How I Overcame Postpartum Insomnia

For a year and a half after giving birth to my third child, a full night’s sleep eluded me like some kind of impossible dream. In retrospect, it is clear that I was suffering from chronic insomnia, and it persisted long after my daughter had started sleeping through the night. 

Sleep researchers define chronic insomnia as difficulty falling asleep or staying asleep that persists for at least 3 months. Chronic insomnia may affect as many as 1 in 6 adults in the U.S., and, as will surprise no one, it is especially common among new mothers.

Whether I was exhausted or well rested, every night, I would lay awake from 2 or 3 am until 5:30 am, running over my problems in the most negative possible light, and despising myself for being unable to fall back asleep.

Then, at dawn, I would finally fall into a deep sleep, only to have to awaken an hour or so later.

The effects on my ability to function were severe: My nerves felt constantly frayed, my patience was thin, and my mind felt like it was encased in cotton. Overall I felt like I was constantly running on empty, pushing myself to get through my day.

Before having children, I never experience like this. I occasionally had trouble falling asleep, before a big exam or after fight with a boyfriend, but it never lasted.

Generally speaking, I slept like a proverbial log. Nothing woke me. Not dogs barking next door. Not thunderstorms. Not my husband waking up in the morning and grinding coffee in the room next to our bedroom. Now, after becoming a mother, my son coughs down the hall and I am wide awake.

(As far as I know, no one has researched whether becoming a mother permanently changes your sleep. I know I am not alone in finding that I sleep less deeply after having had kids. Someone should study this!)

My sleep returned to normal after having my first two children, once they were sleeping through the night, but not with my third.

As I slowly came to the realization that my sleep was simply not going to course correct on its own, I applied my research skills to this problem. And thank goodness. I only wish I had done so earlier.

Chronic insomnia is serious–it affects your outlook, your mood, your weight, and your ability to think and reason clearly. Insomnia is both a cause and a symptom of postpartum depression. In my case, it was causing severe anxiety and occasionally outright paranoia. I would have bouts of believing everyone in my life despised me, including my closest friends. 

These kinds of reactions are not uncommon. Despite our play hard, work hard culture insisting otherwise, we all need sleep. And most of us need a lot more than we are getting. The average American sleeps only 6 hours a night, far less than the 7 to 8 hours most of us need to function optimally.

Even if you do not feel impaired by lack of sleep, you probably are. One of the first things to go out the window with a lack of sleep is meta-cognition–our awareness of how well we are functioning.

(A rare genetic mutation does confer the ability to function well on only 6 hours of sleep a night but, alas, it is found in only about 1 in 10,000 people.) 

The upshot of getting scientific on my sleep is that I am now clocking a steady 8-8.5 hours every night. It’s not the deep, almost unconscious sleep as I enjoyed before becoming a mother, but it is a enough. I no longer stumble out of bed every morning wishing that I could stay in bed. And over the past couple of months, my mood, my patience, and my outlooked have all noticeably improved. My energy levels have lifted, and I feel more like a human, and less like an automaton.

Because postpartum insomnia is fairly common, I wanted to share with you some of the life hacks I have used to conquer my insomnia.

Following CBT

When it comes to treating insomnia, drugs are out and CBT (cognitive behavioral therapy) is in.

Researcher strongly recommend CBT as the first-line treatment for insomnia. Sleep meds are a last resort, because they sedate you but do not recreate natural sleep, and they can be addictive.

The primary goal of CBT is to transform your bedroom into a sleep haven. Some basic principles include:

1. Going to bed at the same time every night, and waking up at the same time every morning, on both weekdays and weekends.

2. Keeping your bed and bedroom are only for sleep (and sex). This means no work emails, playing video games, or tweeting while in bed.

3. If after waking up in the middle of the night, you find yourself unable to fall asleep within 20 minutes, get out of bed, and do a quiet activity in low light (like reading with a book light) until you feel sleepy.

This regimen help retrain your brain to associate your bed with sleep. It also helps re-entrain your body’s circadian rhythm to a set sleep time, making it easier for you to fall asleep and stay asleep. (You can read more about cognitive behavior therapy for insomnia here.)

I have found that following these steps to the letter helped with my night wakings, but alone they were not sufficient to fully overcome my insomnia. I also needed to work on boosting my melatonin production before bed.

Managing My Melatonin

Melatonin, as you probably know, is the primary hormone regulating sleep onset. Our brains release it at night when it is time to sleep, making us feel sleeping as our normal bedtime approaches.

During the day, bright light suppresses its release.

Unfortunately, in modern times, melatonin’s normal nighttime release has taken a drubbing. Artificial lights, TVs, computer, tablet, and phone screens all emit blue light, which effectively shuts off our brain’s release of melatonin.

