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Sleep Deprived No More
From Pregnancy to Early Motherhood-Helping You and Your Baby Sleep Through the Night
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Excerpt
JODI A. MINDELL, PHD, is the author of Take Charge of Your Child's Sleep: The All-in-One Resource for Solving Sleep Problems in Kids and Teens and Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep. She is the associate director of the Sleep Center at the Children's Hospital of Philadelphia and professor of psychology at Saint Joseph's University.
To Scott and Caelie, as always
PART I
An Introduction to Sleep
ONE
Sleep Deprived No More
"To sleep, perchance to dream—ay, there's the rub."
—Shakespeare, from Hamlet
Ahhh, to sleep! Doesn't that sound glorious? There is nothing better than crawling into bed after a long day and falling into a deep sleep, not waking until the next morning. Unfortunately, blissful sleep may be just a fond memory. Now that you are pregnant or a new mom, sleep may not be as simple or as easy as it used to be.
Most pregnant women struggle with sleep problems. And these problems don't just start in the third trimester. Rather, thanks to surging hormones, sleep disturbances may begin right at the start of pregnancy. That means that you may experience nine long months of problems sleeping. And unfortunately, obstetricians and other health care providers often ignore sleep problems. Pregnant women are frequently told that it is just part of pregnancy and they must deal with it. Usually the most sympathy they receive is a comment from friends and family: "Just wait until you have the baby, then you'll know what lack of sleep means."
Once the baby arrives, expect less sleep, at least for the first few months. Your baby is going to be up during the night, especially in the first month or two, and yes, there are sure to be some tough days. After that, your baby's sleep schedule will start to become more predictable and everyone in the house will start getting more sleep. However, heading back to work, taking care of other children, and life's ups and downs can all contribute to continued sleep issues.
Luckily, however, even during pregnancy and post-baby, sleep is possible. You don't have to suffer through countless sleepless nights and spend your waking moments feeling totally sleep deprived. This book will show you many things that you can do to get the sleep you need so that you can fully experience the wondrous moments of pregnancy and your brand-new baby.
Common Sleep Issues Faced by Pregnant Women and New Moms
SLEEP ISSUES ARE almost universal! Look left. Look right. If you see a pregnant woman or a new mom, chances are that she's experiencing some type of sleep struggle, whether just waking up for a quick trip to the bathroom or experiencing prolonged sleepless nights. The National Sleep Foundation's Sleep in America Poll 2007 surveyed women of all ages and found that pregnant women and new moms were especially likely to experience sleep problems.
| Pregnant Women | New Moms | |
|---|---|---|
| Report that they rarely or never get a good night's sleep | 30% | 42% |
| Experience insomnia at least a few nights a week | 84% | 84% |
| Snore | 27% | 29% |
| Have restless legs syndrome | 21% | 8% |
| Nap at least twice a week | 54% | 40% |
| Have driven drowsy at least once a month | 31% | 38% |
Pregnancy
In addition to the above findings by the National Sleep Foundation, a study that we conducted in my lab on sleep during pregnancy found that 97 percent of pregnant women fail to sleep through the night by the end of their pregnancy and 92 percent sleep restlessly. So just about every pregnant woman faces some kind of sleep issue. Just because sleep problems are typical during pregnancy, however, doesn't mean that you can't do anything about them. Your sleep may never be perfect while you are pregnant, but there are many things that you can do to improve it as much as possible. That is what this book is about: helping you sleep better so that you can feel your best.
New Moms
Similarly, new moms are not getting the sleep they need. A majority of new moms do not get enough sleep at night, and most say they don't get a good night's sleep most nights. Some of these sleep issues are related to being up with the baby during the night, but another portion are due to poor sleep habits and other common sleep disrupters. Again, this book is here to help.
How Much Sleep Do You Need?
THE AVERAGE ADULT needs 8 hours of sleep. Actually, studies indicate that it is really 8.2 hours (8 hours and 14 minutes). This number comes from classic studies in which adult volunteers stayed in caves for weeks at a time. All of the adults ended up getting 8.2 hours of sleep every night. There are some individual differences, so we typically recommend that adults need between 7 and 9 hours of sleep at night. That's right, there are just as many people who need less than 8 hours of sleep at night as there are who need more than 8 hours.
Interestingly, recent research seems to show that there really aren't that many individual differences in sleep need. Rather, it indicates that there are individual differences in how well people tolerate being sleep deprived. That is, everyone needs about 8 hours of sleep, but some women have an easier time getting by on 5 or 6 hours than others. Unfortunately, there is no way to train your body to handle being sleep deprived. You can either tolerate it or not. Figuring out whether you are one of these people, though, will help you determine the minimum number of hours of sleep that you need (see quiz, pages 8-9).
