If you’re pregnant you’ve almost certainly heard that a healthy diet and the right amount of exercise are the pillars of a healthy pregnancy. But have you considered the importance of proper sleep?
If not, it’s time to start thinking about the third pillar of pregnancy health. Without quality sleep, you’ll be sleepy in the day and that can affect your ability to work and your enjoyment of life. Checking sleep-related problems like breathing pauses and snoring is important for your health and for the healthy development of your baby in the womb.
But with all the pregnancy changes sleep can be harder to get and less refreshing when you do get it. Even if you’ve never had problems sleeping before, you may find yourself tossing and turning at night during pregnancy. And you’re not alone – about 4 in 5 women experience more disturbed sleep in pregnancy.
Sleep related changes in pregnancy
When you’re pregnant, chances are you won’t sleep as deeply and you’ll find yourself waking up in the night more often. At the end of the day you’ll need to make sure you get a bit of extra sleep to make up for that. The medical term for difficulty sleeping is insomnia, and it refers to everything from difficulty falling asleep at night to trouble maintaining good quality sleep (e.g. waking up too early or not sleeping deeply enough).
Even if you’re getting plenty of sleep there are times during pregnancy that you can expect to feel more tired than you usually would. While feeling tired can be frustrating and concerning, rest assured it’s completely normal and nothing to worry about. Your body is simply telling you to get plenty of rest.
Women often feel pretty exhausted in the first trimester. Changing hormone levels, in particular the increasing levels of progesterone needed to maintain the pregnancy, may make you feel tired in the day, even if you do manage to get a good night’s sleep. Most women feel well and have plenty of energy in the second trimester, but begin to feel tired again as their baby bump grows and they have to carry around extra weight in the third trimester. These changes are part of a normal healthy pregnancy.
Pregnancy changes that may affect sleep
Although your baby bump is not even showing in the first trimester, your body is doing lots of unseen work and changing dramatically. Not only are these changes likely to make you feel more tired and need more sleep, some can also interfere with your sleep. There’s nothing like the feeling of morning sickness nausea, most common in the first trimester, to wake you from a peaceful slumber!
Pain and discomfort
By the third trimester, with plenty of extra baby weight and your baby bump making it harder to find a comfortable sleeping position, your baby’s movements may wake you in the night and other pregnancy symptoms like your higher heart rate, needing to wee more often than usual (including during the night) and leg discomfort may get in the way of quality sleep.
Your growing belly is the most obvious reason you may find it difficult to get comfortable when lying down to sleep. But there are many other body changes which occur in pregnancy that may affect the comfort and quality of your sleep. Many women also experience back pain and general discomfort.
Also known as gastroesophageal reflux disease, heartburn is a very common condition in pregnancy. Between 30-50% of women report constant heartburn during pregnancy, which is most problematic in the third trimester.
Shortness of breath may become a problem as your pregnancy progresses. Usually when hormones kick in early in pregnancy, women feel like they are breathing more deeply. But as pregnancy progresses and your growing baby puts increasing pressure on your diaphragm, it can be harder to fit a good breath in. Shortness of breath can also interfere with a good sleep.
Snoring that starts during pregnancy can be a problem, and is thought to occur at least partly because of the way your changing hormone levels influence the function of muscles. If you have a quiet snore once in a while there’s no need to worry. However if your snoring is something of a dull roar and you’re doing it often, you should seek medical advice. It may indicate you’re having problems breathing in your sleep. Sometimes snoring in pregnancy can also be a sign of high blood pressure or other health issues. So to ensure you and your baby stay healthy make sure you check with your doctor.
Breathing pauses while sleeping (sleep apnoea)
Whether or not you’ve ever noticed it, it’s fairly normal for breathing to pause from time to time while you’re asleep, whether or not you’re pregnant. Often these pauses are followed up with a gasp or choking sound when you start breathing again, and they’re often accompanied by snoring. It is a condition called sleep apnoea.
For some women breathing pauses become more frequent or noticeable during pregnancy. As breathing pauses can disturb a good night’s sleep and may indicate health problems like gestational diabetes or pre-eclampsia that need medical attention, make sure you tell your doctor if you notice any changes. Bear in mind that you’re more likely to experience sleep apnoea if you’re overweight.
Leg movements while you’re sleeping, either little jerks or full kicks, may interrupt your sleep and possibly also your partner’s. Many women experience leg movements while sleeping during pregnancy (whether or not they or their partner notice them) and typically they go away once their baby is born. One in four women experience a condition called restless leg syndrome while pregnant. This occurs when leg discomfort worsens at night and can only be relieved by moving their legs. Frustratingly, leg movements provide only temporary relief from discomfort.
