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Проблемы сна во время беременности


Я акушер-гинеколог. Когда мы с мужем узнали, что у нас будет малыш, я решила что будет просто стыдно, если у меня будут какие-то проблемы, ведь доктор должен сам претворять в жизнь свои рекомендации. Я работала, гуляла, делала гимнастику, но было одно «но». Появилась повышенная сонливость. Было понятно, что с развитием беременности в организме происходят гормональные изменения, повышается уровень прогестерона. Этот гормон вырабатывается в жёлтом теле яичника. Он готовит матку к имплантации эмбриона, стимулирует развитие молочных желез, поддерживает доминанту беременности в центральной нервной системе и подавляет иммунитет. Прогестерон так же способствует задержке солей и жидкости в организме и угнетает психику, что проявляется подавленностью, раздражительностью и сонливостью. Начиная с 10 недель беременности, начинается активная гормонопродуцирующая функция плаценты. В соответствии с увеличением срока беременности и ростом плода кроме прогестерона повышается уровень эстрогенов, оказывающих стимулирующее действие на психику, и сонливость проходит. Но я не могла ждать.

После того как я, словно спящая красавица, уснула на работе, пришлось принимать меры. Мой любимый крепкий кофе пришлось отвергнуть. Его заменил зелёный чай, оказывающий прекрасный тонизирующий эффект и контрастный душ, заканчивающийся прохладной водой. Регулярная утренняя гимнастика, прогулки, из препаратов: таблетки аралии маньчжурской (элеутерококка) по 1 таб. 2 раза в день вернули жизненный тонус.



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Беременность развивалась благополучно, ребёнок начал шевелиться, а мне стали сниться удивительные, прекрасные сны. Из институтских лекций я помнила, что во сне происходят процессы накопления энергетических запасов, регенерации, пластического обмена, восстанавливаются истощенные за день ресурсы. Во время сна меняется температура, пульс, давление, характер нервной деятельности, а сам сон имеет несколько фаз, которые меняются циклически с периодичностью 90-120 минут. При записи биотоков мозга спящего человека были обнаружены чередующиеся фазы медленного, или ортодоксального, и быстрого, или парадоксального, сна. Такие циклы повторяются за ночь 4-6 раз. В свою очередь фаза медленного сна состоит из четырёх стадий. Первая стадия соответствует дремоте. Мышцы расслабляются, но сознание ещё работает. Биоритмы мозга нерегулярные и быстрые. Вторая стадия представляет собой начало собственно сна. Третья и четвёртая являются глубоким, или дельта-сном. Во время него ритмы мозга постепенно замедляются, прекращается реакция глаз на внешние раздражители, организм погружается в состояние глубокого покоя. Органы чувств не реагируют на окружающее. Затем все изменения происходят в обратном порядке, но не до полного пробуждения, а до фазы быстрого сна. Зрачки глаз начинают быстро двигаться, поднимается температура тела и кровяное давление, дыхание становится более частым и менее регулярным, желудочный сок и адреналин выделяются быстрее. Если в этот момент записать энцефалограмму, то электрические импульсы мозга будут аналогичны биоритмам, отражающим дневную жизнь. Но это особое состояние организма, как бы обращённое вовнутрь. Именно поэтому фазу быстрого сна называют парадоксальным сном. В этой стадии снятся сны. Продолжается она около 10 минут, вновь сменяясь глубоким сном.

Когда мы спим, в организме начинают вырабатываться различные гормоны. Некоторые из них запасаются для времени бодрствования, другие расходуются во время сна. Возрастает подача биологически активных веществ семейства аминов, они накапливаются в различных клетках и клеточных группах мозговой ткани. Именно поэтому при болезни нужно вдоволь выспаться, чтобы организм мог сосредоточиться на восстановительных процессах.

Время шло. Я легко носила свое сокровище, которое периодически чувствительно толкало меня под печень, но стала плохо спать. Всего доктора выделяют три основных типа бессонницы. Первый – так называемая стартовая бессонница, когда человек долго не может уснуть, вспоминая события дня, переживая мысли о том, что ему следовало бы сделать или сказать, или беспокоясь о будущем. Второй тип – неспособность сохранить состояние сна. Такой человек просыпается многократно на протяжении ночи и на различные промежутки времени. Это состояние приводит к делению сна и не позволяет получить глубокий отдых. И третий тип, при котором человек просыпается ранним утром и не способен снова уснуть, – бессонница заключительной фазы.

При беременности чаще встречаются проблемы с засыпанием или стартовая бессонница. Мне никак не удавалось удобно устроить выросший живот. Беспокоили боли в спине и пояснице, судороги в икроножных мышцах и частые ночные позывы к мочеиспусканию (так как увеличившаяся матка стала давить на мочевой пузырь). Хорошо, что у меня не было изжоги, одышки и зуда в области живота из-за растяжения кожи, которые беспокоят беременных. Хотя эти проблемы устраняются диетой, дополнительной подушкой под верхнюю часть туловища, смазыванием кожи живота косметическим маслом или кремом.

После трёх бессонных ночей в голову начали упорно лезть мысли об исследованиях, которые проводились с целью уточнения суточной потребности организма человека во сне. Люди, которым не давали спать, ели больше обычного, и хотя сначала прибавляли в весе, потом начинали худеть. После 2-3 дней бессонницы у испытуемых начинала снижаться температура тела примерно на 0,5 градусов в сутки, терялась сосредоточенность, изменялись зрительные и речевые способности, а на 4 сутки появлялись галлюцинации и дрожание рук.