How Much Sleep Are Pregnant and New Moms Actually Getting?
ONE QUESTION THAT often is asked is how much sleep women really get when they are pregnant and after the baby is born. One study surveyed women before they were pregnant, during their pregnancy, and then in the three months after their delivery. Below are some of the results of this study.
In general, this study found that pregnant women are actually getting, and likely needing, more sleep during pregnancy, but that amount drops greatly after the baby is born. In addition, sleep problems are much more common during pregnancy. Some of these sleep problems, like snoring, are specific to pregnancy, whereas others, such as waking at night, become almost universal for both pregnant women and new moms.
Older Pregnant Women Sleep Less
Another interesting finding in this study was that pregnant women over the age of 35 spent the least amount of time in bed, had the shortest amount of total sleep, and woke up earliest in the morning, compared to younger pregnant women. Why is that? It seems that older women are more likely to have established careers, are more likely to be working throughout their pregnancy, and spend less time in bed. All of these factors lead to less sleep overall. Women over 35 should keep this in mind. Adjust your schedule to maximize how much sleep you get, being sure to go to bed early and not wake up too early.
It's Harder the First Time Around
Patricia was pregnant with her second child and was exhausted, especially after running around with her 2-year-old all day. She usually headed to bed soon after tucking in her daughter.
In addition, for some reason, sleep is much more problematic for women the first time around. Contrary to what you might expect, women who are pregnant with their first baby get less sleep at night than women who are pregnant with their second, third, or fourth child. This trend continues once the baby is born. At one month after the birth of a baby, women with more than one child sleep much better at night than women who just had their first baby.
This difference is likely related to a change in priorities and even a change in identity. Women pregnant for the first time are not yet in "mommy mode" and may not have changed their lifestyle yet to reflect this change in status. They may still be working longer hours, staying up later at night, and haven't yet changed their schedules and expectations to be more baby and kid friendly.
Quiz
Are You Getting Enough Sleep?
TO FIGURE OUT if you are getting enough sleep and functioning at your best, take the following test.
Consider the past week or two and answer true or false to the following statements.
1. When I wake up in the morning, I feel groggy.
2. I fall asleep at night in less than 5 minutes.
3. I could fall asleep at any time.
4. I have fallen asleep at a time when I shouldn't have, such as while driving or talking on the phone.
5. I often fall asleep in the evening while watching television or reading (not while in bed).
6. I nap most days.
7. I become drowsy when doing repetitive tasks.
If you answered true to two or more of the above statements, you are probably not getting enough sleep.
Why Sleep Matters
Michelle, mom of 10-month-old Alex, asked only one thing of her husband for Mother's Day—a night in a hotel room all by herself so that she could sleep!
LIKE MICHELLE, THERE are many new moms who crave a good night's sleep. If you are at the point where your greatest wish in life is one night of sleep, then you need to do something about it. So get that hotel room or spend the night at your mom's or best friend's house. Put your husband on baby duty for a night and go sleep elsewhere in the house. You are not helping anyone by walking around feeling like a zombie.
A great deal of research has focused on the impact of not getting enough sleep. Overall, and not surprisingly, we know that being sleep deprived can affect every aspect of your life. Studies have shown that it affects your mood, your performance, your parenting ability, your health, and your satisfaction with your relationship. In addition, being sleep deprived can have dangerous consequences.
Mood
Dawn, mom of 8-month-old Jack, was at the point where she was so tired that she just didn't care anymore. She was also grumpy all the time and felt like she never laughed anymore.
Not getting enough sleep will make you feel irritable and cranky. You may be much quicker to get frustrated and angry, whether at your husband, your children, your boss, or even your poor dog. Some women report that they get mean when they don't get enough sleep. And others find that they become indifferent (a general feeling of "who cares," or as your local teen would say, "whatever").
Cognitive Ability
You literally cannot think as well if you don't get enough sleep. Lack of sleep affects every aspect of cognitive ability, including attention, memory, decision making, and problem solving. You may be forgetful, not able to make a decision, and basically not able to think clearly.
Diane, a 32-year-old new mom, literally spent 15 minutes sitting in her car searching for her glasses. She looked everywhere—dumping her purse, emptying out the diaper bag, and searching under every seat in the car. She knew she wasn't getting enough sleep when she finally realized that they were perched on top of her head the entire time.
Similarly, Courtney couldn't find her car keys anywhere. She knew that the last time she had them was in the morning when she went to the grocery store. After an hour of searching the entire house, the only thing she could figure out that may have happened was that she locked her keys in her car. She finally called her local garage to come and break into her car. Thirty minutes later they had the car open, but no keys to be found. Later that night, Courtney found her keys in the refrigerator. She was mortified.
