Managing Stress and Sleep Dysregulation Before, During, & After Pregnancy

Managing Stress and Sleep Dysregulation Before, During, & After Pregnancy

We all know that stress can negatively affect both the quality and duration of your sleep. Reciprocally, disrupted sleep has the capacity to increase stress levels. It’s a vicious cycle! The harmonious relationship between your sleep, stress, and hormones can be elusive even in the best of times, but becomes especially important during preconception, pregnancy, and postpartum. Understanding the impact of stress and sleep on your fertility can help you understand their effects on maternal and fetal health, which might help inspire you to think about more actively managing and improving both!

Let’s start with SLEEP

Optimizing sleep is an important lifestyle factor that can impact preconception, pregnancy, and postpartum. Even just a few nights of sleep dysregulation (read: terrible rest, like fragmented sleep, disturbed sleep, short or long sleep duration) interferes with hormone production and stress responses, which can play out in conception and/or pregnancy. This is because the same part of the brain that regulates the hormones involved in the sleep-wake cycle (cortisol and melatonin), are also the same hormones involved in reproduction. It’s all connected!

BREAKING SLEEP DOWN, STAGE BY STAGE

FERTILITY

Most of the research around fertility and sleep has been around sleep patterns in shift work, or people whose profession has them working unconventional hours overnight or in extreme stretches. However, a number of pathways by which sleep dysregulation impacts fertility are emerging in the literature, including the direct and indirect impact on hormones (1, 2).

For instance, thyroid function is directly impacted by sleep, and if you remember from our most recent article on thyroid optimization, it plays a pivotal role in fertility and supporting a healthy pregnancy, especially in the earliest days after conception. Several studies confirm that thyroid stimulating hormone (TSH) increases significantly in women who are sleep deprived, which can increase the risk of pregnancy loss (3, 4). Furthermore, sleep dysregulation can negatively affect follicle-stimulating hormone (FSH) and progesterone levels, which play an important role in ovarian function. In one study, FSH levels were shown to be 20% lower in women who were short sleepers compared to long sleepers (those who average more than 8 hrs per night). Progesterone is related to luteal function and is necessary for implantation and maintenance of pregnancy, making low levels concerning to health care practitioners (3).

Sleep deprivation may also trigger inflammatory responses in the body, which can affect the immune system. Chemicals produced in the body during periods of inflammation can negatively impact fertility, with one study noting higher levels in women with infertility compared to fertile women (5).

PREGNANCY & BIRTH

During pregnancy, especially during the first trimester, sleep needs increase due to physical discomfort, emotional changes, and hormonal changes. You are, after all, building an entirely new organ for your baby (the placenta). Despite increased needs, however, quality sleep can be difficult. Though it may take some adjustments, good sleep hygiene, adjusting your sleep position, and managing sleep disturbances, can support your pregnancy in several ways:

  • Maintaining healthy blood sugar levels Sleep is a critical factor in glucose metabolism. Studies show that both overly long or short sleep duration can impact blood sugar levels in pregnant women, with the risk increasing significantly with more than 10 hours of sleep per night (6, 7).
  • Mood supportIn a study evaluating sleep duration in mid - late pregnancy, researchers found that sleep disturbances were linked to higher levels of cytokines, which can impact mood and mental resilience.
  • Longer labors | Some studies show women averaging less than 6 hours of sleep per night during the last month of pregnancy had significantly longer labor durations (9).
  • Exacerbated pain and discomfort during labor | In a small study observing sleep time before birth, researchers observed that less total sleep the night before hospitalization was associated with the elevated perception of pain and discomfort during labor (10).

POSTPARTUM

After pregnancy, women experience a sudden drop in estrogen, progesterone, and thyroid hormones, which can impact sleep in a very big way. These changes - coupled with external sleep disturbances from your new baby - may impact your mood (11, 12). Sleep deprivation can also lead to increased levels of inflammatory markers (13, 14, 15). It’s clear there is a possible relationship between poor sleep quality and postpartum recovery which can lead back into that cruel cycle we talked about earlier.

Now, let’s hit STRESS 

Let’s face it. Some stress during pregnancy is natural. There is, after all, a LOT of big change happening fairly quickly. But prolonged or excessive stress can have harmful effects on both you and baby during pregnancy that can even carry on later on in life. 

For instance, stress hormones like cortisol, epinephrine, and norepinephrine interact with hormones that directly influence the production of estrogen and progesterone, leading to fragmented sleep, decreased slow-wave sleep, and a shortened sleep time.

BREAKING STRESS DOWN, STAGE BY STAGE

FERTILITY

Long durations of stress can impact fertility during menstruation, ovulation, implantation, and placental development. No stage is safe from too much stress. In one study looking at levels of cortisol and alpha-amylase (two known biomarkers of stress) the morning after a menstrual cycle, researchers found that women who had high alpha-amylase levels in their saliva were 29% less likely to get pregnant each month and were twice as likely to be diagnosed with infertility than women with lower levels (16).

PREGNANCY, BIRTH, POSTPARTUM, & BEYOND

During pregnancy, stressed mamas are more susceptible to infection and illness due to the immune system's reactionary response to increased stress (17). Both stress and infection can impact the immune system during pregnancy (18, 19). Likewise, higher than normal levels of CRH, a stress hormone that is produced in reproductive tissues, can impact labor progression and uterine contractions (20).

