Sleep can be difficult during pregnancy. A number of uncomfortable symptoms such as urination frequency, exhaustion, indigestion, discomfort, night-time leg cramps, restless leg syndrome, difficulty breathing (sleep apnoea), anxiousness, depression, back pain, sciatic nerve pain and a moving foetus can keep an expecting mother up all night.
However, disruptions to sleep can have negative consequences to numerous areas of health. The body’s internal or biological clock that regulates sleep and wake cycles is also responsible for other systems that operate on a daily rhythm, like hunger, mental alertness, mood, stress, heart function, and immunity. Sleep disruption can decrease concentration, learning and coordination skills and affect mental health.
What happens when you don’t get enough sleep
When you don’t get enough sleep, your brain can’t perform at its best. You may have difficulty concentrating or learning, and maintaining your coordination skills. You may experience microsleep in the day. During these episodes, you’ll fall asleep for a few seconds or minutes without realising it, which can be dangerous especially while you are driving. Sleep deprivation negatively affects your emotional state, and you may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity. Prolonged sleep deprivation can also cause hallucinations and trigger mania in people who have manic depression.
Some benefits of healthy sleep
Sleep affects processes that keep your heart and blood vessels healthy, including your blood sugar, blood pressure, and inflammation levels. Sleep deprivation may lead to increased blood pressure and higher levels of chemicals linked to inflammation, both which play roles in heart disease.
Too little sleep weakens your system’s defences against viruses or infection. When you sleep, your immune system produces protective substances like cytokines that combat infection.
Hormone production is dependent on sleep. Testosterone production requires at least three hours of uninterrupted sleep. Growth hormones are released by the pituitary gland continuously, but sleep and exercise could help induce the release of this hormone.
How sleep is enhanced through massage
There have been research studies that measure the relaxing effect of massage by monitoring electrical activity of the brain using electroencephalography (EEG).
EEG waves are categorised by frequencies or wave patterns that represent particular states of mind:
- Beta waves (14 to 38 cycles per second) occur when you are most active and engaged.
- Alpha waves (8 to 13 cycles per second) happen when you are calm, relaxed and alert.
- Theta waves (4 to 7 cycles per second) and delta waves (0.1 to 4 cycles per second) occur when you are in a deep resting state of mind, like sleep.
In a 1996 study, Field et al.  provided evidence that the massage procedure lowered beta and alpha waves, which represent the states of mind that correspond to anxiousness and work stress.
The people who received massages experienced lowered beta and alpha waves but heightened relaxation and alertness, compared to the people who did not receive massages in the clinical study.
It makes sense that, by lowering the factors that cause psychological stress, massage promotes relaxation and sleep. You may find that it is easy to fall asleep on the massage table.
Sleep and Pregnancy
The physical discomforts of pregnancy and the emotional stress of a major life change can cause sleep problems. In a 2017 study, Felder et al.  found that women who have sleep disorders during pregnancy are less likely to make it to term.
Many women experience headaches during pregnancy, especially in the first and third trimesters. This is because of hormonal changes in the body and increased volume of blood production. Other causes of headaches include lack of sleep, poor posture, stress, anxiety, depression, low blood sugar, and dehydration.
During the third trimester, night-time leg cramps and restless leg syndrome are common. As low levels of iron contribute to restless leg syndrome, the recommended consumption of iron for expecting mothers is 18 milligrams of iron per day. Taking calcium and magnesium supplements help to manage night-time leg cramps.
Sciatic nerve pain is common in late stages of pregnancy as the uterus rests on the muscles of the pelvic floor and lower back. This pressure spreads tension to the muscles in the leg, causing them to swell and put pressure on nearby nerves. Massage therapy helps release the tension on nearby muscles and can significantly reduce sciatic nerve pain with regular treatment.
Making the connection between sleep, pregnancy and massage therapy, Field et al. in a 1999 study  found that pregnant women reported improved sleep quality after a five-week course of massage therapy. With only two 20-minute sessions a week, they felt less anxiety, slept better, and eventually gave birth to babies with fewer postnatal complications.
In a 2007 study, Field et al.  found that massage therapy contributed to more restful sleep for people with lower back pain. People usually book a professional massage because they have trouble sleeping due to uncomfortable aches and pain. I have personally found that the experience of massage can help to reduce pain levels, and consequently make it more comfortable to sleep.
For anyone interested in optimising their health, and particularly for pregnant woman, healthy sleep is a necessity for cardiovascular health, immunity and hormone production. As part of a multidisciplinary approach, the intervention of massage therapy can help with insomnia and stress reduction, and regain quality of life.
Jason is a myotherapist at Health Space Potts Point. If you have any questions about massage, pregnancy and sleep, feel free to contact a therapist at the Potts Point clinic on 02 8354 1534.
- Finan, Patrick H., Burel R. Goodin, & Michael T. Smith (2013).“The Association of Sleep and Pain: An Update and a Path Forward.” The Journal of Pain 14, no. 12: 1539–552.
- Kelly GA, Blake C, Power CK, O’Keeffe D, Fullen BM (2011). “The association between chronic low back pain and sleep: a systematic review.” Clin J Pain27: 169–181.
- Alsaadi SM, McAuley JH, Hush JM, Maher CG (2012). Erratum to: “Prevalence of sleep disturbance in patients with low back pain.” Eur Spine J21: 554–560.
- Field, T., Ironson, G., Scafidi, F., Nawrocki, T., Goncalves, A., Burman…Kuhn C. (1996). “Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations.” Internal Journal of Neuroscience, 86(3-4), 197–205.
- Felder, Jennifer N. PhD; Baer, Rebecca J. MPH; Rand, Larry MD; Jelliffe-Pawlowski, Laura L. PhD; Prather, Aric A. PhD. (2017). “Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth.” Obstetrics & Gynecology, 130(3):573-581.
- Field, T., Hernandez-Reif, M., Hart S., Theakston, H., Schanberg, S., & Kuhn, C. (1999). “Pregnant women benefit from massage therapy.” Journal of Psychosomatic Obstetrics & Gynecology, 20(1), 31–38.
- Field, T., Hernandez-Reif, M., Diego, M., & Fraser, M. (2007). “Lower back pain and sleep disturbance are reduced following massage therapy.” Journal of Bodywork and Movement Therapy, 11, 141–145. doi:10.1016/j.jbmt.2006.03.001