Performance
No matter your gender or age, pregnant or not, being sleep deprived means that you are not going to do things as well. Your reaction time slows down and your performance can decrease. Many women report making more mistakes at work and not being able to do the simplest tasks.
Caroline, mom to 3-year-old Lindsay and 7-month-old Grace, was making mistakes at work that she had never made before. Letters were going out with the wrong addresses, she lost several important files, and she completely forgot to show up at a meeting with a major client. She was so exhausted all the time that she just couldn't get her brain to function as usual.
It is often these small lapses that you may notice when you are not getting enough sleep. Worryingly, sleep deprivation can lead to bigger errors. There have been several major disasters in which sleep deprivation has been implicated as playing a role, including the Exxon Valdez oil spill, the nuclear meltdown at Chernobyl, and the explosion of the space shuttle Challenger. Fortunately, the impact of being sleep deprived is not permanent. Get a few solid nights of sleep and you'll be back to your usual self.
Health
Yes, what your grandmother always said is likely true. If you don't get enough sleep, you are more likely to get sick. Whether it's a cold, the flu, or something more serious, your immune system is not as good at fighting off illness if you don't get enough sleep. During sleep your body produces cytokines, which help the immune system fight infections. Lack of sleep not only affects how well your body fights off infections, it even affects how well your body produces antibodies after a vaccination. A recent study found that people who were sleep deprived produced less than half as many flu antibodies after receiving the flu vaccine. The result is that you are less protected later on when you are exposed to the flu.
Recent research has shown that being sleep deprived also affects more serious health issues, such as diabetes, obesity, and heart disease. For example, improved sleep can improve glucose control in those with diabetes; less sleep increases the risk for obesity; and sleep apnea can contribute to heart disease. Finally, we also know that lack of sleep makes accidental injuries more likely, such as falling or cutting yourself with a knife.
When Sondra was six months pregnant, she tripped over their dog, who was lying in the middle of the kitchen. The dog always lay down in the same spot, but on that day Sondra was just too tired to notice. Her baby was luckily unharmed, but Sondra ended up in a cast for six weeks. Getting around on crutches is hard enough, but doing so while pregnant is almost impossible!
Life Satisfaction
Lisa and Dan were arguing all the time. They argued over who should get up with the baby when she woke up, they argued over what to do when the baby woke up, and they argued over who was more tired. Basically, they argued over everything and anything. Fortunately, they were able to look back later and realize that their arguing was purely a result of exhaustion and frustration.
It's hard to be happy if you are sleepy and tired all the time. Being sleep deprived can lead to lower parenting satisfaction and marital satisfaction. Many couples report that not getting enough sleep as a result of their baby puts a strain on their relationship. Couples often argue about the best way to handle their baby's sleep, such as whether they should respond to their baby's cries. They also argue more in general, simply because they are so tired and they have less patience. Moms are also less happy as parents. It's hard to enjoy the baby when you are so tired that all you want to do is lie down and take a nap. You will also get more frustrated when your baby is crying for no apparent reason or when you're toddler asks "Why?" for the twentieth time in a row.
The good news, though, is that these same studies show that once everyone is getting some sleep, everything improves. Mom and Dad are happier, are getting along better, and are enjoying parenting. So work on getting the sleep that you need so that you can be alert, energetic, and enjoy life!
Postpartum Depression
Lucinda had no energy, was sad all the time, and just felt like crying. She had a wonderful husband, a beautiful 5-month-old baby (who still woke up twice a night), and a great career. She didn't understand why she was feeling so down.
Not getting adequate sleep has been implicated in the development of postpartum depression. Those women who do not get enough sleep at night are much more likely to feel depressed. Furthermore, sleep deprivation at the end of pregnancy and during the first few weeks after the birth of a baby predicts the later development of postpartum depression. A complete discussion of these topics appears later in chapter 10.
Alertness While Driving
Liz was scaring herself. She was 14 weeks pregnant and just so tired. Every day at 1:00 p.m. she had to pick up her 4-year-old son from camp. One day, she was so worried that she was going to fall asleep at the wheel that she made her son talk to her the entire way home. Liz realized that her sleepy driving was dangerous, so she decided to begin carpooling with another mom. Liz would take both boys to camp in the morning and her friend did afternoon pick-up.
