When you’re pregnant, you’ll hear a lot from friends and family about how much your sleep will change after your baby arrives. (Spoiler alert: You’ll get less sleep. A lot less. But that’s where Cradlewise can help!) 

But as most pregnant people soon learn, changes in your sleep start way before your baby is born. In fact, you’ll most likely notice changes in your sleep habits and schedule starting in the early stages of pregnancy, and continuing through your last trimester.

As your baby grows, your body changes, creating disruptions in your sleep. From fluctuating hormones to aching joints to nausea, pregnancy can make it a struggle to get the restful sleep you need. 

But don’t worry: There are lots of ways to get better sleep during pregnancy and fight pregnancy insomnia. Read on to explore how your sleep changes when you’re pregnant, and get tips and tricks for better zzzs.

Sleep and insomnia during the first trimester

The first trimester is an important time for your baby’s development, and it’s also a time when many women start experiencing difficulty sleeping. In some cases, insomnia may set in around ten weeks into pregnancy.

According to Dr. Kimberly Langdon, M.D., who has 19 years of clinical experience as an obstetrician and gynecologist, “Sleep-related issues are very common, less so in the first trimester, but they can happen. Most women are extremely tired in the first trimester, so sleep is not that much of an issue.”

According to a study in the medical journal Obstetrics & Gynecology, pregnant people tend to get lots more total sleep at around 11-12 weeks (thanks to early bedtime), but sleep quality also starts deteriorating around this time. The study found that mid-sleep awakenings increase and the amount of deep sleep also decreases, at around this time. Translation: more 3 am wakeups, and less quality shut-eye, right when you’re feeling most fatigued. 

What causes insomnia in the first trimester?

During this time, your body undergoes significant hormonal changes, which can affect your sleep patterns. These changes include an increase in progesterone and estrogen, which can cause feelings of drowsiness during the day and insomnia at night.

Progesterone also plays a  significant role in your sleep. This hormone relaxes your muscles, which can cause frequent urination and nasal congestion—both of which can disrupt your sleep and also make it difficult to go back to sleep.

Did you know?
During the first trimester, progesterone decreases the amount of rapid eye movement (REM) sleep and shortens the time needed to fall asleep.

Another hormone, estrogen, also makes sleep challenging for you in your first trimester. It increases the blood flow to the brain, which can cause difficulty falling asleep.

The next culprit: pregnancy nausea or, as it’s commonly called, morning sickness. The term ‘morning sickness’ is misleading because unfortunately, you can experience it any time of the day, not just in the morning. While Dr. Langdon notes that morning sickness isn’t likely to cause insomnia unless there is reflux or severe nausea and vomiting, feeling sick to your stomach can still make it difficult to fall asleep during the first trimester. 

Ways to treat insomnia in the first trimester

Dr. Langdon suggests these tricks for treating insomnia in the first trimester: “Avoid stimulating activities and food 2 hours before bedtime. Consider reading and a warm bath. If you are prone to reflux, take an antacid at bedtime.”

Here are more tips that might help you deal with difficulty in sleeping and insomnia during your first trimester:

1. Establish a bedtime routine: This can help your body prepare for sleep. Try going to bed at a similar time every night and avoid screens and exposure to bright lights for at least an hour before bed.

2. Stay active: Exercise can help you fall asleep faster and stay asleep longer. Try to get at least 30 minutes of moderate exercise each day. If that’s not possible, go on long walks to spend relaxing time outdoors.
   
   According to the American College of Obstetricians and Gynecologists, some of the other benefits of exercising during pregnancy include reduced back pain and constipation, a decreased risk of gestational diabetes, preeclampsia, and cesarean birth.

3. Practice relaxation techniques: Relaxation techniques such as deep breathing, meditation, and yoga can help you relax and fall asleep. A 2015 study published in Obstetric Medicine found that meditation can help insomnia in pregnancy, and prenatal hatha yoga can also help if you’re struggling with sleep.

4. Talk to your doctor: If your insomnia is severe or persistent, talk to your doctor. They may recommend other treatment options or refer you to a sleep specialist.

