Sleep is an important restorative behaviour and plays an integral role in your health. To improve your sleep quality, it is important to understand how sleep helps to restore our health and energy.
1.1 Why do we sleep?
Sleep allows our brains to consolidate our learning and memory so we can perform tasks better the next day. When we have enough sleep, we are less likely to overeat and crave unhealthy food and make wiser food choices.
1.2 Symptoms of Sleep Deprivation
1.3 Health Risks of Poor Sleep
There are many health risks associated with poor quality sleep for preconception women, pregnant and postpartum women.
1.4 Sleep in Pregnancy
Sleep is important in pregnancy but sometimes changes to your body makes it difficult to fall asleep and get comfortable. Pregnant women are more prone to sleep disturbances and short sleep duration due to hormonal changes, physical discomfort, sleep disorders and anxiety associated with childbearing that they experience. Many women experience sleep disturbances especially in their second and third trimester.
Getting quality sleep during pregnancy is important for both mother and baby. Insufficient and poor quality sleep are associated with pregnancy complications like gestational diabetes, high blood pressure and early birth.
The Pittsburgh Sleep Quality Index (PSQI) questionnaire.
Embark on your journey to better quality sleep using these 6 steps!
3.1 Re-wiring your thoughts
Sometimes we struggle with sleep due to our misconceptions and unrealistic expectations of sleep. Changing the way you think and approach sleep can help you sleep better.
Have you ever had these negative sleep thoughts? Read each thought bubble and see how you can overcome these thoughts.
3.2 Changing your behaviour with good sleep hygiene
Sleep hygiene refers to healthy sleep habits or behaviours that you can adopt to improve your ability to fall asleep and remain asleep throughout the night. Changing your behaviour is crucial in achieving better quality sleep! There are some ways in which you achieve this.
1. Go to sleep and lie down on your bed ONLY when you are sleepy. Avoid lying in bed and forcing yourself to sleep if you don't feel sleepy. The bed should only be used for sleep and intimacy. This will help your brain to associate your bed for sleeping only, making it easier for you to fall asleep in the long run. 2. If you are not able to fall asleep after 20 minutes of lying in bed, GET UP and go to another room. It is a common misconception that we should stay in bed and try to fall back to sleep when we have difficulty falling asleep. Although it seems counter-intuitive, it is better to leave your room and do other activities such as reading, listening to soft music. Only come back to your bed when you are feeling sleep. 3. Set a regular sleep and wake time This will help you strengthen your circadian clock which regulates your sleep and wake cycle. Try to maintain a regular sleep and wake up time every day, including the weekends! 4. Avoid napping too much in the day Limit your napping to once a day for a short duration of 15 to 30 minutes. It should be taken approximately 7 to 9 hours after waking up. It can be refreshing and not likely to disturb your nocturnal sleep. 5. Sleep in a cold, dark and quiet bedroom A cold, dark and quiet room would be the most optimal for a good night's sleep. 6. Avoid caffeine, nicotine, alcohol before bed Avoid big meals, smoking, alcohol, caffeine, heavy, spicy or sugary foods four to six hours before bedtime. 7. Minimise your pre-bedtime screen time Turning off electronic devices (phone, tablet, TV) earlier helps to improve sleep quality by minimizing blue light exposure. 8. Exercise regularly Especially if taken earlier in the day, exercise can help improve sleep quality, allowing you to fall asleep faster, and sleep more easily and soundly. However, vigorous exercise in the late afternoons and evenings should be avoided as it can make falling asleep at night more difficult. For more information on how to get started on exercising and what kind of exercises to do, check out our section on Physical Activity. 9. Manage your stress Stress can cause you feel anxious and your heart to beat faster, making it more difficult for you to fall asleep. A way of managing your stress is to designate a worry time – a particular time period of the day set for thinking about things that worry you. This can help to reduce your worried thoughts when you are going to sleep at night. For more information on how to relax your mind and reduce muscle tension, check out our section on Relaxation Techniques. 10. Avoid supplements like melatonin If you feel you that you require supplements or medications to help with sleep, discuss it with your doctor. Products labelled as 'natural', such as melatonin, have the potential to interfere with your body's normal processes, especially if you're trying to conceive or in pregnancy.
1. Go to sleep and lie down on your bed ONLY when you are sleepy.
2. If you are not able to fall asleep after 20 minutes of lying in bed, GET UP and go to another room.
3. Set a regular sleep and wake time
4. Avoid napping too much in the day
5. Sleep in a cold, dark and quiet bedroom
6. Avoid caffeine, nicotine, alcohol before bed
7. Minimise your pre-bedtime screen time
8. Exercise regularly
9. Manage your stress
10. Avoid supplements like melatonin
Here are additional tips for getting yourself comfortable when sleeping during your pregnancy
3.3 Relaxation techniques
Relaxation techniques help to limit cognitive arousal and reduce muscular tension that might be making it difficult for you to fall asleep.