One of the biggest concerns about being sleepy is driving drowsy. Did you know that drowsy driving causes more car accidents than driving while intoxicated? Approximately 60 percent of adults have driven drowsy in the past year, and one-third have literally fallen asleep at the wheel. The National Sleep Foundation's Sleep in America Poll 2007 found that 31 percent of pregnant women and 38 percent of new moms have driven drowsy in the past month. Be careful! If you are not getting enough sleep, and especially if you feel sleepy, don't drive! Drowsy driving can have deadly consequences.
The frightening thing about drowsy driving is that most people are not able to tell when they are sleepy or are about to fall asleep while driving. We are notoriously bad at recognizing sleepiness in ourselves. Study after study has shown that during a driving simulation test, sleep-deprived adults will report that they are fine, but then fall asleep moments later.
Drowsy-driving accidents are more likely to occur in the middle of the night, as you might expect. But, surprisingly, the next most dangerous time is between three and five in the afternoon, when our bodies experience a natural circadian dip (meaning that we are likely to feel tired at this time of day). Turning up the radio or rolling down the car window to get a blast of fresh air is not going to prevent you from falling asleep at the wheel. Instead, the only thing that will counteract sleepiness is sleep.
If you are sleepy, be careful. Don't take long drives in the car (some moms and dads even fall asleep on short drives!). Stop and take a quick nap, even if just for ten to fifteen minutes. Figure out the limits of what you can reasonably and safely achieve.
Sleepiness can be dangerous in other situations too. Be careful in the kitchen and when doing other chores, such as yard work. Accidents can happen when you are tired. Often we are expected to get things done no matter how much sleep we got the previous night, week, or even month. Before you jump in and do whatever is expected, think about whether you realistically can. Will you be safe? Will you be endangering others?
Quiz
How Sleepy Are You?
THE EPWORTH SLEEPINESS Scale is the most widely used questionnaire to measure how sleepy a person is during the day. Complete the following questionnaire to assess your level of daytime sleepiness.
How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0 = no chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
| SITUATION | CHANCE OF DOZING |
|---|---|
| Sitting and reading | ____________ |
| Watching TV | ____________ |
| Sitting inactive in a public place (e.g., a theater or a meeting) | ____________ |
| As a passenger in a car for an hour without a break | ____________ |
| Lying down to rest in the afternoon when circumstances permit | ____________ |
| Sitting and talking to someone | ____________ |
| Sitting quietly after a lunch without alcohol | ____________ |
| In a car, while stopped for a few minutes in traffic | ____________ |
SCORING:
Add up your score and see how sleepy you are.
| Score between 1 and 6 | Congratulations, you are getting enough sleep! |
| Score between 7 and 9 | Your score is average. |
| Score of 10 or higher | You are very sleepy during the day. |
What You'll Learn in This Book
THIS BOOK PROVIDES practical advice and tips on how to help you and your baby get a good night's sleep. It will help you no longer feel as sleep deprived, from the moment that you find out that you are pregnant through the first six months after your baby is born.
The book is organized into four sections:
PART I (chapters 1 through 3) provides an introduction to sleep and sleep problems, a basic overview of sleep, and an essential review of good sleep habits that you should develop.
PART II (chapters 4 through 7) presents what you can expect in terms of sleep issues throughout the three trimesters of pregnancy. Sleep tips specific to each trimester are provided.
PART III (chapters 7 through 9) provides information on the most common sleep problems experienced by women during pregnancy and following the birth of their baby. Chapter 7 discusses insomnia and strategies to conquer sleepless nights. Chapter 8 discusses restless legs syndrome and periodic limb movement disorder, two related sleep disorders. And, finally, chapter 9 presents information on snoring and sleep apnea, two sleep problems that often develop during pregnancy.
PART IV (chapters 10 through 12) focuses on sleep after the baby is born, offering strategies to help both you and your baby sleep through the night. Chapter 10 helps Mom get the sleep she needs in the first six weeks after the baby is born. Additional information is provided on postpartum depression, managing sleep, and ways to share nighttime duty. Chapter 11 focuses on moms who are past the newborn stage, from the time their baby is six weeks to six months. And, finally, chapter 12 provides all the information that you need to help with your baby's sleep.
Reminders
• Sleep issues are almost universal for pregnant women and new moms.
• The most common sleep problems experienced include insomnia, not getting a good night's sleep, and feeling sleepy during the day.
• The average adult needs between 7 and 9 hours of sleep.
• Not getting enough sleep is going to affect your mood, cognitive ability, performance, health, and life satisfaction—basically, every aspect of your life.
• There are many things that you can do to help you no longer feel as sleep deprived, from the moment that you conceive through the first six months after your baby is born.
Genre:
- On Sale
- Nov 23, 2007
- Page Count
- 304 pages
- Publisher
- Da Capo Lifelong Books
- ISBN-13
- 9780738215044
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