(For pregnant women: Melatonin does not just help us fall asleep, it also helps us labor. Melatonin potentiates the effects of oxytocin on the uterine muscle, strengthening contractions. This may be why most women experience more contractions at night. And it may explain why labor so often stalls once women arrive at the hospital. Florescent hospital lights bathe women blue light, shutting off their melatonin production, and likely weakening their contractions.)

 

Nurse helping in baby delivery
Nurse helping in baby delivery in clean hospital room, with all the lights on.

 

Melatonin supplements are widely available. Not being a doctor, I cannot recommend a specific supplement, but I have personally found that a low dose melatonin supplement (containing only 1 mg of melatonin) helps me fall asleep quickly and, most quickly, stay asleep. Most melatonin supplements contain 3 to 5 times as much melatonin, and these seem to make my middle of the night awakenings worse.  (For more information on why most melatonin supplements contain a larger than optimal amount, check out this post.)

Women who are pregnant or breastfeeding should not take melatonin, because it passes through the placenta and into breast milk.

The Bane of Blue Light

Confession time: I love my iPhone, and becoming a mother has only made that attachment blossom. I use my phone to text with my busy mom friends, to read while nursing or before going to bed, and to send last-minute work and family-related emails. It’s hard to imagine juggling this crazy mom life without it.

Unfortunately, like other electronics, smart phones like the iPhone emit blue light, and this is disastrous for our sleep.

Experts recommend not just putting your phone down but leaving it outside your bedroom when you go to bed.

Well, ha. I am sure this good advice, it is frankly not advice I have any hope or desire of following.

And avoiding artificial lights for at least an hour before bed? How is anyone supposed to manage that feat? I just cannot wander around my house in the dark for several hours before bedtime. That’s my hour. I need that those hours to wash dishes, put away toys and books, fold laundry, and catch up on other miscellaneous chores, usually while listening to a podcast or audio book.

Thankfully, I have found a solution for both these problems. I wear these super sexy blue light blocking glasses for a couple of hours before my bedtime. I now feel much sleepier before going to sleep, and when I wear them, I typically fall asleep within minutes of my head hitting the pillow.

IMG_1608
Me, wearing blue light blocking glasses at dusk.

The Bottom Line

A lack of sleep is an inevitable part of being a parent, and its also one of the most challenging parts of being a parent. But when sleep problems persist, we need to seek help. I hope by sharing my experience, I can help fellow unwilling burners of the midnight oil seek help, and perhaps give them a few life hacks to try.

For more information on the importance of sleep, and how to get more of it, I highly recommend the book Why We Sleep, by sleep researcher and founder and director of the Center for Human Sleep Science at Berkeley, Matthew Walker.

You may also enjoy my sleep-related blog post series for Bloomlife, a startup that has developed an at-home contraction tracker for pregnant women. Post topics include what baby sleep can teach us about adult sleep, how sleep debt hinders postpartum weight loss, and why exposure to blue light during labor might stall its progress.

Note: This post contains affiliate links. Clicking on these links helps support my blog and research (access to scientific articles is expensive!). I only link to products that I personally use and would recommend to my own friends and family.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Published by

Amy Kiefer

As a former research scientist and proud mama of three little munchkins, I love digging into the research on all things baby-related and sharing it with my readers.

One thought on “How I Overcame Postpartum Insomnia”

  1. Two weeks into my pregnancy with my daughter, I lost my ability to sleep. This was not insomnia, but some sort of chemical imbalance which led to 2 weeks of sleeplessness, including 96 hours of no sleep straight- broken up ONLY because I finally found an ER Dr who would prescribe me Ambien as a pregnant woman. In my sleep-induced haze I was sure that the blood vessels in my brain had stopped allowing the blood to activate the area of my brain that induces sleep. Strangely, I was not tired at all, but found myself unable to do anything but pace my condo floors. Eventually with the help of the drugs, I would sleep 4-5 hours a night. I became addicted to Ambien for 8 more weeks and then finally switched to Trazadone. I stayed on Trazodone through my pregnancy. During this time, I suffered terrible OCD, depression, paranoia, and spent my entire pregnancy believing that I was dying from an autoimmune disase.

    Note- prior to this I had never had any serious mental health issues outside of minor social anxiety, easily treated with Zoloft.

    Following the birth of my daughter, my husband and I shared the night time feedings. Suddenly, I no longer needed sleep medications to fall asleep and would sleep easily 5-6 hour a night. Six months after she was born, I would easily 8-9 hours with no complications and wake up feeling amazing. I sleep SOUNDLY.

    I have never met another woman that suffered such horrible insomnia during pregnancy- only postpartum. I always wonder which came first- depression or insomnia. Did insomia cause my depression or vice versa. Either way- thank you for this artoicle. It is very helpful to know I am not alone!

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