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Lack of sleep drove me crazy

 

Sleep disturbances are commonly reported during pregnancy and increase in frequency and duration as the pregnancy progresses. [Courtesy]

To fall asleep, Loice Karima tried bubble baths, physical exercises and even dressing warmly besides carrying a hot water bottle to bed. But most times the 38-year-old spent the better part of the night staring at the ceiling.

Lack of sleep for Karima was triggered by a cough for which she was advised to take boiled green banana soup, but it persisted.

The mother of four from Moi Flats Estate in Nakuru County took piriton tablets, but still suffered insomnia and “the lack of sleep drove me crazy” she says. 

The problem continued after the birth of her fourth child. And the pressure of caring for a baby took a toll on her.

“It left me fatigued during the day, but still, I could not sleep,” she says.

“My peers advised me to take green tea, but it did not work,” continues Karima who resorted to spending her nights knitting and playing phone games.

Karima’s condition is not an isolated case. There are many women who struggle to sleep due to hormonal changes after pregnancy.

Laura Chebet, a media practitioner, went through nights of sweat and loss of appetite during the first three months of her pregnancy.  The baby was lying on one side of her pelvis, making it difficult to turn without pain.

“I lacked a better position to sleep. Pillows did not help much. I would sleep while seated, but you get tired and keep changing positions throughout the night,” recalls Chebet.

Women suffer more

Scientific findings reveal that women are more deprived of sleep compared to men, affecting their physical and mental health with the National Sleep Foundation pegging “the lifetime risk of insomnia as 40 per cent higher in women.”

Another study published in Lancet and titled ‘Sleep and Women’s Health’ attributes lack of sleep to variation in reproductive hormones ranging from menstrual cycle, pregnancy and menopause, stress, depression and life roles transitions.

The study noted that the menstrual cycle is associated with changes in circadian rhythms and sleep architecture and “menstruating women-even without significant menstrual-related complaints, often report poorer sleep quality and greater sleep disturbance during the premenstrual week compared to other times of her cycle,” reads a section of study findings.

In addition, women with severe premenstrual syndrome often report more disturbing dreams, sleepiness, fatigue, decreased alertness and concentration during the premenstrual phase.

Sleep disturbances are also commonly reported during pregnancy and increase in frequency and duration as the pregnancy progresses.

The Kenya Obstetrical and Gynecological Society (KOGS) president Dr Kireki Omanwa said pregnant women suffer insomnia more as pregnancies come with physiological changes due to the formation of a baby.

“Formation of a baby takes over a woman’s body completely, that changes her physiology, blood circulation, breathing system and skeletal system, which results in lack of sleep,” said Omanwa.

The Lancet study noted that significant fluctuations in hormones affect the sleep-wake cycle and cause physiologic changes that lead to sleep disturbance.

Hormonal changes cause a multitude of anatomic and physiologic changes, which are essential to maintain the pregnancy, but also contribute to sleep problems.

Common physical symptoms that affect sleep during pregnancy are anxiety, urinary frequency, backache, fetal movement, general abdominal discomfort, breast tenderness, leg cramps, heartburn and reflux.

During the first trimester, women tend to sleep longer and experience greater daytime sleepiness.

Sleep disruptions are also attributed to frequent urination during pregnancy.

“The prevalence of sleep disturbance among perinatal women is as high as 58 per cent, and a probable diagnosis of perinatal insomnia is estimated at 10 per cent,” added the study.

Hormonal changes

Dr Omanwa further explained that during pregnancy, a woman too releases hundreds of hormones, more so progesterone which relaxes muscles, more so of the digestive and urinary system.

“Some women keep urinating at night, because of hormones, with the digestive system not being able to digest food as expected, an issue that leads to constipation- with such, a woman cannot be comfortable, an issue that keeps them awake all night,” Omanwa explained adding that “enlargement of the baby in the womb, also contributes to the discomfort of a woman, making it difficult to sleep.”

Dr Edith Kamaru Kwobah, a consultant psychiatrist at Moi Teaching and Referral Hospital, Eldoret argues that besides depression, anxiety and backache, women suffer insomnia due to high societal expectations.

“Women are homemakers, they take care of children and have their careers too. Insomnia worsens when they have to balance their home roles and career,” says the specialist, and adds there is a need for women to embrace work-life balance and have mental health issues addressed professionally.

“Women should be taught self-care and delegate chores that can be done by others,” far and above sleeping about seven to eight hours at night.

Most pregnant women sometimes sleep for two or three hours a night due to fatigue and Dr  Omanwa advises the use of natural ways like taking a hot bath to relax body muscles.

“For some people, chocolate can help them sleep. Some listen to soothing music, if it does not work, they can visit a physician for medication. We do have some tablets that can help,” explains Dr Omanwa

Pregnant women are also advised to avoid watching TV at late hours and being on phone for long periods.

Also, it was noted that precipitous decline in hormones and unpredictable sleep patterns of the newborn exacerbate poor sleep and daytime sleepiness during the early postpartum period.

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