Your Ultimate Guide to Pregnancy and Sleep

Pregnancy can be the beginning of an exciting journey for soon-to-be parents, but it can also signal the beginning of some new sleep challenges. 

Understanding how the stages of pregnancy impact your sleep will help you and your family stay ready to enter this new (and sometimes a tad overwhelming!) phase of life with as much energy as possible. 

How Does Pregnancy Affect Sleep?

When you ask a pregnant person how they’re feeling, one of the most common answers you’ll hear is “tired.” In fact, studies show an overall increase in sleep time and daytime sleepiness throughout the duration of pregnancy and especially during the first trimester. So if you’re finding that you can suddenly barely keep your eyes open, trust us that you’re not alone in this. 

Other ways pregnancy might impact your sleep can include: 

• Difficulty getting comfortable
• Frequent trips to the bathroom 
• Leg cramps 
• Back pain
• Breast tenderness
• Vivid dreams 

Common Sleep Disorders During Pregnancy

Thanks to the different physical changes happening during pregnancy, you may be more susceptible to some common sleep disorders. However, this doesn’t mean you’re doomed to nine months of sleepless nights — most of these disorders are easily treatable. 

Obstructive Sleep Apnea

We all know pregnancy means a lot of changes happening to the body, but most people don’t realize those changes can lead to sleep apnea, a common disorder that creates a pause in breathing during sleep. This is due to the higher levels of estrogen and a change in tissue around the neck that can lead to restricted air flow. Symptoms of sleep apnea include: 

• Weight gain
• Loss of sleep
• Snoring
• Feeling restless during sleep 
• Headaches upon waking 

The good news is sleep apnea is incredibly common and very treatable, with treatments  including: 

• CPAP. CPAP machines, or a sleep apnea machine also known as a continuous positive airway pressure device, enables oxygen to enter the lungs by promoting air flow into the blocked airway. 
• Oral appliances. Oral appliances are typically prescribed to people with mild sleep apnea and work like a mouth guard by pulling the jaw and tongue forward and opening the airway. 

Even better, there’s evidence that sleep apnea often improves or resolves post-birth, so it’s likely this isn’t a permanent condition new moms have to contend with. 

Restless Leg Syndrome 

Since pregnancy disrupts sleep, expectant moms may be at risk for restless leg syndrome, a condition marked by general discomfort and an uncontrollable urge to move the legs. 

One of the most common symptoms is increased sensation while sleeping — this can feel like throbbing, aching, itching, or twitching at night. 

If this sounds like you, try slow, gentle movement for relief. A nice wind-down routine may also help. Try adding a warm bath, meditation, or a gentle yoga routine to your before-bed routine. 

Gastroesophageal Reflux Disorder

Even though many expectant moms already have to deal with morning sickness, that isn’t always the end of it when it comes to stomach discomfort. Gastroesophageal Reflux Disorder (GERD), refers to a digestive disease where the food pipe lining is irritated by stomach acid or bile. 

Symptoms of GERD include: 

• Burning chest pain that occurs after eating
• Trouble swallowing
• Discomfort in upper abdomen 

Treatments for GERD include: 

• Elevating your head during sleep by raising the head of your bed six to eight inches via a pillow or bed risers.
• Talk with your doctor to explore medications such as antacids, H2 receptor blockers, or proton pump inhibitors.
• Keeping track of dietary triggers such as high fat foods and modifying food intake accordingly — we know this one can be a challenge thanks to pregnancy cravings, but it can make a big difference!
• Pace yourself as you eat—eating too quickly can trigger the condition. 
• Avoid laying down right after eating. 

Insomnia 

Remember how we said most expectant moms will freely admit to feeling tired? It’s true — the struggle to sleep while pregnant is real, with approximately 80 percent of pregnant women experiencing insomnia that peaks in the third trimester. Everything from heartburn to a growing baby belly can lead to discomfort and make it harder to get some quality shut eye. 

Symptoms of insomnia include: 

• Difficulty falling asleep
• Not feeling well-rested
• Frequent awakening during the night 

Treatments for insomnia include: 

Building A Better Sleep Routine

Your sleep routine can make all the difference when it comes to the quality and amount of sleep you’re getting each night. For example, if you sleep comfortably after a bubble bath and a meditation session, but you’ve nixed both because of busyness or exhaustion, your sleep routine could probably use a tune up. Try to build a healthy sleep routine for yourself — check out our guide to practicing good sleep hygiene. 

Cognitive Behavioral Therapy

Consider trying cognitive behavioral therapy (CBT), a psychotherapy technique that aims to reduce mental health symptoms. Different from talk therapy, CBT focuses on changing different behaviors that can lead to a better night’s sleep. 

Meditation

Meditation is catching on for a reason — there’s a good deal of science behind how it can help you sleep better. A study in the journal Obstetric Medicine found that meditation may help insomnia during pregnancy. For anyone who is newer to meditation and could use some guidance, there are apps available that can help you get a jumpstart. 

