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Pregnancy-Related Sleep Disturbances and Sleep Disorders

  • Beth Ann WardEmail author
Chapter
Part of the Current Clinical Neurology book series (CCNEU)

Abstract

Pregnancy is a time characterized by vast hormonal and physiologic changes. The dramatic increase in estrogen and progesterone impacts sleep architecture and produces systemic effects that may disrupt sleep. As pregnancy progresses, women experience a progressive increase in both the number and duration of nocturnal awakenings. The awakenings arise from a myriad of causes, including nocturia, nausea, heartburn, pain, and anxiety. Short sleep duration and poor quality sleep during pregnancy have been associated with a multitude of adverse outcomes, including maternal depression, gestational diabetes, prolonged labors, higher rate of cesarean deliveries, preterm birth, and low-birth-weight infants. Restless leg syndrome (RLS) and sleep-disordered breathing (SDB) are two of the most common sleep disorders during pregnancy. Both of these disorders may cause significant sleep disruption and daytime fatigue. RLS has been associated with an increased risk for maternal depression, preeclampsia, and need for cesarean delivery. Treatment of RLS during pregnancy is focused on repletion of iron stores, elimination of factors that may exacerbate RLS, and management of symptoms with behavioral techniques. SDB may increase the risk for intrauterine growth retardation, gestational diabetes, pregnancy-induced hypertension, and preeclampsia. CPAP has been demonstrated to be safe and effective for treatment of SDB during pregnancy. By optimizing sleep hygiene, utilizing cognitive behavioral therapy, and employing measures to reduce discomfort, heartburn, and nocturia, clinicians may improve a woman’s sleep. Due to concerns of risk to the fetus, pharmacologic treatment of insomnia during pregnancy is reserved for women with severe symptoms refractory to conservative measures.

Keywords

Pregnancy Nocturnal awakenings Restless leg syndrome Sleep-disordered breathing Obstructive sleep apnea Insomnia 

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Sleep MedicineSt. Luke’s Sleep Medicine and Research CenterChesterfieldUSA

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