Best sleep positions during the first trimester

During your first trimester, it’s often recommended to sleep on your side, specifically the left side. Studies have suggested that sleeping on your left side can improve blood flow to the placenta and your developing baby. But don’t worry if you happen to roll around in your sleep: According to Dr. Langdon, “Your sleeping position does not matter in the first trimester as the uterus has barely reached the pelvic brim or pubic symphysis.”

Another beneficial sleep position during the first trimester is the semi-reclined position—prop up your upper body with pillows and place a pillow between the legs to support your lower back. If your back is aching and you’re experiencing heartburn and shortness of breath, this position can help alleviate these symptoms.

Avoid sleeping on your back during the first trimester. Back sleeping can put pressure on the vena cava, a major vein that carries blood to the heart, which in turn decreases blood flow to the placenta and the developing fetus. Sleeping on your stomach should also be avoided, as it puts pressure on your abdominal area and can cause discomfort.

Tip: If you feel uncomfortable because of tender breasts, try wearing a loose sleep bra for support.

Sleep and insomnia during the second trimester

The second trimester is a special time in your pregnancy—your baby bump is growing and you’re glowing with excitement and anticipation. 💛

Your nausea and morning sickness will subside by this time, and your hormones will stabilize, making sleep a little easier than in the first trimester. However, as your body changes and your baby grows, there are more things to keep in mind about your sleep.

What causes insomnia in the second trimester?

The second trimester of pregnancy is typically considered the “honeymoon phase” as many of the unpleasant symptoms of the first trimester, such as morning sickness, fatigue, and food aversions, begin to subside. A 2017 study published by Sleep Research Society found that in the second trimester, women tend to get around 7.5 hours of sleep per night on average.

According to Dr. Langdon, insomnia during the second trimester is less common than the third trimester, “But around 26 weeks onward, the uterus starts to protrude above the pubic symphysis, and it may be uncomfortable to sleep prone.” Langdon recommends a good body pillow for a comfortable night’s rest:

However, there are different challenges in this phase of pregnancy: As your little one grows, you may experience increased pressure on your bladder, which can lead to frequent trips to the bathroom. Additionally, as your belly grows, finding a comfortable position to sleep in can be difficult.

Sleeping might also become uncomfortable during this trimester because of leg cramps and swollen feet. As you gain weight and your ligaments loosen in the pelvic region, you might also experience lower back pain.

Another factor that may contribute to insomnia during the second trimester is anxiety and stress. It’s normal to feel overwhelmed by the responsibility of caring for a new baby, and you may worry about the upcoming delivery.

Ways to treat insomnia in the second trimester

If your sleep is disrupted by heartburn and discomfort, a little advance planning can go a long way. As Dr. Langdon suggests, “Reflux may start to get worse, and you might not tolerate some foods which could keep you awake. Try antacids before bed and an extra pillow.”

Here are some tips that might help you deal with difficulty in sleeping and insomnia during your second trimester.

1. Practice relaxation techniques: Deep breathing, meditation, or yoga can help you relax and fall asleep quickly. 

2. Get regular exercise: This tip is a constant during all stages of your pregnancy. Regular exercise can improve your sleep quality and help you fall asleep faster. Avoid activities that carry the risk of falling or hurting yourself in favor of exercises like walking, swimming, and gentle yoga. 

3. Keep yourself hydrated: Drink plenty of water and fluids during the day but try to reduce the number of drinks a couple of hours before bedtime so you don’t keep waking up for bathroom breaks.

4. Avoid heartburn-causing food: Spicy and greasy foods, fatty and fried food, chocolate, and onions can trigger heartburn, so if you’re uncomfortable, you might try to skip them for now.

Finally, keep your sleep environment comfortable. Make your bedroom dark (try blackout drapes), quiet, and at a comfortable temperature before you head to bed.

Note: If your insomnia is severe or persists, talk to your healthcare provider about possible treatments.

Best sleep positions during the second trimester

During this time, your baby’s vital organs are developing, and your body is undergoing significant changes as well. The best sleep positions during the second trimester promote proper spine alignment while providing plenty of comfort. The two most recommended positions are the side-lying position and the semi-reclined position. Dr. Langdon notes that side sleeping is the best position during your second trimester.

