Perinatal insomnia is a very common occurrence, with many factors like waking up constantly to go to the bathroom or pregnancy discomfort. If you are able to fall back asleep quickly, this may not be a problem. However, when you find yourself spending long periods of time laying awake in bed unable to fall back asleep, fatigued during the daytime, and anxious about your sleep, you may be experiencing perinatal insomnia. When significant and prolonged, perinatal insomnia has been associated with preterm birth, gestational diabetes, and perinatal mood and anxiety disorders (PMADs).
There are 3 components in the development of insomnia- predisposing, precipitating, and perpetuating. You might have already experienced insomnia in other parts of your life, and may identify with a few "predisposing factors". One of these predisposing factors is the female sex, others being a background of anxiety or depression, tendency to be hyper-aroused, or hormonal changes (pregnancy or may insomnia around your period). When insomnia starts becoming a problem, there is often a "precipitating factor". In pregnancy that might be physical discomfort or needing to use the restroom, in postpartum part that might be having to wake to care for your baby or feeling hyper-aroused or worried about your baby's safety in the middle of the night. The 3rd component is "perpetuating factors". These are the components that help you feel a little better in the moment, but lead to maladaptive behaviors and beliefs around sleep and contribute to chronic insomnia. This might look like staying in bed for many hours waiting for sleep to come, napping during the daytime because you're fatigued, and extreme increases in anxiety around sunset or bedtime with catastrophic thinking about "never being able to sleep again".
Treatment of insomnia is focused on the prevention and treatment of the perpetuating factors. This means the work can start whether you are in the precipitating phase to avoid the insomnia getting worse or at the perpetuating phase to undo the maladaptive behaviors. CBT-i has an average treatment response rate of 70-80% and can be paired with sleep medications if needed. CBT-i may included techniques like sleep restriction and stimulus control. Sleep medications may help jumpstart your sleep, reset your circadian clock, and give you temporary relief of your fatigue as we work through the behaviors around sleep using CBT-i.
____________________________________
Resources: "The Women's Guide to Overcoming Insomnia" by Shelby Harris: link here.
Medical Advice Disclaimer: This website does not provide medical advice. All content and information on this website, including but not limited to, text, graphics, images and other material, is for information and educational purposes only, and does not constitute medical advice. No material on the site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Visiting this website does not constitute establishing a therapeutic or physician-patient relationship.