Postpartum insomnia is defined as trouble falling and staying asleep during the phase after delivery. It may be characterized by sleep disturbance such as sudden waking up in the middle of the night and not going back to sleep for the rest of the night. The major cause of sleepless nights during the postpartum period is the drastic change in hormones during and after pregnancy. If your insomnia symptoms last for more than three to four weeks, you should seek medical help as chronic insomnia may sometimes be a risk factor for postnatal depression (1). Read on to know about the causes, symptoms, treatment, prevention, and management of postpartum insomnia. Read on to know about the causes, symptoms, treatment, prevention, and management of postpartum insomnia.
Is It Normal To Have Insomnia After Childbirth?
Yes. Sleep deprivation or lack of sleep is a common occurrence after childbirth. It usually resolves in a few weeks as you and your baby adjust to a daily routine. However, if your symptoms of difficulty falling asleep or wakefulness after sleep onset last for more than three to four weeks in the postpartum period, you should consult your doctor and talk about ways to improve your sleep efficiency (1).
What Causes Postpartum Insomnia?
The change in the mother’s circadian rhythm is the primary cause of lack of sleep during pregnancy and postpartum. Circadian rhythm changes may occur due to the following reasons and factors (2) (3).
Decreased production of progesterone, which has sleep-inducing properties
Nighttime feedings, which often cause sleep interferences
Stress of taking care of the baby Image: Shutterstock
Erratic sleep schedule of the baby during the first few months
Constant needs of the baby, such as diaper changes even during the middle of the night
Changes in the regular sleep schedule as a result of adjusting to parenthood
What Are The Symptoms Of Postpartum Insomnia?
Nighttime sleeplessness and the inability to fall asleep after waking up abruptly, at night are the most notable symptoms of postpartum insomnia. You may also experience the following symptoms.
Constant fatigue
Increased sleepiness during odd hours, such as increased daytime napping Image: Shutterstock
Overwhelming emotions and depressive symptoms
Poor sleep quality during all times
Is Insomnia Linked To Postpartum Depression And Anxiety?
Postpartum insomnia may be interrelated to depression and anxiety during the postpartum period. The results of a cohort study state that causes and symptoms of postpartum depression and postnatal insomnia are interrelated, with insomnia acting as the precursor and negative prognostic factor for depression and anxiety disorders (4). Insomnia is one of the several factors that may contribute to the risk of postpartum depression and anxiety. However, a study noted the two to be potentially bidirectional, meaning women with existing postpartum depression and anxiety may have a risk of developing postpartum insomnia eventually (5).
What Is The Treatment For Postpartum Insomnia?
The treatment options may vary based on several factors such as the severity of insomnia and whether it interferes with your ability to breastfeed and care for the baby. Your doctor may consider the following treatment options (6).
1. Lifestyle changes
Postpartum insomnia may usually be managed with lifestyle changes. These may include the following interventions.
Changing your sleep habits. An example is sleeping when your baby sleeps, ensuring you get sleep whenever possible.
Creating a soothing bedtime routine. It includes having a warm bath before bedtime. It may help reduce the stress that often arises during the postpartum period.
Delegating responsibilities. For instance, you may ask your partner or a family member to change the baby’s diapers or soothe them at night for every alternate night. Image: Shutterstock
Feeding expressed breast milk. If your sleep is often disturbed due to the baby demanding a feed at night, you may express breast milk and ask your partner or a family member to feed it.
Breastfeeding in lying down position at night
2. Therapies
Cognitive-behavioral therapy (CBT) and light-dark therapy (LDT) are some of the common therapies considered for treating postpartum insomnia (7) (8).
Cognitive-behavioral therapy: It involves various techniques to modulate your thoughts, breathing, and mindfulness. Your therapist may guide you through the process based on their assessment of the causes of postpartum insomnia in your case.
Light-dark therapy: It involves managing the amount of exposure you have to natural and artificial light in the day and after sunset. This may involve using light-blocking glasses after sunset to minimize exposure to artificial light.
3. Medications
The medicines you have during lactation may reach breast milk from where they can reach the baby’s body. Therefore, medications may be considered the last resort for postpartum insomnia treatment if other interventions yield no results. The insomnia medicines and dosage may depend on various factors, such as the severity of insomnia, the age of your baby, and the frequency of breastfeeding. Some of the common medicines prescribed for insomnia include melatonin, ramelteon, antihistamines, antidepressants, and other sleep-inducing agents.
Are There Ways To Prevent Postpartum Insomnia?
Treatment for insomnia may also help you deal with your sleeplessness. Besides that, the following practices and measures may help you sleep better and avoid postpartum insomnia.
Get back to exercising: If your doctor has given you the green light for going back to the gym or exercising, some lightweight exercises may help you de-stress and make you tired, making falling asleep easier.
Monitor your time of food intake: Research has shown that consuming food right before going to sleep or having a heavy dinner in the nocturnal period may negatively affect sleep quality (9). You may keep the portion size small and avoid caffeine, which may interfere with sleep.
Keep nighttime care brief: In case your baby wakes up during the night for feedings or diaper changes, ensure that you do not take too long to put them back to sleep. This will also help you in falling back to sleep easily.
Sleep training: If your baby wakes up frequently during the night, talk to your pediatrician about the ways and advantages of sleep training Having a set sleep time and routine for the baby may benefit them and you as well.
Try relaxation techniques: Manage postpartum stress, which may lead to postpartum insomnia. Some effective interventions to relax your mind include meditation, yoga, breathing exercises, and reading books on harboring a positive mindset.
Along with these measures, you may consider other ways to maintain good sleep hygiene such as having a proper sleeping environment, maintaining quiet time for bedtime, and having a quiet, dark bedroom. You may also avoid screen time before going to bed.
References:
In the first few weeks, accept help and let someone else take most of your responsibility. Sleep along with your baby. Practice relaxation techniques such as deep breathing and meditation. Keep the bedroom temperature and light conducive to sleep.