Though sleeplessness can quickly start to feel a lot like hopelessness, there’s a light at the end of the tunnel: Insomnia may continue into the “fourth trimester,” but many new moms will find themselves sleeping better post-birth with the help of solid sleep hygiene.

Anxiety

Getting pregnant and having children can be a huge change. Even if it’s not your first pregnancy, you’ve likely got a lot on your mind: your body’s changing every day, you’re eager to meet your new addition, and you’ve probably got a long to-do list of things to do and buy ahead of you (babies are adorable, but there’s no doubt they require a lot of stuff). So it’s no wonder that anxiety during pregnancy is extremely common. Luckily, it’s also extremely treatable. 

Not sure if you’re experiencing anxiety? A few common symptoms include: 

• Worry
• Discomfort 
• Fear 
• Sense of panic 
• Being flooded with overwhelming thoughts 
• Loss of appetite 
• Struggle to concentrate 

There are several ways to treat anxiety during pregnancy. Some common options include: 

Psychotherapy (also called talk therapy)

As you might have guessed from the name, talk therapy focuses a lot on working with a therapist to talk through your specific problems, possible causes, and also solutions. 

Cognitive Behavioral Therapy (CBT)

As we mentioned earlier, cognitive behavioral therapy differs from talk therapy in that it tends to focus more on specific behavior modifications you can implement to help reduce insomnia. 

As part of your treatment, your doctor or healthcare provider may recommend you limit your time in bed to a certain number of hours, use a sleep journal before bed, or go to bed only when sleepy. They’ll work with you to develop a CBT plan tailored to your specific needs. 

Relaxation techniques

Some research has suggested that meditation and breathing exercises may reduce some symptoms associated with anxiety, like racing thoughts — and that, in turn, may help you get better quality sleep. Your doctor may also suggest specific relaxation techniques as part of CBT. 

Medication

Medication is another safe, effective treatment option. If you were prescribed a specific anxiety medication before pregnancy, your doc may recommend you keep taking it throughout your pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG). 

Your doctor might also recommend medication if you’ve tried therapy and it hasn’t helped. Not comfortable with the idea of taking medication during pregnancy? Talk to your doctor, who will be able to help you sift through all the options and figure out the right one for you. 

Why Is Sleep So Important During Pregnancy? 

Sleep is important all throughout our lives, but it can play a unique role during pregnancy, too — getting adequate sleep while pregnant can affect parental health, the baby’s health, and even labor.  

Sleep’s Impact On Mom’s Health 

Though all eyes might be on the baby post birth, research suggests that sleep deprivation in parents contributes to postpartum depression. All the more reason for pregnant mamas to make sure they’re prioritizing themselves even when it seems like everything has shifted to focus on the baby.

Sleep’s Impact On Baby’s Health

If you’re struggling to prioritize sleep for yourself, you might consider doing it for your baby. A study published in the journal Sleep indicates that lost sleep during pregnancy is associated with higher blood pressure and body mass index for offspring. 

Sleep’s Impact On Labor And Delivery

We all want to have the most comfortable, safe, and fast labor possible — and sleep might be the way to get there! Research suggests that sleep deprivation during pregnancy has been associated with:

• Longer labor
• Elevated perception of pain and discomfort during labor
• Higher cesarean rates
• Preterm labor

If you’re hoping to breeze through labor, we recommend catching up on those Zzz’s when you get the chance. 

How Many Hours Of Sleep Does A Pregnant Woman Need? 

There’s an idea that a pregnant person is “eating for two” — well, some experts say pregnant people are “sleeping for two.” With the need for more rest during this crucial time, one study recommends at least eight hours of quality sleep per night. Many physicians recommend eight to ten hours of sleep per night during pregnancy. 

Above all, tune into how you feel and get more rest if needed. 

Sleep Hygiene Tips To Help Through Pregnancy 

Though sleep might feel more and more out of reach as your pregnancy progresses, there are some ways to increase your chances of getting some quality shut eye, including:  

• Keep the room cool and dark 
• Follow a consistent, relaxing bedtime routine
• Start trying to sleep on your side early in the pregnancy 
• Stay hydrated 
• Block out sound using white noise 
• Avoid blue light 
• Avoid heavy meals before bed
• Reserve the bed for sleep and sex only — or other relaxing activies you know won’t keep you up
• Try not to have liquids before bed 

Sleep Products To Help Through Your Pregnancy

Try Blackout Curtains: Here’s our guide to the best blackout curtains. Check out this review of Nicetown Curtains from a mom who tried them while pregnant and appreciated the color choices and the price point.

Consider Pregnancy Sleep Pillows: Check out our guide to the best pregnancy pillows. We love the Queen Rose pillow for the back support it offers. 