Recent studies suggest that managing prenatal maternal stress can have benefits that span the generation, including:

  • Increased mental resilience in infants | Exposure in utero can affect the development of the baby’s stress response, which can impact the developing nervous system and create lasting effects on behavior and physiology (21, 22). This is of particular interest as studies show that this can be connected to emotional temperament later in life (23, 24)
  • Healthy infant growth | Managing stress during pregnancy has been  shown to help promote healthy infant growth and development in animals and humans (25, 26)
  • Healthy behavioral development | Animal studies have show that the development of learning and memory is impacted by prenatal maternal stress (27) promotes calm, relaxation and encourages sleep.*

4 ways to support sleep & stress in day-to-day life

There’s no magic formula for the right amount of sleep, but, there are a few simple lifestyle modifications that you can implement to optimize & manage stress during preconception, pregnancy, and postpartum.

1. Limit blue light exposure

Blue light from electronics suppresses melatonin, a hormone that helps control the sleep-wake cycle and is necessary to support egg quality, healthy menstrual cycles, and progesterone production. Without adequate melatonin production, egg quality suffers and makes achieving pregnancy more difficult. Limit blue light exposure by using blue blockers, orange filters, or orange glasses, OR, stop scrolling. :) We’re all guilty.

2. Breathe. No really, breathe.

Numerous studies have shown that implementing relaxation techniques can effectively calm the nervous system. Progressive Muscle Relaxation (PMR) is a deep relaxation technique that has been effectively used to promote relaxation and control stress. The simple practice involves tensing or tightening one muscle group at a time, holding it, and releasing the tension. Box breathing is another technique used to focus on slow, deep breaths which arouses the parasympathetic system, producing a calming effect in both the mind and the body.

3. Get moderate exercise

Getting enough movement is vital for fertility, however, too much exercise can activate the stress response system. Exercising at a moderate intensity is ideal, and pairs well with restorative exercise types of movement like yoga and pilates.

4. Supplementing for less stress and better sleep

FullWell’s new Nourished Nerves formula supports the hormonal shifts, disrupted sleep, and the life-changing adjustments that growing and caring for a new baby bring. I formulated Nourished Nerves especially for women before, during, and after pregnancy, bridging science and nature with my training both as a Registered Dietitian and herbalist. Nourished Nerves blends broad spectrum herbs to support your nervous system when you need it the most. After thorough peer review by top leaders in the field, I’m thrilled to introduce this first-of-its-kind tincture packed with beneficial nervines to soothe the nervous system and encourage quality sleep. Ideal for those looking for natural solutions, this organic, plant-based supplement is easy to incorporate into your routine and uses only five high quality natural ingredients.

Check out these herbs:

Organic Chamomile (Matricaria recutita) is a gentle, yet powerful nervine,  promotes calm, relaxation and encourages sleep.*  It contains apigenin, an antioxidant that binds to receptors in your brain that may induce relaxed muscles and support sleep. Because of its mild, yet sunny disposition, chamomile combined with ginger and lemon balm is also good at supporting you to have healthy and comfortable digestion during pregnancy.* 

herbs

Organic Lemon Balm (Melissa officinalis) is a gentle and calming herb that helps support the nervous system. A member of the mint family, it has been used for centuries to support cognitive function, recent clinical studies have validated its many uses, including its role in supporting mood and general wellbeing.*

lemon balm

Organic Linden (Tilia spp.) is one of the most gentle nervines and valued for its sedative properties which can help promote sleep, support mood and an overall sense of calm.* Studies show that it promotes relaxation by mimicking the activity of gamma-aminobutyric acid (GABA), a neurotransmitter that boosts mood and has a relaxing effect on the nervous system.

linden

Organic Milky Oat Tops (Avena sativa) are harvested from the same plant that produces oatmeal. This nervine not only nourishes the nervous system, but helps to maintain the myelin sheath which covers our nerve fibers. Milky Oat Tops are also exceptionally rich in silica, calcium, chromium, and magnesium.

oat straw

Organic Ginger (Zingiber officinale) supports the digestive system, but it is also a versatile herb that warms and supports circulation. Ginger's anti-inflammatory properties help support brain health and function, which includes increasing blood flow to the brain and supporting normal vagus nerve function.

ginger

Nourished Nerves can be used by anyone, regardless of sex, gender, or where you are on your fertility journey. By incorporating it into your lifestyle, you’re ensuring you’re doing everything you can to support not just your fertility, but your own mental and physical health and wellbeing.

*The information provided on this website is provided for educational purposes only and should not be treated as medical advice. FullWell makes no guarantees regarding the information provided or how products may work for any individual. If you suffer from a health condition, you should consult your health care practitioner for medical advice and before introducing any new products into your health care regimen. For more information please read out terms and conditions.

REFERENCES

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  2. Axelsson, G. Rylander, R. Molin, I. Outcome of pregnancy in relation to irregular and inconvenient work schedules. National Library of Medicine - National Center for Biotechnology Information. Web. Published Jun 1989. Accessed Feb 2022. https://pubmed.ncbi.nlm.nih.gov/2818973/.
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  4. Verma, Indu. Sood, Renuka. Juneja, Sunil. Kaur, Satinder. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. National Library of Medicine - National Center for Biotechnology Information. Web. Published Jan 2012. Accessed Feb 2022. https://pubmed.ncbi.nlm.nih.gov/23776802/.
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