Anyone who has been around a newborn knows what a precious commodity sleep can be. For some women, getting a good night’s sleep even before the baby arrives is easier said than done. Normal pregnancy-related issues—such as swollen feet, heartburn, and the need to get up during the night to empty her bladder—may interfere with a pregnant woman’s much-needed shuteye. In addition, some women develop sleep disorders such as leg cramps or restless legs syndrome (RLS) late in their pregnancies.
In addition to wreaking havoc with sleep and affecting daytime functioning, leg cramps and RLS can have other consequences. A recent study showed that having one of these sleep disorders during pregnancy can impact the length and mode of delivery. The researchers found that women who slept less than six hours a night and had a sleep disorder were more likely to experience longer labor and to have a cesarean section. By identifying women who have sleep disorders during their pregnancy, the researchers felt that they could treat the sleep disorders and give the women a better chance of having an uncomplicated delivery.
Leg Cramps
Leg cramps are painful muscle contractions that can occur in the foot, calf, or both the foot and the calf. The cramps occur during sleep and usually happen in only one leg at a time. To relieve the cramp, the muscle must be forcefully stretched to relieve the cramping sensation.
When making the diagnosis of leg cramps, doctors need to rule out any underlying conditions that cause leg cramps in pregnant women. There is no strong evidence to support any specific treatment of uncomplicated leg cramps, but taking supplemental magnesium may have some benefit. Also, stretching before bed may be helpful, even though no statistical evidence has shown benefit.
Restless Legs Syndrome
RLS is a sleep disorder in which the woman has the urge to move her legs (or arms) and an uncomfortable feeling in her legs. These uncomfortable feelings or sensations have been described as “creepy crawly,” “aching in the bones,” or “growing pains.” This urge to move and the sensations typically occur during times of rest, such as when sitting or lying down, and are relieved by moving around. They are usually worse in the evening and into the night. If a woman has RLS, the first test that should be done is to check iron levels in her blood. Low iron stores in the body can cause RLS, as can certain types of medications.
Treating RLS in a pregnant woman can be difficult because the benefit of treatment for the mother must outweigh the possible risks to the unborn child. There are some non-drug treatments that the pregnant woman can try first, after discussion with her doctor. Sleep hygiene is very important. Sleep hygiene involves
Going to bed and getting up at the same time every day, regardless of weekends or holidays Avoiding strenuous activity after 4:00 in the afternoon Sleeping in a dark, cool, quiet room Using the bed only for sleeping and sex and not for working Avoiding caffeine and chocolate later in the day Taking a warm bath before bed
Advice
If optimizing your sleep hygiene doesn’t help and RLS is still a problem, talk with your doctor about further treatment options. You may find it reassuring to know that, for most women, RLS that occurs during pregnancy goes away within a few days after the baby is born.
Hensley JG. Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health 2009;54(3):211-218.
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