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June 18, 2019
Reviewed by Kimberly Langdon M.D.
You know you need to “sleep when the baby sleeps,” but you just. can’t. sleep. No matter how exhausted and brain-dead you are, sleep just won’t come. It’s a common story among new parents, but it’s not something you have to live with, at least long term. Postpartum insomnia can be a symptom of an underlying medical issue, and resolving it can have a lot of benefits, like a stronger immune system, an easier time losing the baby weight, and a lower risk of postpartum depression and other PMADs.
If you’re up all night with a crying child, I feel for you. That is not fun and sometimes there isn’t a lot you can do about it, except wait out the growth spurt, or teething, or whatever is causing it. But if it lasts for a while, I would encourage you to try sleep training in some form (sleep deprivation can have real consequences). There is a whole industry built around getting babies to sleep, with books, blogs, sleep consultants and more. So read some books, find a method that works for you, take turns with your partner, get professional help, and do what you need to do to get some sleep.
If your baby is actually “sleeping like a baby” (who came up with that expression, anyway?), and you still have trouble falling or staying asleep, welcome to the postpartum insomnia club. If your sleep difficulties have lasted for more than a few weeks, they may be the result of a medical issue, so it’s worth a chat with your doctor. Do you have symptoms of postpartum thyroiditis or hyperthyroidism, like sudden weight loss, diarrhea, or feeling hot and sweaty? Do any of your relatives have a history of thyroid disorders? You can discuss these answers with your doctor and if there’s concern, your thyroid levels can be checked with a blood test.
Related: Postpartum Thyroiditis
Also, check in with how you’re feeling emotionally. When you’re lying in bed trying to sleep, are you feeling worried, concerned, or afraid, or thinking scary thoughts about your baby? Take a few minutes to complete the Edinburgh Postnatal Depression Scale and review the results with a health provider. Insomnia can be a symptom of several perinatal mood and anxiety disorders (PMADs), including postpartum depression, anxiety, psychosis, PTSD, bipolar, and panic disorder. There are a variety of medication and non-medication therapies available to treat PMADs, along with associated insomnia.
If there doesn’t seem to be an underlying cause of your insomnia, there are still methods for treatment available. Some sleep aids (OTC and prescription) are considered safe for use while breastfeeding, and your doctor should be able to discuss their pros and cons and recommendations for safe use. Also, cognitive-behavioral therapy (CBT) has been shown to be effective and quick in treating insomnia.
In the meantime, there are things you can try at home to improve your ability to fall and stay asleep. Again, this is assuming it’s not the baby that’s keeping you up.
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