Relaxation techniques include mindfulness, meditation, guided imagery and breathing techniques. Here are some ideas on how you can practice these relaxation techniques!
a. Mindfulness and Meditation
Mindfulness is a type of meditation where individuals practice an intentional awareness to present thoughts and sensations with acceptance and no judgement.
The basic steps of mindfulness meditation include:
b. Guided imagery
Take a look at this picture, close your eyes and imagine yourself at this calming beach. You can imagine the cool breeze on your skin, the bright blue of the water, the sound of the waves, the scent of sea air and the taste of coconut so that you actually feel like you are there.
Take a look at this picture, close your eyes and imagine yourself at this calming beach.
You can imagine the cool breeze on your skin, the bright blue of the water, the sound of the waves, the scent of sea air and the taste of coconut so that you actually feel like you are there.
c. Breathing techniques
Diaphragmatic breathinghttps://youtu.be/OB5X8wZLpas
4-7-8 Breathinghttps://youtu.be/gz4G31LGyog
d. Progressive muscle relaxation
Progressive muscle relaxation is an exercise to calm the body and calm the mind, which will help you with your sleep
Steps for progressive muscle relaxationhttps://youtu.be/OB5X8wZLpas
3.4 Helplines and Other Resources
Helplines
If you realise that your sleep problems are associated with symptoms of depression or anxiety for most days up to 2 weeks, or if you've difficulties functioning in your daily life, you should seek help from the following helplines.
To book an appointment to see a doctor at the Women's Mental Wellness Service, please call our hotline at 6294-4050.
For more information check out these free apps and websites which can help you with your sleep!
References
1. Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation's updated sleep duration recommendations: final report. Sleep Health. 2015;1:233-243. doi: 10.1016/j.sleh.2015.10.004
2. Wang, I.D., et al., Non-Apnea Sleep Disorder Increases the Risk of Subsequent Female Infertility-A Nationwide Population-Based Cohort Study. Sleep, 2018. 41(1).
3. Park I, Sun HG, Heon GH, et al. The more, the better? The impact of sleep on IVF outcomes. Fertil Steril. 100;3:S466. doi.org/10.1016/j.fertnstert.2013.07.428.
4. Lateef OM, Akintubosun MO. Sleep and Reproductive Health. J Circadian Rhythms. 2020;18:1. doi: 10.5334/jcr.190.
5. Cai S, Tan S, Gluckman PD, et al. Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus. Sleep. 2017;40. doi: 10.1093/sleep/zsw058.
6. Loy SL, Cheung YB, Cai S, et al. Maternal night-time eating and sleep duration in relation to length of gestation and preterm birth. Clin Nutr. 2020;39:1935-1942. doi: 10.1016/j.clnu.2019.08.018.
7. Mellor, R., S.C. Chua, and P. Boyce, Antenatal depression: an artefact of sleep disturbance? Arch Womens Ment Health, 2014. 17(4): p. 291-302.
8. Tomfohr, L.M., et al., Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period. Sleep, 2015. 38(8): p. 1237-45.
9. Skouteris, H., et al., Sleep quality and depression during pregnancy: a prospective study. J Sleep Res, 2008. 17(2): p. 217-20.
10. University of Massachusetts Medical School (n.d.). Accessed 18 July 2021. {https://www.umassmed.edu/globalassets/psychiatry/cbti/overcoming_insomnia_session_3.pdf}
11. Stanford Health Care (n.d.). Accessed 18 July 2021. { https://stanfordhealthcare.org/medical-treatments/c/cognitive-behavioral-therapy-insomnia/procedures/stimulus-control.html}
12. Irish LA, Kline CE, Gunn HE, et al. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev. 2015;22:23-36. doi: 10.1016/j.smrv.2014.10.001.
13. Heo JY, Kim K, Fava M, et al. Effects of smartphone use with and without blue light at night in healthy adults: A randomized, double-blind, cross-over, placebo-controlled comparison. J Psychiatr Res. 2017;87:61-70. doi: 10.1016/j.jpsychires.2016.12.010.
14. Lewis BA, Gjerdingen D, Schuver K, Avery M, Marcus BH. The effect of sleep pattern changes on postpartum depressive symptoms. BMC Womens Health. 2018;18(1):12. doi:10.1186/s12905-017-0496-6
Subscribe to our mailing list to get the updates to your email inbox...
