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Lack of Sleep in Pregnancy Could Lead to Childbirth Complications

Katlyn Joy |20, August 2013


According to Science Daily, a study out of the University of Pittsburgh School of Medicine links poor quality sleep in expectant mothers with disrupted immune system processes and birth complications. The study was published in the July 17, 2013 journal Psychosomatic Medicine.

The lead author of the study, Michele Okun, Ph.D., assistant professor of psychiatry at Pitt's School of Medicine stated, "Our results highlight the importance of identifying sleep problems in early pregnancy, especially in women experiencing depression, since sleep is a modifiable behavior."

Getting both enough hours of sleep and high enough quality of sleep is an important criteria for good health, as sleep impacts the immune system of both men and women. However, pregnancy is known to interfere with sleep in terms of sleep quality and sleep length, and many expectant mothers suffer from insomnia during pregnancy.

Poor sleep affects the immune system because when a woman doesn't get adequate sleep or has poor sleep patterns in pregnancy the body's inflammatory responses are set off. This in turns causes an overproduction of cytokines. Cytokines are molecules that are a sort of alarm messenger in the body to the immune system.

While cytokines are generally a positive element in a pregnant woman's body, too many of them will end up attacking and even destroying healthy cells. This in turn leads to the destruction of healthy tissue in the pregnant woman resulting in a hampered ability to fight off disease and illness in the mother.

Excess cytokines are also related to depression, vascular disease, and problems with the spinal arteries leading to the placenta in pregnant women.

Previous studies have found higher concentrations of cytokines in women who had experienced pregnancy and birth difficulties such as preeclampsia and premature labor and birth.

"There is a dynamic relationship between sleep and immunity, and this study is the first to examine this relationship during pregnancy as opposed to postpartum," said Dr. Okun.

With adverse outcomes such as preterm labor or preeclampsia, infection is the culprit in about half of the cases. However, researchers now believe that behavioral processes such as sleep have a role to play in these types of cases as well, since sleep disturbance affects immune function.

Higher cytokine concentrations were also found in depressed people.

This study is unique in that it was the first to study depression, insomnia and inflammatory cytokines particularly in combination and their subsequent affect on pregnancy.

Researcher examined over 170 pregnant women at 20 weeks in the pregnancy, including both depressed and non-depressed expectant mothers. For the study, the women's sleep patterns and cytokine production levels were examined for 10 straight weeks.

The researchers looked specifically at the 20 week mark because prior to this the cytokine levels are too inconsistent to study. After 30 weeks the differences in cytokine levels were negligible between depressed and non-depressed women, likely since the levels increase normally as pregnancy progresses.

Researchers found women with both poor sleep functioning and depression were at greatest risk for negative or adverse birth outcomes. It appears that cytokine levels are an important issue in this regard, especially in cases of preterm birth.

Researchers also discovered that any disruption in immunity sets up a pregnant mother for adverse birth outcomes. These disrupters would include poor sleep and depression.

The importance of the study is summed up by lead researcher, Dr. Okun, "The earlier that sleep problems are identified, the sooner physicians can work with pregnant women to implement solutions."

Women who have trouble with sleeping while pregnant should do what they can to improve sleep quality and quantity.

13 Tips to Help You Sleep Better

  • Save bed for sleep and sex, nothing else unless of course, on bedrest.
  • Try to have a consistent bedtime schedule.
  • Have a sleep ritual that works for you, be it some gentle yoga, a warm cup of decaf tea, or a nice shoulder rub from your husband.
  • Eliminate sleep distractions such as office paperwork on the nightstand, a TV left on all night, or a bright light in the corner.
  • Eat a light snack before bed but no heavy meals. Indigestion is a frequent sleep-disrupter of pregnant women.
  • Invest in a good set of sheets that are comfortable to your skin.
  • Buy a pregnancy or body pillow that will support your blossoming figure throughout your pregnancy. Women often find some support under the tummy while sidelaying, or back support especially helpful during pregnancy.
  • If worries keep you up, a few hours before bed, make a list of concerns and put them away and to bed before you go to sleep. Deal with them tomorrow after you are rested.
  • Try slow and rhythmic breathing exercises, prenatal yoga or meditation.
  • Limit the demands on yourself should stress be interfering with your sleep.
  • Watch your diet for any foods that keep you up at night whether due to gassiness or indigestion.
  • Grab catnaps if you can, especially if you know a full night's sleep is an improbability due to insomnia or perhaps a crabby toddler in the house.
  • Make sleep a priority. Many times we act like it's a badge of honor to get by on as little sleep as possible. If that's you, then drop that attitude at least while pregnant for the sake of your little one. Depriving yourself of sleep is depriving your unborn child as well.


ScienceDaily, UPMC/University of Pittsburgh Schools of the Health Sciences

Katlyn Joy is a mother to 7 children, and a freelance writer. She earned her Master of Arts in Creative Writing and Poetry, and a Bachelor of Arts in English and was previously an adviser to new mothers on breastfeeding through a maternity home program. She currently resides in Colorado with her family.

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