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Why does pregnancy cause nightmares and vivid dreams?

Why can pregnancy cause nightmares and vivid dreams?

People love to tell pregnant women how their sleep will change after they've had their baby, but for many, pregnancy can disturb their rest long before birth. Studies suggest lots of expectant women have vivid dreams or nightmares during pregnancy, particularly in the third trimester. But why?

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Why pregnancy can cause strange dreams and nightmares

If you've experienced an increase in bizarre pregnancy dreams, you're not alone. According to a 2016 study published in the journal BMC Pregnancy and Childbirth, women report more frequent nightmares during pregnancy, many of which have to do with childbirth or danger to the newborn baby. Researchers surveyed 406 pregnant women to find that they reported nightmares more than twice as often as women who were not pregnant. Often, the nightmares were baby-related.

Another study, published in 2014 in the journal Sleep Medicine, surveyed 57 pregnant women who were in the last trimester of their pregnancies. Of those polled, 32% described having weekly nightmares and 21% reported more than one pregnancy nightmare per week.

Interrupted sleep

Most dreams are believed to occur during rapid eye movement (REM) sleep, a restorative phase of sleep thought to play a role in learning, memory and mood. Pregnancy triggers changes in hormones, your sleep pattern and emotions, which may impact your dreams and how well you remember them.

Disrupted sleep is another factor that can impact how we remember dreams, or how vivid they feel when we wake up. Frequent sleep disruption increases the likelihood of waking up during the REM stage of the sleep cycle, which can make dreams seem more memorable and instantaneous.

Sleep is often already broken during pregnancy and insomnia can occur during all stages of pregnancy. This can be due to stress, discomfort, an inability to move or turn over easily in bed and the need to urinate more frequently. Restless legs syndrome is another condition which often starts in pregnancy, and which causes an intense urge to move the legs (predominantly at night), which can interrupt sleep.

Impact of stress

Dr Emma Haynes, psychotherapist and spokesperson for the UK Council for Psychotherapy, says there are many reasons why we may experience disturbing pregnancy dreams.

"Throughout pregnancy women can feel stressed and anxious. Close to the baby's birth, stress and anxiety can escalate to a level that may feel overwhelming," she says. "Existential aspects such as fear of the unknown - even in second or third pregnancies - may bring up fears about birth, how to cope with the pain of childbirth, and whether the baby will be healthy.

"This may cause a woman to experience dreams about the baby, particularly close to birth," Haynes adds. "There seems to be some relation to daytime stress and dreams or nightmares, and this makes absolute sense."

Additionally, research suggests that worry and the negative emotions associated with it not only increase the likelihood of nightmares but their severity too. This can be distressing and impact women during the day too, as they may be more likely to reflect on their dreams when awake.

Anxiety can feel more intense at night

Anxiety can affect us at any time of day, but it can often feel much worse in the quiet of the night. The brain doesn't 'switch off' during sleep, so worries or anxieties may crop up in our unconscious brains as we sleep. If we wake up at night and start to worry about something, it's possible to experience stressful dreams when we do eventually fall back to sleep.

"Fears seem to multiply at night, and if we try to go to sleep when anxious or stressed, the chances are our sleep may well be poor," says Haynes. "If the woman is especially anxious, these dreams may turn into nightmares, which can cause a woman to shout out, or thrash about in her sleep."

Fears about birth and the aftermath

Unsurprisingly, many women worry about how they will cope with labour and childbirth during pregnancy. These fears can become more intense in the third trimester, as the anticipation begins to build. However, it's also common for new parents to feel anxious about how they will cope after giving birth.

Women may worry about feeling isolated or a lack of a family support system. Studies show it's common for women to worry about losing their identity as they adapt to the idea of being a mother. Research suggests intense negative emotions can have a serious impact on the content of our pregnancy dreams.

Impact on maternal mental health

One in five women are estimated to struggle with their mental health in pregnancy, but stigma remains a problem. Often, women are deterred from seeking psychological support because they're afraid of being judged or deemed a bad mother. As a result, problems such as anxiety and depression can go unchecked.

Experiencing nightmares and disturbed sleep can exacerbate mental health problems, even after the baby is born. In fact, studies have suggested insomnia during pregnancy may be linked to postnatal depression.

"Dreams and nightmares can cause a spiral in mental health issues. Pregnancy evokes fear, uncertainty, anxiety and stress. Dreams can feed into these, as women can imagine that the dream may mean something about the baby," says Haynes.

"In turn, this may escalate fear and daytime rumination, which disrupts and disturbs sleep and can exacerbate mental health problems. Sleep is an important part of mental well-being."

How to cope with vivid dreams and pregnancy nightmares

Speak to your GP or midwife

If you are struggling with anxiety, depression or any other mental health problem in pregnancy, it's important to speak to your doctor, midwife or health visitor. They will be able to advise on the best course of action for you. You can also self-refer for talking therapy on the NHS.

Try therapy

"Psychotherapy can really help as it directly addresses the cause of the anxiety and fear and will help women to gently confront and challenge these causes," says Haynes.

"Therapy also offers the gaze of another on the situation - someone who can help the woman to learn strategies to cope with her emotions, and can help them feel less isolated and listened to," she adds. "Safety and security are areas I would always address, as often prior difficulties can be re-evoked close to birth and the transition into motherhood."

Improve your bedtime routine

Making small changes to your evening routine may also help improve the quality of your sleep in general. There are lots of steps that can help manage sleep problems, from creating an evening routine to avoiding screens and going to bed at the same time each night. Baths, breathing exercises or reading can help you relax before going to sleep.

Talk to people you trust

If you're feeling anxious or low, it's important to speak to friends and family about how you feel. Pregnancy can be an incredibly difficult period and it's common to experience anxiety, stress or mood problems. Antenatal groups are a good place to meet and chat with other expectant parents who may well be feeling the same.

Nap during the day

Pregnancy insomnia can be exhausting, so it's important to get some rest while you can. Napping during the day can be a good way to recharge if you're struggling to sleep at night.

Article history

The information on this page is peer reviewed by qualified clinicians.

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