Category: Sleep

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.

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Back sleeping and stillbirth revisited: A reason for caution, or a few extra pillows

As longtime readers of my blog know, in 2011, carrying my first child, I became obsessed with the question of whether pregnant women could lie on their backs–either for short periods of time, such as during a yoga class, or while asleep at night.

Several OBs told me to avoid lying on my back. But their justifications were murky, and their advice conflicting. Not a one could point to a single published study backing this advice up. And when asked at what point in pregnancy I needed to start avoiding back sleeping, their answers were all over the place. One told me it was verboten from 4 months on, another from 5 months on, and the third claimed I should worry only in the last month or so.

Sleeping with a bowling ball-sized stomach is challenging, to say the least. At the same time, groundless sleep prohibitions with vague but terrifying warnings that you might harm your baby are immensely frustrating, and yet almost impossible to disregard.

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Surviving the First Year: Two books to help you understand baby’s sleep

For most new parents, sleep becomes an obsession, their most precious commodity. They will happily trade exercise, sex, and time with friends for just a shot at catching some Z’s–kind of like how a rat with ad libitum access to cocaine will happily forgo food. Continue reading “Surviving the First Year: Two books to help you understand baby’s sleep”

The Middlemiss Study Tells Us Nothing About Sleep Training, Cry-It-Out, or Infant Stress

Last week, I wrote a post about sleep training and stress, in which I argued that everything we know about stress suggests that sleep training is not harmful.

In response, some people objected that sleep trained babies continue to experience elevated cortisol and significant distress, even after they have stopped crying. In their view, sleep training teaches babies that crying does not help. They haven’t learned to self-soothe or to fall asleep on their own, they’ve simply given up.

What a heartbreaking thought. And one that surely strikes fear in the heart of many parents.

So it’s important to realize that this claim comes from a single small and deeply flawed study of 25 babies, led by Wendy Middlemiss, a researcher at the University of North Texas’s College of Education.

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Critics of Cry-It-Out Fundamentally Misunderstand How Stress Affects the Brain

Because whether or not to sleep train can be such a fraught decision for new parents, I wanted to share my sleep training story, and to explain why, given everything we know about stress, the argument that sleep training causes long-term harm doesn’t hold water.

Sleep Training My Son

When my son was 4.5 months old, I decided to sleep train him. Even by baby standards, my son was not much of a sleeper. He’d snooze for at most 4 or 5 hours, and then wake up every hour like clockwork, wanting to nurse but not wanting milk, popping on and off my breast and screaming in frustration.

I had gone back to work a month earlier, so napping to catch up on sleep was out of the question. Worse, I was commuting an hour to the office each way.

By then, I had reached the end of my sleep deprivation rope. I was so tired I could barely string two thoughts together. I had to coach myself through even mundane tasks like checking out at the grocery store. Say hello to the cashier. Take out your credit card. Pick up the grocery bags. Leave.

I was terrified every time I got into my car to head to work that I would nod off at the wheel and kill someone, quite possibly myself. I joked with coworkers that driver’s licenses should be temporarily suspended for new parents, but the situation really wasn’t funny.

So there I was the first night of sleep training, dripping sweat as I listened to my son’s cries. Minutes ticked by, each seeming longer than the last. I pondered whether the Ferber method included soothing every five minutes just so that you would realize only five minutes had passed.

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Back Sleeping During Pregnancy and the Sydney Stillbirth Study

Pregnancy can be cruel. Just when you are at your most swollen, bloated, and exhausted, sleep proves frustratingly elusive. Every night, you toss and turn, trying to find a comfortable position, your back aching, and your belly pressing down on your bladder. And then, as you finally start to drift off, you realize you need to pee.

To make matters worse, despite having an enormous bowling ball attached to your stomach, you are told you cannot sleep on your back:

“After 16 weeks of pregnancy, experts advise women to not sleep on their backs, but rather should lie on their sides, ideally the left side” states a popular pregnancy blog.

But who came up with this idea?

This advice stems three studies that have linked back sleeping with late stillbirth (pregnancy loss after 28 weeks). (Interestingly these warnings predated the three studies, so they are not exactly the reason women are told to avoid back sleeping)

I described the first two studies, one conducted in Ghana, the other in New Zealand, in an earlier post, and concluded that not only did they provide no reason for alarm, they certainly do not justify blanket advice again back sleeping.

In 2015, a third study came out linking back sleeping with late stillbirth. Does it change the overall picture?

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