Throughout an expecting mother’s nine-month pregnancy, her relationship with sleep becomes paramount in both her own health and the health of her child. After all, it takes a lot of energy to grow a baby!

Dr. Francesca Facco

Researchers at Magee-Womens Research Institute are looking at the associations between sleep health and pregnancy and if there’s evidence of those sleep behaviors and conditions being modifiable. Dr. Francesca Facco, a maternal fetal medicine specialist and primary investigator at MWRI, focuses on the prevalence of sleep disorders in pregnancy as well as how poor sleep may impact pregnancy health. “Knowing what those associations are is just the first step. Then, if those behaviors are modifiable, we have to find a way to translate that message—that sleep health is important for moms and babies and here’s what you can do—into real-world information that can be disseminated to OB/GYNs and pregnant women.”

Dr. Facco is currently a co-investigator in the sleep-related studies of the Nulliparous Pregnancy Outcome Study. Though studies are ongoing, she notes that, “there’s still a lot to be learned about how sleep adversely impacts pregnancy health. There’s data that suggests that having sleep apnea may increase risk for diabetes and preeclampsia and there’s also data that suggests that the quality and length of sleep may increase the risk of gestational diabetes.”

“Most interestingly, however, there’s a lack of data when it comes to if any of the associations between sleep and pregnancy are modifiable. For instance, if you are able to treat sleep apnea, would that improve pregnancy outcomes or the rate of diabetes in a population? We’re working to understand more about how possible interventions could impact the overall outcome of a pregnancy in terms of sleep health.”

How Pregnancy Affects Your Sleep

Between discomfort, heartburn, morning sickness, and more, a good night’s sleep can be hard to find. Yet pregnancy affects an expectant mother’s sleep just as much as sleep affects her pregnancy. Poor sleep quality can lead to health complications for mom and baby, including a weakened maternal immune system or birth abnormalities.

Pregnancy can significantly reshape the sleep habits of expectant mothers, often for the worse. Even women who have not experienced sleep problems in the past find that they have difficulty falling and staying asleep during pregnancy. There’s no magical way to get a good night’s sleep during pregnancy, but healthy sleep habits are the first step. Dr. Facco stresses the importance of sleep as a “health behavior, just like diet or exercise. Certain habits are healthier in regards to sleep. Just as you might look at your diet and ask ‘Am I eating enough calories?’, you should be looking at your sleep habits and similarly asking ‘Am I getting enough sleep?’ or ‘Am I getting continuous sleep?’”

For pregnant women though, everything from nausea to cramps can make it hard to get a full night’s rest. Nausea during the first trimester—commonly referred to as “morning sickness”—often strikes during the evening and early hours of the morning and can keep women awake and feeling ill. A growing uterus that is pushing against the bladder can also cause more frequent urination, in addition to heartburn caused by pressure on the stomach. Back pain and leg cramps, or even Restless Leg Syndrome (RLS), can also disrupt even the most dedicated of sleep schedules.

An established sleep pattern can help to lessen some of the inconsistencies of sleep during pregnancy. However, it’s not just pregnant women who should be aware of their sleep patterns. “All sorts of people—men, children, women who aren’t pregnant—should be able to examine their own sleep patterns and see if they’re practicing healthy sleep habits,” Dr. Facco notes. Good habits seem to always be hard to form and easy to break, but awareness of sleep patterns early in life can help with healthy sleep years later.

How Sleep Affects Your Pregnancy

While pregnancy can pose serious challenges to sleeping well, it is imperative for women to get an adequate amount of sleep during this crucial time of fetal development. There is mounting data that suggests that short sleep duration can have an adverse effect on maternal and fetal outcomes.

Lack of Oxygen

Sleep apnea is a condition in which a person experiences interruptions in breathing during sleep, impacting the amount of oxygen to key areas, like the brain. Studies have found that obese women with sleep apnea were more likely to have other complications during pregnancy, such as chronic high blood pressure and gestational diabetes.

Additionally, when sleep is disrupted and blood flow to the placenta is compromised, there can be significant consequences. If a developing fetus does not get a sufficient amount of oxygen, the infant is at risk for developing disabilities, including cerebral palsy, autism, attention deficit hyperactivity disorder (ADHD), seizures, and behavioral problems.

Elevated Inflammation

Researchers at the University of Pittsburgh Medical Center have found that poor sleep quality and quantity during pregnancy can disrupt normal immune processes and lead to lower birth weights and other complications.

Poor quality sleep contributes to elevated levels of inflammation in the body. This can cause an overproduction of cytokines, which act as signal molecules that communicate among immune cells. Excess cytokines can attack and destroy healthy cells and tissue in pregnant women, inhibiting the body’s ability to fend off disease.

Tips for Expectant Mothers

Sleeping well throughout pregnancy can be challenging. Common tips like limiting liquids before bed or avoiding spicy foods can help to cut down on your waking up in the middle of the night. But for Dr. Facco, getting a quality night’s rest comes down to three things: duration (How many hours of sleep are you getting?), timing (When are you going to bed or waking up?), and continuity (Are you getting a solid block of time or are you waking up multiple times a night, whether naturally or due to something like sleep apnea or restless leg syndrome, etc.?).

“Try to aim for a regular sleep routine. Go to bed around the same time and try to wake up around the same time each day. If your schedule allows, go to sleep prior to midnight and aim for 7-8 hours of sleep (which is the healthy amount for adult populations). Don’t be shy about talking to your OB/GYN or care provider if you think you’re experiencing a significantly disturbed sleep; it may warrant more evaluation by a sleep specialist.”

Researchers at Magee-Womens Research Institute are studying the association between sleep and pregnancy as well as key pregnancy-related complications such as preeclampsia, fetal growth restriction, and preterm birth in order to improve healthcare for mothers and their babies. Learn more about Dr. Facco’s research and MWRI’s other sleep-related investigations here.