Try A Knee Pillow: Some medical professionals suggest using pillows in-between the knees for comfort. The Cushy Form Knee Pillow is a great pick because it’s specifically designed to align the spine for a more relaxed sleeping position that relieves overall pressure on the body. 

Think About Your Mattress: Here’s our guide to the best mattress for your pregnancy. For pregnant folks, we recommend the Saatva Mattress as it provides some additional pressure relief and is cooling, which is good news for anyone facing hot flashes or night sweats. 

How To Sleep In Your First Trimester (1 to 3 months) 

In addition to facing increased fatigue during the first trimester, you may also encounter insomnia early in your pregnancy. 

The first trimester is a good stage to experiment with baby pillows to help with discomfort and find one that works well for you. It’s also a good time to explore sleep hygiene routines such as limiting light exposure and trying yoga before bed to determine what habits help you fall and stay asleep. Learning to get comfortable in bed with a growing belly is key to helping combat potential insomnia. 

According to Dr. Natalie Dautovich PhD, Environmental fellow at National Sleep Foundation and Assistant Professor at Virginia Commonwealth University, hormone levels change during the first trimester of pregnancy, impacting sleep. She says, “Hormonal changes can also affect muscle tone during the night, which can lead to snoring and sleep apnea.”

Sleeping on your side may help combat snoring and keep the baby safe. Research suggests that sleeping on the left side in particular has been shown to help combat the symptoms of sleep apnea by encouraging blood flow. According to the American Pregnancy Association, sleeping on the back and stomach should be avoided when possible. 

How To Sleep In Your Second Trimester (4 to 6 months)

The second trimester, Dautovich says, often comes with good news: better sleep for mom! Though even as you get used to sleeping with a baby bump, you may still face hormonal changes affecting muscle tone, snoring, and sleep apnea. 

As with the first trimester, sleeping on your side and avoiding sleeping on the back and stomach is recommended in the second trimester as well. 

Some people find that chin straps help reduce their snoring. Here’s our guide to the best ones. 

How To Sleep In Your Third Trimester (7 to 9 months) 

“Insomnia can increase during the third trimester due to physical discomforts such as back pain, leg cramps, or heartburn,” says Dautovich. 

Studies show cognitive behavioral therapy (CBT) can help reduce insomnia in 80 percent or more of patients who complete treatment. A 2017 study found that pregnant women had significant reductions in insomnia while enrolled in a five-week trial of weekly CBT therapy sessions. 

While side sleeping is preferred to back and stomach sleeping in the first two trimesters, it is relatively safe to end up sleeping on your back until you hit the 20 week mark in the third trimester when back sleeping should be especially avoided. While rare, the risk for stillbirth can be higher while sleeping on the back, according to a meta analysis paper published in The Lancet. 

Sleep in the third trimester may also be disrupted by frequent trips to the bathroom (we’ve all been there). As you get closer to birth, you may feel the baby moving more at night, which might also contribute to less sleep. 

Here are Dr. Dautovich’s tips for improving sleep in the third trimester: 

• Sleeping on your left side helps to improve the flow of blood and nutrients to the fetus. Consider using pillows to position your belly, legs, and back for optimum comfort.

• When you do experience wakefulness during the night, avoid lying awake in bed. If possible, get out of bed and engage in a relaxing activity until you feel sleepy again. Trying to “force” sleep or focusing on how much sleep you’ve obtained (and the potential next day consequences of not sleeping) will backfire and prevent you from sleeping.
• Avoid bright light in the evening (especially from electronic devices) and expose yourself to sunlight in the morning to keep your circadian rhythm in check.

How To Sleep In Your Fourth Trimester (12-week period after giving birth)

The 12-week period after giving birth can be one of the most challenging periods when it comes to rest for the following reasons, according to Dautovich: 

• Frequent infant awakenings 
• Adjustment to new roles 
• Hormonal fluctuations 
• Recovery from the birthing process 

New parents might expect a certain degree of sleeplessness in the fourth trimester, but that doesn’t mean there aren’t tools available to try to get adequate rest. 

If support is available to you, Dautovich says to consider trading off care for your baby in the evening to a spouse, babysitter, night nurse, or other caregiver “to maximize your longest sleep period in order to obtain some deep and REM sleep so you can feel more physically and mentally restored.” 

In many cases, parents do not have additional caregiving support. Here are two courses of action Dautovich recommends trying: 

• Try to compensate for missed nighttime sleep by taking light naps during the day when the baby is napping. 
• Even as you incorporate daytime rest, be sure to keep your body clock regulated by exposing yourself to bright, outdoor light in the morning and minimizing bright light (especially from electronics) in the evening. 

The Last Word From Sleepopolis 

With so much on your plate as a new parent, try to be gentle with yourself when it comes to sleep. Remember: This period of life is only temporary. With some adjustments and experimentation, you (and your baby) can get the rest you need.