Evaluating Insomnia During Pregnancy and Postpartum

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Abstract

Most women (78%) report that their sleep is worse during pregnancy than at any other time in their lives (1). Reasons for poor sleep vary by trimester, but sleep problems begin early in the first trimester with complaints of urinary frequency as progesterone level rises and creatinine clearance increases (2– 4). Pregnant women who are obese are at higher risk for obstructive sleep apnea (OSA). The hypoxia associated with OSA may contribute to maternal hypertension and intrauterine growth retardation (IUGR). Furthermore, women with snoring and daytime sleepiness are at higher risk for developing pre-eclampsia (5). Anemia associated with pregnancy places women at increased risk for restless legs syndrome (RLS), and insufficient amounts of sleep during the third trimester may place women at increased risk for longer labors and cesarean births (6).