Massage Benefits for Postpartum Maternal Sleep Issues

Sleep may be the ultimate luxury for someone who has just had a baby. Nighttime baby wakings and feedings can leave moms – and dads, too – exhausted and unable to function normally the next day. The Sleep Foundation reports that more than two thirds of people giving birth lack quality sleep during the six months after the baby is born, and sleep problems can continue long after. [1]

What causes postpartum insomnia?

Trouble sleeping may start before the baby is born. Sleep difficulties are particularly common during the third trimester due to discomfort, heartburn, and frequent need to go to the bathroom during the night.

While it may start before the baby is born, troubled or disrupted sleep can persist in the postpartum period. To compensate for lack of sleep or inferior quality sleep at night, caregivers may find the need to take long naps in the afternoon. In a vicious cycle, afternoon napping can make it difficult to fall asleep at night.

Troubled sleep patterns carried over from pregnancy and once the baby is born due to attending to its needs every few hours – feeding and changing diapers – may be the cause of insomnia. But the problem become worse because an irregular sleep schedule can disrupt a person’s circadian rhythm, which is the body’s natural clock that keeps it operating on a 24-hour healthy wake-sleep cycle. As a result, someone may be sleepy when they want to be awake and awake when they want/need to sleep. [2]

There are other contributors to postpartum sleep issues or insomnia. A decrease in certain hormones, including progesterone and estrogen, after giving birth can affect mood, energy, emotions, and sleep. Progesterone aids relaxation and sleepiness. Estrogen enhances serotonin activity, a chemical that transmits messages between nerve cells and influences sleep and other body functions. The reduction of estrogen may delay the time it takes to fall asleep and decrease the quality of sleep.

During the period after childbirth, a person may experience pain, which affects postpartum sleep. Pain may come from several sources including breastfeeding, uterine contractions, abdominal muscle strain, or perineal pain, which results from tears or episiotomies (surgical incisions) during vaginal childbirth.

Postpartum insomnia, in turn, can lead to depression and anxiety and conversely such changes in mental well-being can affect postpartum sleep.

Treating postpartum sleep issues

Fortunately, there are ways to treat or manage postpartum insomnia. Lifestyle modifications are a start, which includes avoiding caffeine and alcohol later in the day, both of which are known to cause problems with sleep. Eating late can disrupt sleep as well. The goal should be to finish the last full meal of the day two to three hours before retiring for the night.

Another treatment for postpartum sleep problems is cognitive behavioral therapy. This approach can help a person address thoughts and behaviors that interfere with sleep and work on mindsets and practices that promote healthy sleep. Someone who experiences insomnia during pregnancy might want to begin cognitive behavioral therapy before the baby is born.[3] Overseen by a therapist, common components of cognitive behavioral treatment for insomnia include stimulus control, sleep restriction, relaxation techniques, cognitive restructuring, and sleep hygiene education.[4]

Massage as a component of postpartum insomnia

Because inadequate quality postpartum sleep is a risk for developing postpartum depression, researchers conducted a review in 2018 to determine if non-pharmacological interventions improved maternal postpartum sleep and to compare the effectiveness of the diverse types.

Researchers found that among the non-pharmacological sleep interventions that improved subjective reports of maternal sleep, massage and exercise interventions had the largest impact. Researchers, however, concluded that there should be more research on the durability of non-pharmacological interventions using objective measures of sleep quality. [5]

Key benefits of massage for sleep

·         Massage helps improve sleep because it lowers cortisol, the primary stress hormone, and increases calming neurotransmitters to decrease anxiety.

·         Massage can help ease pain and muscle tension in arms, lower back, shoulders and hips and improve blood flow to healing tissues, which helps improve sleep.

·         Massage eases fatigue and promotes relaxation to improve sleep. Research indicates massage therapy contributes to an increase in delta brain waves, which are those that accompany deep sleep.[6]

When to offer postpartum massage

Clients should check with their doctors about when it is safe to begin postpartum massage. Many people begin massages within 1-2 weeks after a normal birth or when their doctor clears it. Clients who have had C-sections can have postpartum massage but should wait after the incision heals and they have approval from their medical provider. [7]

American Pregnancy Association says that any position is safe after delivery but the position should accommodate a client’s comfort and the type of treatment. Some clients will want to be face-down after almost nine months of lying on their side, the Association says. However, others may be uncomfortable because of breast discomfort or milk leakage. Lying on the side can be most comfortable and effective when treating shoulders, pelvis, and legs. [8]

You may have clients may want to bring their newborns to the session. That is something you and your client can work out. Postpartum massage can be a key part of a client’s post-delivery recovery aiding mental and physical well-being and contributing to a much needed good night’s sleep.