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I Can’t Sleep!

After a Pregnancy Loss, Difficulty Sleeping Is a Common Problem

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Updated March 08, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

I Can’t Sleep!
Photo © Patrick Coughlin/Getty Images

You lie down at night, and you just can’t seem to turn your brain off. Thoughts of your baby, of your sadness, of what might have been, all prevent you from falling asleep as you normally would. The problem gets worse when you start doing "sleep math," figuring out how many hours you’ll get if you could only fall asleep now.

Or maybe you’re so exhausted you fall asleep the moment your head hits the pillow only to find yourself wide-awake after just a few hours. You spend the early morning hours wondering if you’ll fall back asleep, and how long you have to lie in bed before it’s acceptable to get up and face the day.

You’re not alone.

Grief is an all-encompassing experience. It affects everything from your ability to think clearly to your immune system’s ability to fight off illness. One of the most common experiences of grief is trouble sleeping.

It’s one of the terrible ironies of grief that just when your body and mind could use more of the restorative properties of sleep, you can’t get enough. You’re probably already feeling more tired than usual during the day -- fatigue is another one of the symptoms of grieving. When you add trouble sleeping at night to that problem, it can feel like you’re never going to be well-rested and alert again.

So what do you do if you can’t sleep?

First of all, give yourself permission to grieve. It’s a normal, healthy reaction. As writer Paul Bennet said, "Grief is the inevitable consequence of love." It is because we love that we feel the pain of loss, and that is a noble thing. So, it’s OK that you’re feeling sad, and experiencing the mental, psychological, emotional, and physical symptoms of grief.

If you’re trying to suppress your feelings of grief, or trying to follow other people’s misguided advice to "move on," you may find those feelings sneaking up on you in the quiet moments before sleep. Letting yourself grieve consciously may be the first step in calming your mind enough to get some rest at night.

However, there will be times that acknowledging your grief is simply not enough to get you the sleep you need. When that happens, there are some strategies you can try.

Before Bed

  • Cut out caffeine. Although your instinct may be to drink coffee or cola to keep yourself awake during the day, caffeine can interfere with your ability to fall asleep.

  • Avoid alcohol. Drinking can also interfere with your ability to sleep. Even though it’s a depressant, alcohol can disrupt your sleep in many ways. It can also make the physical symptoms you’re already experiencing worse in the morning through its dehydrating properties.

  • Follow a routine. Going to bed at the same time every night, and getting up at the same time every morning, will help your body get the cues it needs that now is the time for sleep.

  • Try quiet activities. Many of us are guilty of watching TV before bed, or even in bed. If that’s your usual habit, you might try something less noisy and stimulating. Reading, or a calming craft like knitting or needlepoint, may help lull your mind.

  • Be more active during the day. A little exercise can go a long way toward making you more physically tired. Exercise also releases endorphins to elevate your mood and may keep the blues at bay. Just be sure you’re done exercising at least 4 hours before bed.

  • Get comfortable. Make sure the room is the right temperature for you. Try a warm shower or bath before climbing in bed. Ask your partner to give you a massage before bedtime.

  • Try journaling. Keeping a grief journal can be beneficial for so many reasons. Taking 15 minutes to jot down your thoughts and feelings before bed may help "get it off your chest" and clear your mind before bed.

Tricks for Getting to Sleep

  • Breathe deeply. Simply lying in bed and taking slow, measured breaths can be a wonderful way to clear your mind and relax your body. Try breathing in for a count of five and breathing out for another count of five. Focusing on your breath and repeating those numbers might be all you need.

  • Use guided imagery. Imagining your breath penetrating into all the corners of your body or taking a journey in your mind through a calming environment can be relaxing all on its own, not to mention helping you get to sleep. There are guided imagery CDs available for almost everyone’s tastes.

  • Try progressive muscle relaxation. While lying on your back in a comfortable position, begin with your toes and flex your muscles. Let them relax and move up to the bottoms of your feet. Slowly work your way through all the muscles of your body, tightening them and releasing until your entire body feels like it’s sinking into the mattress.

  • Focus your mind with a simple game. Count backwards from 1000, or try to think of a word for each letter of the alphabet that goes with a simple theme, like Colors, Places I’ve Visited, Movies, etc. Engaging your mind with a task that requires attention, memory, and patterning can prevent you from getting into the kinds of thoughts that keep you awake.

Sleep Aids

  • Warm milk: It really works. If you’re not a milk drinker, you may find some of the same soothing effects from a different, non-caffeinated warm beverage like decaf tea or hot water with lemon and honey.

  • Aromatherapy: There are several scents that are especially beneficial for sleep. Eucalyptus, lavender, and chamomile are particularly soothing.

  • Herbal remedies: Several herbal treatments are used for sleep, such as valerian and melatonin. Always consult with a physician before beginning an herbal supplement, as some are known to interfere with prescription medications.

  • Prescription medications: Not sleeping enough can be very detrimental to your health. If none of the tips above help, or if you think your inability to sleep is affecting your ability to be safe during the day (behind the wheel, at your job, or caring for children), talk to your doctor about a short-term prescription for a sleep aid. Many of the newest medications are less habit-forming than older sleeping pills, and may get you the rest you need as you work through the worst of your grief.

If You Wake Up In the Middle of the Night

  • Try, try again. Going back to one of the simple techniques above may be enough to send you back to dreamland.

  • Reset yourself. Get up out of bed, and try restarting your bedtime routine. Use the restroom, brush your teeth again, whatever you need to do. Just finish your routine back in bed and see if you fall asleep.

  • Don’t watch the clock. If you’ve got a clock facing your bed, you’ll only count the minutes as they pass. Turn it away, or get rid of it altogether.

  • Don’t pressure yourself. If you’re not falling asleep, don’t let it stress you out. Adrenaline from worrying will only make sleep even more elusive. Get out of bed, go into another room and try a quiet activity for a while. Don’t even think about sleeping. Think of it as the perfect time to catch up on a favorite TV show, or read one more chapter of that novel. You may find yourself getting drowsy as soon as you take the pressure off yourself to fall asleep.

  • Remember, it’s only one day. There will be times you just don’t fall asleep. Resign yourself to being exhausted the next day, but remember, you can just try again tomorrow night. The good news is, you’ll probably be so tired after not sleeping the night before, it’ll be a lot easier to get some shut-eye tonight.

Sources:

Church, Lisa. Hope is Like the Sun. 2004.

National Institutes of Health. Insomnia. National Heart Lung and Blood Institute Condition Index. Accessed: 6 Mar 2012.

National Sleep Foundation. Healthy Sleep Tips. Sleep Topics. Accessed: 6 Mar 2012.

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