Ask the parents of newborns what they crave more than anything and they will usually answer: "A good night's sleep." Yet despite the changes in sleep during pregnancy and parenthood being well known, sleep health is not a part of routine perinatal care in Australia.
Research into what interventions are most effective in helping new parents get some quality shut-eye is hoping to change this.
During pregnancy many people experience frequent waking at night and may find it difficult to fall asleep. These difficulties may be caused by changes in hormones, physical discomfort, or worries and stress.
After birth, sleep can be impacted by waking during the night to care for the baby and daytime sleepiness and fatigue are common.
Sleep disturbances and sleep deprivation due to night-time caregiving are common during the first few months after the baby's arrival. But for some new parents these changes in sleep can bring about insomnia symptoms, which can first start in pregnancy and then continue for a long time after birth.
Insomnia is different from the sleep disturbances and deprivation commonly experienced by new parents.
Sleep disruptions refer to often external factors that lead to waking, like hearing your baby cry. Frequent sleep disruptions lead to sleep deprivation.
While sleep disruptions and sleep deprivation are common in the perinatal period, many people can sleep well when the opportunity allows.
For those experiencing insomnia, however, sleep does not come so easily — they often struggle to go to sleep or fall back to sleep even when they have the opportunity such as when their baby is sleeping.
This is a sign that new parents may need outside support and treatment, particularly as insomnia is a distressing condition.
About 43 percent of people will experience insomnia at least once between late pregnancy and two years after birth.
Both sleep deprivation and insomnia during pregnancy and after birth are associated with symptoms of depression, anxiety and may make it more difficult for parents to cope with the demands of parenthood.
Although some degree of disrupted sleep is experienced by most new parents, it is always helpful to speak to a health practitioner if new parents find sleepiness, fatigue, and worries about sleep affect their daytime activities.
And the good news is while treating insomnia in new parents has been previously overlooked, there are treatments available which can support parents to get better sleep.
Cognitive behavioral therapy for insomnia is a drug-free treatment which supports those experiencing insomnia to overcome the challenges for their sleep.
It works by changing what we do around sleep and how we think about sleep, and is more effective in treating insomnia long-term compared to medication.
Cognitive behavioral therapy can start during pregnancy where it's been shown to be associated with lower symptoms of insomnia, sleep disturbance and sleep-related impairment.
Another randomized controlled trial has found that therapist-assisted cognitive behavioral therapy was safe, feasible and effective at reducing postpartum insomnia symptoms in the year following a baby's birth.
It also found that light dark therapy — where research participants were asked to wear light glasses that provided blue-enriched light for 20 minutes each morning and seek out bright light in the morning and avoid it before bedtime — was also effective at reducing insomnia symptoms and sleep disturbances in the postpartum period.
Cognitive behavioral therapy has also been shown to lead to better sleep outcomes overall, including reduced insomnia symptoms and improved sleep quality, two years postpartum and to be of most benefit to those with elevated insomnia symptoms at the outset of the trial.
Now researchers are looking at whether it would be possible and useful to implement a sleep health program based on cognitive behavioral therapy in routine perinatal care.
By understanding how to best implement this treatment for insomnia in perinatal care researchers are laying the groundwork to better support new parents to sleep and feel better.
(Dr Meagan Crowther is a research fellow at the Turner Institute for Brain and Mental Health at Monash University. Bei Bei is an associate professor in psychology at the Turner Institute for Brain and Mental Health at Monash University. This article was originally published under Creative Commons by 360info)
