Pregnancy sleep tips

Pregnancy massage specialist Samantha Thurlby-Brooks gives you her top 10 tips for achieving maximum comfort as your tummy grows.

You would think in preparation for the months of wakeful nights with your newborn your body would allow you all the sleep you can get before birth. However, as your body adjusts to growing your little guest, you will find that at some point during your pregnancy your body is uncomfortable and your sleep is suffering. The following are the top tips that helped my clients achieve a restful slumber.   

Lower back pain
The most common pain in pregnancy is in your lower back and is often caused by lying on your side unsupported. You have ligaments that attach from your uterus to the base of your spine. As your baby gets bigger the weight pulls on those ligaments, creating discomfort or pain in your sacrum (just above your bottom). Placing a wedge-shaped pillow, or a very thin pillow, right under your belly will help greatly.

The other cause of lower back pain, which happens whether pregnant or not, comes from twisting due to an unsupported leg. Lying on your side means that your upper leg must stretch a long way down to reach the mattress. Without the correct pillows you will feel the twist in your lower back.

Sandwiching a pillow between your knees will not solve the issue as most pillows are not long or thick enough to give you the correct support, and it will also put undue pressure on the bottom leg. A pillow between your knees will also round your lower back and carry on pulling on your buttock muscles. Instead, make sure your top hip, knee and foot are at the same height by resting them on one pillow and allow your bottom leg to stretch out. One of my clients told me: "Getting my leg up high in bed has made such a difference! It's unbelievable how it's made my backache disappear and halved my trips to the loo!"

Hip and leg pain
During pregnancy your hormones change. Increased amounts of relaxin help your joints to loosen, allowing you to carry and deliver your baby more easily. Unfortunately, however, it can make some of your joints unstable and create pain. Your hips and buttocks are more prone to pain as you lie on your side with your hip joint being pulled down towards the mattress.

As I've advised for lower back pain, try using a pillow under your top leg to put your hip, knee and foot at the same height. I've tried this positioning on over 1500 of my pregnant clients and discovered that 96% of them felt this position was more comfortable than the traditional pillow between the knees.

Rib pain
There are two causes of discomfort around your bra line. The first is that your ribs are having to move out and closer together to allow space for baby to grow, causing pain in your muscles between each rib. The other cause comes from your shoulder and leg pulling down towards the mattress, creating a twist in your spine. Getting your leg up high, as mentioned previously, will help, but hugging a pillow will too. Another great tip for giving your ribs some exercise and releasing tension is to practise conscious breathing. Just by observing your breath, your body will breathe more effciently and help your ribs to expand with each inhalation. This will help you to relax and sleep better as well as being great practice for breathing during labour.

Shoulder and neck pain
Hugging a pillow, teddy bear or your partner (if you can get that close!) will prevent your shoulder from dropping down towards the mattress. When your shoulder drops down as you lie on your side, tension builds in muscles halfway down your back and all the way up your neck. Sometimes this can cause headaches. As well as hugging a pillow, you need to ensure that your head pillow is high enough (or low enough) to keep your neck straight. If you're normally a back or front sleeper it's likely you'll need to change your pillows so that your neck stays straight.

Heartburn and reflux
Heartburn is caused by the hormone relaxin loosening the valve that stops your stomach acids from going up into your throat and can be aggravated by lying down. You may find relief from placing thick books underneath the top end of your bed. Although this creates a slope which your partner might find weird, you'll find it more comfortable than propping yourself up with pillows, which can create tension in your neck and back. Eating little and often during the evening rather than a big meal will also help keep stomach acids happy. Make sure snacks are light and nutritious such as fruit, vegetables, yoghurt or a sandwich.

Carpal tunnel
Some pregnant women find they get numb, aching or tingly fingers during the night and through the day. The carpal tunnel is the space in the wrist where the nerves lead into the hand. Carpal Tunnel Syndrome happens if the median nerve is pinched, which can be caused by water retention (oedema). It affects the thumb, index finger and middle finger as well as the hand and wrist becoming weak. If all your fingers are affected then it's likely to be something other than Carpal Tunnel Syndrome. You might be bending your wrist and creating a fist while you sleep. Many people sleep in this "tucked up" way but during pregnancy, with the extra joint relaxation, this can create issues. The other cause can be tension in your shoulders, so hugging a pillow will help.

If the weakness and sensations (or lack of) in your hand are particularly bad, you may benefit from wearing a splint which will keep your wrist straight. Once baby is born the condition normally goes away. Occasionally it doesn't and might require therapy or surgery.

Insomnia
For many pregnant women, waking in the middle of the night for extended periods is very common. Lots of people shrug it off as getting into practice for when baby arrives. Others feel that the mind gets over-active with all the things that need to be done and the new life ahead. I recently read an article on the BBC website that claimed we used to sleep in two four-hour blocks with hours in between that would be used for prayer, visiting friends or writing letters. It's been only since the 1700s that we've been sleeping through the night.

I recommend my clients eat something to help them go back to sleep. Hunger (as well as needing the toilet) produces the stress hormone adrenalin which makes you alert, thus waking you up and keeping you awake until you eat and stimulate the relaxation hormone, oxytocin.

Leg cramps
The only thing that will get a pregnant woman leaping out of bed at top speed is leg cramps. For some reason they seem to happen only at night and generally it's from 22 to 28 weeks (some unlucky women get them right up to the birth). It's possibly from poor positioning or baby requiring more magnesium and zinc at night time.

Just don't point your toes as this will cause cramping or make it worse. If you want to stretch in the morning push your heels down and pull your toes up. Eating green leafy vegetables and having a banana in the night may prevent cramps.

Turning over in bed
Turning over at night is a mission for any woman in late pregnancy. Usually if you wake up on your back it's because you've been trying to turn over but with such a heavy belly you haven't quite made it. From watching my clients swap sides on the massage table, I've noticed a big difference between those who turn via lying on their backs and those who turn by going on all fours. Belly up is heavy and hard work whereas with belly down you have the momentum already with you. Some women don't find it easier but most do. Have a go and see if it helps.

From 34 weeks it's recommended you lie on your left side to help baby stay on the left for an easier birth. However, making someone stay still all night long is just a little cruel. If baby is asleep then spend some time on your right side, but try to stay on your left as much as possible, especially when relaxing through the day.

Pubic pain
Pubic pain during pregnancy can be one of the most crippling of all pregnancy complaints. The pain at the front of the pelvis can vary from slight discomfort to being so bad you need a wheelchair or crutches. The joint at the front of the pelvis, the symphysis pubis, is a moveable joint that can over-stretch during pregnancy and cause one side to drop lower, creating pain. Some women find sleeping with the hip, knee and foot at the same height very helpful as it prevents the pelvis from twisting. However, others prefer a pillow between the knees. Experiment and see what works best for you. The universal advice is to avoid spreading your legs wide. When turning over or getting up out of bed, keep your knees together.

Samantha Thurlby-Brooks is a top New Zealand pregnancy massage therapist, birth doula and antenatal teacher. She is also the creator of the Mumanu Pregnancy and Postnatal Pillow - a self-inflating pillow to keep your hip, knee and foot at the same height. Visit http://www.mumanu.com