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Sleep & Stress While TTC

Sleep

When attempting pregnancy, it is important to consider all aspects of your lifestyle, including sleep.  Proper sleep patterns are just as important to your overall health as a balanced diet and exercise.  During sleep, the body rejuvenates, repairs, grows, and promotes optimal immune system functioning.  In the absence of quality sleep, the body grows increasingly stressed, damaged, and more prone to sickness.

Lack of appropriate sleep patterns also disrupts hormonal balance in the body.  The circadian clock ( the body’s inner time-keeper)  within the hypothalamus (the “master gland” in the brain that controls and links both nervous and endocrine systems), dictates several biochemical processes in our bodies including hormone production, appetite, body temperature, blood pressure, heart rate, metabolism, libido, and other functions that control neurotransmitters and enzymes in our body.  When the normal circadian rhythm is regularly disrupted by irregular sleeping patterns due to work schedules, medical issues, or other conditions, the hormonal balance is upset.

A study performed by the University of San Diego found that sperm maturation and the ovulation process is affected by the body’s clock.  Fertility hormones are affected by inadequate sleep and a woman experiencing sleep irregularities is more likely to experience irregular periods and difficulty conceiving than a woman who has the recommended amount of sleep. 

Another hormone affected by inadequate sleep is Cortisol.  Cortisol is also known as the “stress hormone” and is made by the adrenal glands.   Short term elevations of this hormone are normal and healthy.  Chronic elevation of cortisol leads to elevated blood sugar, insulin resistance, and weight gain.  Cortisol and two hormones called Leptin (responsible for appetite suppression) and Ghrelin (responsible for stimulating appetite),are related and play a role in the secretion or suppression of the other. When Cortisol is elevated, the body’s ability to suppress appetite is inhibited and appetite is increased.  An elevated cortisol level also affects the hormone melatonin which in a balanced body, slows down cortisol production at night and encourages proper rest and repair cycles.  When cortisol is chronically elevated, it interferes with the production of melatonin and makes it difficult to sleep.

Most experts agree that adults need between 7-9 hours of sleep per night, with best sleep being undisturbed to ensure a normal sleep cycle.  Signs of a sleep disorder include insomnia, loud snoring, disrupted sleep, tiredness during the day, poor concentration, memory problems, morning headaches, and mood changes such as agitation, irritability, depression, and being short tempered.

According to the National Sleep Foundation, about 75% of Americans report having a least one symptom of a sleep problem a few nights a week or more within the past year.  The most common reason for seeing a sleep specialist is lack of amount or quality of sleep needed to feel rested and energetic during the day. Based on your overall symptoms, your primary doctor may send you to a sleep specialist for further evaluation.   Among the top issues treated by sleep specialists are insomnia and sleep apnea.  A sleep specialist will evaluate your symptoms and determine a treatment plan that could include more intensive follow up such as a sleep study, medication, or psychological referral.  Less intensive recommendations could include behavioral and lifestyle changes- practicing good sleep hygiene.

Sleep hygiene refers to the habits, environmental factors, and practices that may influence the length and quality of one’s sleep.

  • Get up and go to bed at the same time every day, even on weekends. Establishing a schedule helps regulate your body’s inner clock
  • Make sure your bedroom is quiet, dark, cool, and comfortable. Wear comfortable clothing to bed.
  • Avoid watching television or doing work in bed. Only use your bed for sleep and sex.
  • Avoid caffeine, alcohol, and nicotine 4-6 hours before bedtime.
  • Don’t take naps.
  • Exercise every day, but avoid doing it 4 hours before bedtime.
  • Develop sleep rituals which include quiet activities, such as reading, 15 minutes before bedtime.
  • If you are unable to get to sleep within 15 minutes, go to another quiet place and pursue a relaxing activity such as reading until you feel ready to fall asleep(avoid TV watching or computer use)
  • Avoid eating or drinking in the few hours right before going to bed, as these might lead to sleep disruptions
  • Make sleep a priority: don’t sacrifice sleep to do daytime activities.

Stress

Chronic stress can cause many physical changes including infertility. A study done by the University of California at Berkley found that stress causes the adrenal gland to produce certain steroid hormones which through certain mechanisms affect the production of the major reproductive hormones, estrogen and testosterone.  In men this can cause reduced sperm count and erectile dysfunction.  In women, the hormonal imbalance can affect ovulation and implantation.  Infertility is a stressful process, and research has shown that the number one reason why patients drop out of treatment is stress.

As mentioned previously, during a state of chronic stress, the “stress hormone” cortisol is released.  Over time this leads to elevated blood sugar, insulin resistance, and weight gain.  Some of the first ways stress is manifested physically are tense muscles/cramps, headaches, diarrhea, dizzy spells, irregular menstruation, chest pains, and anxiety/panic attacks. Stress can also lead to bad habits such as alcoholism, smoking, drug use, or compulsive eating that are used as a temporary escape.

Talk to your doctor or a counselor if you feel like stress is becoming a problem for you.  We are here to support you. Other ways to help deal with stress and infertility are the following: