What to Do When You Can't Rest When the Baby Rests


How to Manage Sleep Issues During Pregnancy and Postpartum.


Sleep strategies are an effective way to prevent and address mental health issues without medication.


We understand the importance of sleep for overall health and mental well-being. But what do you do when life changes during pregnancy and after childbirth disrupt your sleep? Sleep disruptions are common during the perinatal period, which includes pregnancy and postpartum.


About one in five women experience mental health challenges during this time, and three out of four face sleep issues like insomnia, poor sleep quality, or disturbed sleep. This underscores the strong connection between mental health and sleep during pregnancy and postpartum. Essentially, mothers with more severe mental health symptoms are likely to have more sleep disturbances, and those with poor sleep are more prone to mental health complications.


Pregnancy and Sleep

Recent research has found that women experiencing sleep disturbances in the second and third trimesters of pregnancy are three times more likely to have postpartum depressive symptoms. This risk is highest among Black or African-American participants.


Postpartum and Sleep

Sleep after childbirth is linked to several important health factors, including an increased risk of postpartum mental health issues, lower quality of life, and poorer overall health for the mother, baby, and family. Studies have shown a correlation between postpartum sleep disturbances and postpartum anxiety.


Support and Intervention

Screening: Despite sleep problems being associated with a higher risk of postpartum anxiety, they often go undetected during pregnancy because they're sometimes considered normal and prenatal visits may be brief. However, given the increased risk of mental health issues associated with sleep disturbances during pregnancy, it's important to screen for them routinely. If you're pregnant and struggling with sleep, bring it up for discussion during your prenatal appointments.


Protective Sleep Measures: New parents should plan to protect their sleep after childbirth. This may involve taking turns caring for the baby during the night. For example, One parent can handle the evening shift (8 p.m. to 2 a.m.) while the other manages the overnight shift (2 a.m. to 8 a.m.). The parent on the second shift should try to sleep as soon as possible to maximize their rest. If they're breastfeeding, they should try to pump or breastfeed before sleeping and wake up if they need to pump or feed during their sleep window. This arrangement may also involve temporary sleep arrangements to reduce sleep disruptions (e.g., sleeping in a different room with earplugs or a white noise machine). This approach not only promotes physical recovery for the birthing parent but also prevents or reduces symptoms of mental health issues in both parents.


Treatment: Cognitive behavioral therapy for insomnia (CBT-I) has been shown to be effective in reducing sleep problems and the risk of postpartum anxiety. CBT-I is a short-term treatment that combines behavioral interventions to promote good sleep habits (e.g., implementing healthy sleep routines and creating an optimal sleep environment), cognitive interventions to address negative thoughts and worries about sleep, and education about sleep health.



Key Focus: Sleep is one of the few modifiable risk factors for perinatal depression that is relatively easy to identify and treat. Sleep interventions are a potentially low-cost, effective, non-medication strategy to prevent and address mental health problems during pregnancy and postpartum.

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