The term ‘morning sickness’ has been the phrase used to describe nausea and vomiting that is associated with pregnancy for roughly the past 200 years,1 but can be misleading, because ‘morning sickness’ can also occur at night, or any time of the day.
Nausea and vomiting occur in up to 74% of pregnancies, with 50% experiencing just vomiting (without nausea). 2
This translates to roughly 4 million women in the US and roughly 350,000 women in Canada experiencing nausea and vomiting during their pregnancy each year. 3
Though referring to nausea and vomiting that occurs with pregnancy as just ‘morning sickness’ is misleading, as they both can occur at any time of the day. 4
Eighty percent of women report that their symptoms last all day, with less than two percent reporting symptoms that occur solely in the morning. 2
A questionnaire (the Pregnancy Unique Quantification of Emesis or PUQE) was developed to rank the severity of ‘morning sickness’ and is based on three things:
- Duration of nausea (given in hours) (ranked on a 1 to 5 scale)
- Number of vomiting episodes (ranked on a 1 to 5 scale)
- Number of retching episodes (ranked on a 1 to 5 scale)
The higher the total number, the more ‘severe’ the symptoms are considered. The original range goes from ‘mild NVP’ (3 to 6 points), ‘moderate NVP’ (7 to 12 points), and ‘severe NVP’ (13 to 15 points). 5 One group divided the mild into two separate groups of ‘no NVP’ (score of 3) and ‘mild NVP’ (4 to 6 points), during a study done in Finland. 6
Morning sickness usually resolves itself by the end of the first trimester for 60% of women, and 87% of the remaining cases resolve themselves by 20 to 22 weeks. Though there are some women who have morning sickness throughout their entire pregnancies. 2,3
Nausea has been frequently reported as a symptom of sleep disturbance during the first three months of pregnancy, and the more severe the nausea the less sleep the woman was getting. 6
Though there are several different home remedies for morning sickness at night that one can try, and they include:
Having a small snack at bedtime, and possibly when you get up to go to the bathroom in the middle of the night.7
- Drinking ginger tea or ginger ale before bed.7
- Having good airflow in the house to reduce odors.7
- Having crackers nearby to eat before getting out of bed in the morning. 7
Morning sickness at night can occur frequently, and keeping a ‘nausea’ journal to take with you to your doctor can help. It helps you advocate your position, details your nausea and vomiting, and can help your doctor develop a tailored treatment plan for dealing with the symptoms.
Morning sickness at night may resolve itself once you are through your first few months of pregnancy, and though if it doesn’t you should make an appointment with your doctor.
References:
(1) Gadsby R, Ivanova D, Trevelyan E, Hutton JL, and Johnson S. (2020) “Nausea and vomiting in pregnancy is not just ‘morning sickness’” British Journal of General Practice DOI:https://doi.org/10.3399/bjgp20X710885
(2) Herrell, H. (2014) “Nausea and Vomiting of Pregnancy” American Family Physician 89(12): 965-970
(3) Lee NM, and Saha S. (2011) “Nausea and Vomiting of Pregnancy” Gastroenterology Clinics of North America 40(2): 309-334
(4) FAQs for Morning Sickness: Nausea and Vomiting of Pregnancy. The American College of Obstetricians and Gynecologists online: https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-pregnancy Visited August 12, 2021
(5) Ebrahimi N, Maltepe C, Bournissen FG, Koren G. (2009) “Nausea and Vomiting of Pregnancy: Using the 24-hour Pregnancy-Unique Quantification of Emesis (PUQE-24) Scale” Journal of Obstetrics and Gynaecology Canada 31(9):803-807
(6) Laitinen L, Nurmi M, Rautava P, Koivisto M, and Polo-Kantola P. (2021) “Sleep quality in women with nausea and vomiting of pregnancy: a cross-sectional study” BMC Pregnancy and Childbirth 21:152
(7) Smith JA, Fox KA, and Clark SM. “Nausea and vomiting of pregnancy: treatment and outcomes” UptoDate(online) https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome Visited August 12, 2021
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