnant women may experience problems such as snoring and leg cramps.

Learn more about sleep and pregnancy here.