Community Q&A - Pregnancy, Postpartum, and Partner Sleep
How Sleep and Dreams are Impacted by Procreating
Monthly Community Q&A
Hello Friends, Happy End of April!
This month we’re wrapping things up with a community Q&A that comes to us by my dear, long-time friend Meghan. When Meghan sent me this question, I was going to do what I often do, which is rocket my friends and family off a 2-4 minute voice memo over-simplifying some of what I know and slightly steering it towards their question. However, Meghan’s questions were so thoughtful I couldn’t help but get curious about what new & cutting edge science I might discover around this topic since I’ve left grad school.
Truly fascinating stuff.
Although this is tip of the iceberg on this topic of literature, I’ll be giving a very high overview in our community Q&A around:
How does sleep change during pregnancy?
How are dreams shifting during this process, too?
How does sleep shift postpartum?
How do the non-pregnant partners adjust to this period of sleep shifting?
How do different groups of people (i.e. White Women vs Black Women) shift sleep differently during this time?
Just as a reminder: this is by no means comprehensive and is vastly oversimplified. If you’re interested in diving further into the research, please see the links provided in the footnotes to explore more.
Alright friends, let’s impregnate ourselves with some knowledge.
How Does Sleep Change During Pregnancy?
In the shortest possible way to say this—it changes a lot.
The body is undergoing so many changes while growing a tiny human that sleep will, of course, be impacted. Often during pregnancy, in general, those carrying the growing child will experience more fragmented sleep (waking up more frequently throughout the night), lower total sleep time. Pregnant humans are also at an increased risk for various sleep disorders, such as insomnia, restless leg syndrome, and obstructive sleep apnea. These changes are due to a variety of things not limited to: musculoskeletal changes, increase in sex hormones, and shifts in other circadian related hormones like oxytocin, melatonin, and cortisol.
In general, the third trimester is when the pregnant individuals experience their most exaggerated changes in sleep (compared to pre-natal sleep) and approximately 30% of folks in this stage are sleeping well under the benchmarks of “healthy” recommended sleep:
under 7 hours of sleep a night.
sleep efficiency is under 85%
increased nighttime disturbances
increased waking after sleep onset
increased daytime sleepiness and decreased daytime alertness
decreased sleep satisfaction overall
It’s important to note here that while many pregnant folx see an increase in sleep difficulties, some folx are impacted more than others. non-Hispanic Black and Asian pregnancies a significantly shorter total sleep time. Additionally, younger pregnant folx often spend more total time in bed than older pregnant folks.
Dreams also seem to have a significant shift during this life change. Across the board (in pregnant and non-preganant folx) having more fragmented sleep is associated with higher dream recall. As sleeping conditions get worse for pregnant folx—particularly those in the third trimester—dream recall seems to become more frequent, more vivid, and have more provocative content.
In a recent literature review, there were a handful of interesting changes to dream-life in pregnant people, but some of the most fascinating ones are:
Dreams during pregnancy and postpartum contain more dream content about babies and parenting tasks compared to other adult populations (duh, but still interesting)
First time parents (in comparison to people who have already birthed their first child) experience more stress dreams, nightmares, and overall dream content and recall
Postpartum folx with vivid dreaming is highly associated with checking behavior upon waking (specifically related to checking on their child)
Frequent nightmares in pregnancy are predictive of continued nightmare content for up to 3.5 years postpartum
What About Postpartum Sleep?
As difficult as sleep becomes during pregnancy, postpartum sleep for many people is actually worse for up to a year. Interventions for pregnant and postpartum folx can bolster severe sleep deprivation, but even with successful intervention new parents can expect difficult sleeping conditions that fall well below “healthy” benchmarks for a minimum of 9 months postpartum.
In general, most new parents experience a fairly significant disruption in sleep the first 6-8 weeks after birth. Sleep symptoms will exaggerate and become disruptive to daily life for most people until about 4-6 months, and then many folks will begin to trend back towards a more sustainable baseline from 6-9 months. This doesn’t necessarily mean new parents will sleep as well as they did before pregnancy and having children, but after 6-9 months, severe sleep difficulties often reduce to a manageable level where parents can find a new baseline and begin to calibrate from there.
It’s important to note here that getting better sleep does not always mean sleeping for longer. Many of the studies show that, in fact, new parents rarely ever sleep much longer than 7 hours, even when their sleep is “healthy.” However, what does seem to change is the overall quality of their sleep as they navigate postpartum. In other words, there is a tendency to fall asleep faster, wake up less throughout the night, and feel more satisfied overall with the sleep that has happened.
As you might expect, for people who have a history of insomnia, these sleep disturbances are more exaggerated and tend to last longer. Most parents with pre-existing insomnia often report significant impact to sleep health for 2 or more years postpartum.
Similarly, folks with different backgrounds face different challenges in health variables. Specifically, when compared to White women, Black women during postpartum sleep less overall, have lower sleep efficiency, less time in bed and less sleep satisfaction. The difference in these demographic differences are not small. For example, at 4-12 months postpartum, White women on average are are reported have bounced back to sleeping an average of 7 hours a night, whereas Black women float somewhere around 6 hours. In recent research, these differences are reported due to socioeconomic factors, rather than from any behavioral differences.
How Does Any of This Impact the Non-Pregnant Partner?
I want to caveat this by saying there is very, very little research on sleep-parity (two partners sleeping in the same bed) and that the paper I was able to access was the first known of it’s kind published in 2021 and looked at 87 couples who were 100% white, German, and in a heterosexual partnership. So take all of this with a grain of salt (as you might with anything you read) since we cannot generalize these findings in all cases of partnership.1
Anyway—onward!