Экспериментально установлено, что суточная потребность организма человека в сне –10 часов (именно столько спят человекообразные обезьяны). Важно помнить, что различным людям требуется разное количество сна, в зависимости от физического состояния и типа личности. В наших условиях, человек спит в среднем по 7,5 часов. При этом недосыпание составляет 2,5 часа. Компенсировать «сонный долг» могут только два или три полноценных (10 часовых) сна. Нехватка сна за неделю в 7-8 часов могут стать причиной чувства тревожности, депрессии, зуда или жжения в глазах, затуманивания зрения, озноба, быстрой утомляемости, повышенного аппетита, нежелания общаться, раздражительности. В результате постоянного недостатка сна снижается иммунитет, так как антитела, которые борются с инфекцией, вырабатываются в больших количествах во время сна. Нейропсихолог Стенли Корен считает, что хроническое недосыпание может привести к преждевременной смерти.

Вся эта информация была не очень жизнеутверждающей. Утешало только, что в своей проблеме я была не одинока. С течением беременности постепенно активизируются подкорковые структуры головного мозга, возникает торможение коры, формируется доминанта родов. Женщины становятся спокойнее, но многим не дают уснуть нервное напряжение из-за страха перед родами, хроническая усталость. Психологические причины бессонницы ликвидируются режимом дня, физическими нагрузками (гимнастика для беременных, плавание, прогулки), отказом от дневного сна. Иногда беременным снятся кошмары, являясь отражением скрытого страха и беспокойства о течении беременности. Снимает тревожность понимание и знание о том, что с тобой происходит, как развивается ребёнок. В этом могут помочь курсы для будущих мам. Нужно обсудить плохой сон с близким человеком. Рассказав о проблеме, проще с ней справиться. Так же снять стресс помогут занятия с психологом. Что же касается толкования сновидений- то, как пишет Л. Шепперд в книге «Загляни в свои сны»: «Сновидения о рождении приходят к нам в переломные моменты, когда мы начинаем новый виток жизни или открываем в себе новые аспекты».

Из лекарственных препаратов лечащий врач порекомендовала глицин по 2 таблетки под язык перед сном. Снотворные препараты были отвергнуты из-за побочных эффектов, возможности накапливаться в организме, нарушать функции печени и почек. Химические снотворные, седативные средства и транквилизаторы в той или иной степени нарушают структуру сна, лишая его естественной глубины. Тем самым снижается восстанавливающее действие сна. Этих отрицательных эффектов в значительной степени лишены растения, из которых при беременности можно применять пустырник, валериану. Хорош чай, состоящий из померанца, лаванды, мелиссы, солодки или чабера, чабреца и мяты. Нежелательно использовать в отварах хмель, так как он ядовит. Из пищевых растений для снижения нервной возбудимости и улучшения сна используют салат огородный, спаржу, дыню. Сок репы с мёдом, сок редьки с мёдом по 1 столовой ложке 3 раза в день. Сок свеклы с мёдом по ½ стакана 3-4 раза в день. Настой из травы сельдерея: 20 грамм измельчённого сырья на 1 стакан кипятка, настоять 30 минут, процедить и принимать по ½ стакана 3 раза в день. Плоды чёрной смородины и сок тыквы с мёдом по 1/3стакана на ночь также используются в народной медицине как успокаивающее средство.

Желательно не переедать перед сном. При этом о качественном составе вечернего приёма пищи существуют два мнения. Одни учёные – считают, что белковые продукты (мясо, сыр, молоко, яйца, индейка) способствуют сну, поскольку содержат L-триптофан. Это вещество сокращает время засыпания, поэтому лёгкая, богатая белком закуска, поможет уснуть, несмотря на недостаток времени для её переваривания. Другие рекомендуют на ночь углеводистую пищу, которая быстро переваривается, не вызывая сильной перистальтики кишечника и возбуждения нервной системы. Я старалась не есть на ночь, а выпивать перед сном стакан тёплого молока или ромашкового (мятного) чая с 1 чайной ложкой мёда.

Проветривание спальни, удобная пижама, тридцатиминутная прогулка перед сном, три подушки: под бок, под шею и между ногами (к сожалению, у меня не было специальной клиновидной подушки для беременных) облегчили положение. Для снятия боли в пояснице и судорог в икроножных мышцах муж делал мне массаж спины, стоп и голеностопных суставов. Также помогал отдых на полу на ковре с подложенным под поясницу валиком и комплекс упражнений на чередование напряжения и расслабления мышц.

Для улучшения сна я использовала ароматерапию. Авиценна рекомендовал: «Ромашка – снотворное средство. Если нюхать её свежую, она усыпляет». Можно сделать снотворную подушку, набив её гречневой шелухой или тимьяном, листьями лавра благородного или орешника (лещины), цветами бессмертника, хвоёй сосны, шишками хмеля, травой герани, лепестками розы. У меня была с травой мяты и душицы. Тёплая ванна с добавлением эфирных масел: лавандового, мятного, ромашкового, апельсинового или отваров цветов календулы, травы череды, мяты, душицы и дыхательные упражнения на релаксацию также помогли восстановить сон.

Сейчас я счастливая мама и проблемы с бессонницей кажутся такими далёкими. Ночью, когда я убаюкиваю сына, и глаза закрываются сами, муж тихонько трогает меня за руку и шёпотом просит: «Мама, котю…» И я в полусне снова начинаю петь колыбельную песню: «Котик, котик приходи, мою детку усыпи». Потом спохватываюсь, что ребенок у меня ещё не умеет говорить, открываю глаза и встречаюсь с виноватым взглядом мужа. «Твоя колыбельная так хорошо помогает при бессоннице», – шепчет он мне.

Врач акушер-гинеколог Елена Шамова
Школа «Современные родители»

По материалам сайта www.sibmama.ru


  


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