What is it?
If you have trouble getting a good night’s sleep during your pregnancy, you’re not alone. Sleep issues during pregnancy are a common complaint caused by a number of factors, including hormone shifts, which can cause insomnia or interrupted sleep in early pregnancy, frequent need to pee (including over the course of the night) due to increased water intake and the baby putting pressure on your bladder, as well as the dramatic body changes taking place and weight of your belly can make finding a comfortable position tricky (mostly in the second and third trimesters).
In the 1st trimester, the hormone progesterone rises exponentially and then plateaus. This can make you feel exhausted and lower the quality of your sleep.
In the 3rd trimester, your baby's movements may seem more noticeable at night, when your body is still, and when they tend to be more active. This can disrupt your sleep or make finding a comfortable position difficult. Pressure on your bladder as your baby grows may mean more frequent bathroom trips, especially as your pregnancy progresses.
How common is it?
What can I do about it?
It can be difficult to get quality sleep during all phases of pregnancy. While there are many reasons your sleep may feel less satisfying, here are some helpful tips on how to get the rest you need:
Pillows and props
- If you’re comfortable sleeping on your side, try placing a pillow between your knees to support your hips and legs and make it easier to stay asleep. This can also help alleviate lower back pain and pelvic pain. If you’re experiencing pregnancy rhinitis, or nasal congestion, propping your head up on an extra pillow can help you to breathe more easily.
Create a sleep-promoting environment
You may find that you need to make some adjustments to help improve your sleep quality when you’re pregnant.
- Creating a bedtime routine that includes things like a warm bath, some light reading, a dark room (or eye mask), and using dim lights to guide your bathroom trips
- Avoiding screens, late afternoon naps, and caffeine close to bedtime
- Exercising earlier in the day (at least 4-6 hours before bedtime) can allow your body adequate time to relax.
- If heartburn is keeping you awake, avoid spicy, heavy, and fried foods and discuss antacid use with your healthcare provider.
- If you wake up at night because you are hungry, keep a protein-rich snack by your bed so you can eat quickly and without much disruption, making it easier to go back to sleep
Over-the-counter sleep aids
It’s important to discuss your sleep challenges with your healthcare provider before you try any over-the-counter or prescription medications.
A medication called Unisom (doxylamine) is an antihistamine that has been safely studied for use in pregnancy, and is often used in combination with vitamin B6 to help with moderate nausea and vomiting in early pregnancy. It’s also an effective sleep aid when used on its own. Other antihistamines, such as diphenhydramine in other over-the-counter sleep formulations (like Tylenol PM or Advil PM), do not have enough data to support use in pregnancy.
Do I really need to sleep on my left side?
Current research shows that while sleeping flat on your back may make some people feel lightheaded during pregnancy, there is no evidence that this will negatively affect you or your fetus up to 30 weeks of pregnancy. The research regarding the safety of sleeping on your back beyond 30 weeks gestation is limited and inconclusive. If sleeping on your back before 30 weeks gestation feels comfortable and allows you to get the rest you need, there’s no reason to avoid it.
Hormones relax your esophagus, and lying down for sleep or bedtime can cause stomach acid reflux. Heartburn tends to be a more common issue in the third trimester as your digestive organs are compressed by your growing uterus and shift up to make room for your growing baby. Smaller meals in the later weeks of pregnancy can help alleviate heartburn. Read more about pregnancy heartburn here.
Leg cramps and spasms
Muscle contractions in your feet or calves (also known as a Charlie Horse) are common in the second and third trimesters, commonly occurring in the middle of the night, which can cause you to wake up. Stretching your calves before bed can help alleviate nighttime cramps. Staying hydrated is also key to avoiding muscle cramps. While conclusive evidence is lacking and inconsistent, anecdotal evidence suggests that magnesium supplements may improve sleep and leg cramps and are safe to consume in pregnancy.
Restless Leg Syndrome (RLS)
Feeling like you need to constantly move your legs to relieve discomfort is called Restless Leg Syndrome (RLS). These sensations tend to be more common at night. RLS is 2-3 times more common in pregnancy. Hormones likely play a role in RLS, but this is not fully understood. RLS increases with low folate and iron levels, so prenatal vitamins can help stave it off. This condition usually resolves after you give birth.
When should I be worried?
Sleep issues in pregnancy are common and shouldn’t be a cause for concern unless insomnia or sleep disruptions leave you unable to sleep at all, which can negatively affect your overall physical and mental health. Sleep disruptions during pregnancy are also associated with an increased risk for postpartum depression, so addressing your concerns early in pregnancy is important. Talk to your healthcare provider if you feel a lack of sleep is negatively affecting your body or mental health.