In general:
Both parents have a significant decrease in sleep health during pregnancy and postpartum for up to a year
Overall, Women have worse sleep quality than men
Men tend to sleep less overall minutes, but have higher efficiency and sleep satisfaction
Women’s sleep behavior is significantly impacted by their partners sleep behaviors, however men’s sleep behavior is only impacted by their own previous sleep habits
Couples who slept poorly before pro-creating were significantly associated with sleeping poorly postpartum.
Remember— Sleep is not fixed and final!
It feels important to wrap up this article by stating that while sleep might be rightfully more difficult or tenuous during different chapters of our lives, we are not doomed to be “bad sleepers” forever. Many sleep difficulties can be addressed and shifted, and if sleep difficulties that interrupt our ability to enjoy life persist—seeking out the help of a professional can be an empowering choice.
When I teach about sleep, I remind people that sleep is impacted by everything we do and everything we do is impacted by sleep. When we go through a major life transition like conception, it makes sense that our sleep will be forever shifted to a new normal. At least until our next big major life transition changes it again. Much of sleep health is about assessing honestly what chapters of life we are in and learning to optimize our sleep, rest, and stress management towards the current chapter.
Sleeping differently when becoming a parent is normal. However, feeling noticeably distressed by a major change in sleep, and an inability to get sleep might need an extra layer of support! There is no shame in asking for more help when you need it.
If you need help connecting to sleep resources in a new chapter of life, don’t hesitate to reach out. Whether it’s working with me, or working with a more specialized professional, I am happy to help point people in the right direction on how to start shifting their relationship to sleep towards something that supports them more fully.
Thanks again, to Meghan, for raising some really fun and interesting community questions this month. I can’t wait to hear what conversations it starts.
Thanks for being here,
Dagny Rose
Articles
Like I mentioned, this Community Q&A came from some recently published peer-reviewed papers. To check them out yourself you can find them in the footnotes here:
This sub-section of The Art of Rest, is all about threads that hold us together—The Community Wisdom.
Here the Art of Rest honors and acknowledges there is no “one” right way that works for everyone. There are so many valid ways of knowing, and we need each and every one.
We believe deeply that a diversity of thoughts, creative practices, and perspectives is what keeps our lives rich and evolving. In this section, “Community Wisdom” is where we post short interviews with creatives, scientists, and restful people4 so that we might continue to learn from each other’s inherent and earned wisdom.
Looking For A Personalized Way to Optimize Your Rest?
Exciting announcement—My final spring bookings are open! I am looking forward to giving seasonal guidance around sleep health & nervous system regulation around stress. I offer individualized 1:1 guidance for those who want to use rest as a way to expand their creativity, folks who just need a tune up, all the way towards people who might be dealing with chronic rest related issues.
Shoot me an email at dagnyrose@theartofrest.me to inquire about getting started, having a seasonal spring check up, or to see how we might be able to work together. My final spring bookings are open from April 28 - June 15.
Due to the nature of the paper that this information comes from, please excuse me as I refer to partner examples below as simply “men” & “women” because, that’s technically exactly what was studied. I recognize that this is not how all people choose to pro-create and so please take this as a jumping off point to explore your own day-to-day anecdotal data gathering.
Pengo MF, Won CH, Bourjeily G. Sleep in Women Across the Life Span. Chest. 2018 Jul;154(1):196-206. doi: 10.1016/j.chest.2018.04.005. Epub 2018 Apr 19. PMID: 29679598; PMCID: PMC6045782.
Serena Scarpelli, Valentina Alfonsi, Luigi De Gennaro, Maurizio Gorgoni,Dreaming for two: A systematic review of mental sleep activity during pregnancy, Neuroscience & Biobehavioral Reviews, Volume 163, 2024,105763, ISSN 0149-7634, https://doi.org/10.1016/j.neubiorev.2024.105763. (https://www.sciencedirect.com/science/article/pii/S014976342400232X)
Nina Quin, Liat Tikotzky, Laura Astbury, Marie-Antoinette Spina, Jane Fisher, Lesley Stafford, Joshua F Wiley, Bei Bei, Preventing postpartum insomnia: findings from a three-arm randomized-controlled trial of cognitive behavioral therapy for insomnia, a responsive bassinet, and sleep hygiene, Sleep, Volume 47, Issue 8, August 2024, zsae106, https://doi.org/10.1093/sleep/zsae106
Erin E. Kishman, Jihong Liu, Shawn D. Youngstedt, Chih-Hsiang Yang, Bridget Armstrong, Xuewen Wang, Sleep characteristics during the first year postpartum in a cohort of Black and White women, Sleep Epidemiology, Volume 4, 2024, 100096, ISSN 2667-3436, https://doi.org/10.1016/j.sleepe.2024.100096. (https://www.sciencedirect.com/science/article/pii/S2667343624000222)
Karen Wynter, Lauren M. Francis, Richard Fletcher, Nyanda McBride, Eileen Dowse, Nathan Wilson, Laura Di Manno, Samantha Teague, Jacqui A. Macdonald,Sleep,
mental health and wellbeing among fathers of infants up to one year postpartum: A scoping review, Midwifery, Volume 88, 2020, 102738, ISSN 0266-6138, https://doi.org/10.1016/j.midw.2020.102738. (https://www.sciencedirect.com/science/article/pii/S0266613820301108)
Cattarius, B. G., & Schlarb, A. A. (2021). How the Sleep of Couples Changes from Pregnancy to Three Months Postpartum. Nature and Science of Sleep, 13, 251–261. https://doi-org.proxybz.lib.montana.edu/10.2147/NSS.S259072