If you experience leg movements that are severe enough to interfere with your sleep they’re worth talking to a doctor about.
Emotions and anxiety
If you’re feeling anxious about labour and childbirth, it’s probably also making it harder for you to drift off to sleep and get quality sleep at night. While pregnant it’s also not uncommon for women to feel anxious or worried about their commitments at work or the way their relationship with their partner is changing. You may have difficulty getting to sleep or have dreams about labour or becoming a parent that make you a bit anxious. Remember they are just dreams and talk to your partner or a friend about them.
But make sure the odd anxious or upset feeling doesn’t turn into constant worry or feelings of hopelessness. Depression and anxiety symptoms should be discussed with your doctor.
Pregnancy sleep tips
- Avoid sleeping tablets including those sold over the counter at pharmacies and herbal remedies. They can have dangerous side effects for your baby.
- Sleep on your left side with your knees and legs bent to help nutrients flow to your growing baby and your womb and kidneys.
- Make sure you have a comfortable sleep potion by supporting your belly, arms and legs with pillows or a pregnancy pillow.
- Plan your sleep! Make a schedule and ensure getting enough sleep is a priority. Get yourself into a good sleep routine, going to bed at the same time each night and waking up at the same time each morning.
- Go to bed a little earlier than usual so you get a bit of extra sleep every night.
- Consider napping for an hour or two in the day if you find that you’re not getting enough sleep at night. But try to nap earlier in the day so you don’t disturb your sleep at night.
- Ensure you have a good mattress and pillow that support your neck and spine.
- Raise the head of your bed or use an extra pillow to avoid indigestion or heartburn.
- Relax for 15 minutes or so before bed, for example by having a warm bath.
- Eat a healthy pregnancy diet, maintain a healthy weight and avoid foods that cause heartburn.
- Exercise everyday unless your doctor advises you not to. It can give you an energy boost and relieve symptoms like leg cramps (especially if you give your calves a good stretch as part of your routine).
- Avoid eating big meals for a few hours before you go to bed. If morning sickness is not only affecting you in the morning and also keeping you up at night, try a few dry crackers before bed.
- Raising your head with pillows when lying down and avoiding certain foods relieve heartburn.
- Avoid unwanted toilet trips that disturb your sleep by managing your fluid intake. Avoid drinks containing caffeine. Drink plenty of fluids early in the day so you don’t feel thirsty and need to drink close to bedtime.
- Don’t worry if you can’t make it through the night without a wee- it’s perfectly normal for pregnant women to make more than one trip to the toilet at night. Leave a soft light on in the bathroom so that you don’t wake yourself up even more by turning on a bright light when you have to go to the toilet.
- For leg cramps, try pushing the affected leg into the wall or standing on it. Stretching your calves can also help.
- Keep your bedroom only for sleep and sex.
- Get stress relief by talking to your doctor or a trusted friend about concerns or attending pregnancy classes to relieve your anxieties about child birth.
One of the best things you can do is accept the changes to your sleeping patterns. Rest assured that as much as they are frustrating and make dealing with pregnancy challenges a bit more difficult, sleep disturbances are not doing you or your baby any harm. With your baby soon to enter the world, it’ll probably be quite a while before you get back to a pattern of regular easy sleep.
- Sleep Health Foundation. Pregnancy and Sleep. 2012. (cited 20 September 2014). Available from: (URL Link)
- Mayo Sleep during pregnancy- follow these tips. 2013 (cited 30 September 2014). Available from: (URL Link)
- National Sleep Foundation. Pregnancy and Sleep. 2014 (cited 30 September 2014). Available from: (URL Link)
- Office on Women’s Health- United States Department of Health and Human Services. Pregnancy- Body Changes and Discomforts. 2010. (cited 30 September 2014). Available from: (URL Link)
- American Pregnancy Association. Sleeping Positions During Pregnancy. 2007. (cited 25 September 2014). Available from: (URL Link)
- Pien GW, Schwab RJ. Sleep Disorders During Pregnancy. Sleep. 2004; 27(7): 1405-7. Full Text: (URL Link)
- Medline Problems sleeping during pregnancy. 2012. (cited 30 September 2014). Available from: (URL Link)
- National Health Service. Tiredness and Pregnancy. 2013. (cited 30 September 2014). Available from: (URL Link)
- American Chiropractic Association. Proper Sleep Ergonomics. 2011. (cited 25 September 2014) Available from: (URL Link)
- Woods M. Pregnancy and Sleep: A contradiction in terms? 2014. (cited 25 September 2014). Available from: (URL Link)
- Women’s and Children’s Health Service- Department of Health Government of Western Australia. Physiotherapy Before and After Childbirth. 2006. (cited 30 September 2014). Available from: (URL Link)