The side-lying position, specifically the left side-lying position, is the most recommended sleep position for pregnant women during the second trimester. This position allows for optimal blood flow to the placenta, essential for the baby’s growth and development. It also reduces the risk of stillbirth. According to a study by the American Journal of Obstetrics and Gynecology, women who sleep on their left side during the last trimester have a lower risk of stillbirth than those who sleep on their right side.

The semi-reclined position is another recommended sleep position during the second trimester. This position involves propping up a few pillows behind the back to support your head and shoulders. The semi-reclined position helps reduce the pressure on the spine and supports the growing belly. It also reduces the risk of acid reflux, which is common during pregnancy.

It’s important to know that sleeping on the back is strongly discouraged during the second trimester. Sleeping on the back can lead to decreased blood flow to the placenta and can cause discomfort, back pain, and difficulty breathing for you. 

Sleep and insomnia during the third trimester

Congratulations! You’re in the home stretch. As the excitement of finally holding your baby in your arms and bringing them home builds, so does your struggle to sleep properly. 

In the third trimester, finding a comfortable sleep position might become even harder, thanks to a variety of sleep-stealing culprits. 

What causes insomnia in the third trimester

One of the most significant physiological causes of insomnia in the third trimester is discomfort and pain due to your baby’s growing size and weight.

As your uterus expands, it puts pressure on your bladder, stomach, and intestines, causing frequent urination, heartburn, and constipation — all of which can make it difficult to get comfortable, fall asleep, and stay asleep. As your baby grows and develops, their movement and kicks might disrupt your sleep sometimes, too.

During this stage of your pregnancy, your digestive system slows down, which causes heartburn (a burning sensation in your chest). The discomfort often keeps women from falling asleep. “Third-trimester insomnia is very common,” says Dr. Langdon, “And it occurs if you tend to toss and turn to get comfortable. Reflux is also an issue.”

According to a 2015 study published in the Journal of Clinical Sleep Medicine, one in three pregnant women develops restless legs syndrome (RLS), a condition in which they feel an uncontrollable need to move their legs. Many women also experience leg cramps during the third trimester of their pregnancy.

Hormonal changes are another reason you might experience difficulty sleeping and insomnia during this period. Pregnancy is characterized by a surge of hormones, including estrogen, progesterone, and human placental lactogen (a hormone released by the placenta), which can affect your circadian rhythm, or sleep-wake cycle. These hormones can cause anxiety and nervousness, making it difficult to relax and fall asleep.

Psychological factors can also contribute to insomnia in the third trimester. It’s natural to worry about your baby’s health, the upcoming birth, and how you’ll take care of them once you bring them home. These concerns can make it difficult to relax and fall asleep, leading to insomnia.

Ways to treat insomnia in the third trimester

According to Dr. Langdon, getting enough sleep in the third trimester calls for some creativity:  “It’s best to take naps if the night time is too hard to sleep—consider a reclining chair with a pillow tucked all around you to elevate your right side so that you are lying more left lateral.”

Here are some tips that might help you deal with difficulty in sleeping and insomnia during your third trimester:

1. Try a body pillow: Now that your belly has grown, a body pillow can help support your belly and for more comfortable sleep.

2. Use relaxation techniques: Methods like yoga, meditation, and deep breathing can help you relax and fall asleep.

3. Talk to your doctor about sleep aids: If you’re having trouble sleeping, your doctor may be able to recommend a safe sleep aid for you.

4. Maintain your diet and supplements: To avoid heartburn, eat smaller portions of your meals, especially at dinner. Avoid foods that might trigger it. And to prevent restless leg syndrome, do light stretching exercises before bed. Remember to take your mineral supplements to avoid leg cramps.

5. Exercise: During your third trimester, you can join prenatal yoga or pilates class or start pelvic floor exercises to help you with pregnancy, labor, birth, and postpartum. Or go on long, relaxing walks. 

Best sleep positions during the third trimester

The best sleeping position during your third trimester is sleeping on the left side. 

Sleeping on your left side can help to improve blood flow to the uterus, which is essential for delivering oxygen and nutrients for your baby’s growth and development. When you sleep on your left side, it can help alleviate the pressure on your vena cava (a large vein that carries blood from your lower body back to your heart).

“We tell women not to lie flat on their backs to avoid the uterus from compressing the inferior vena cava—blood return to the heart,” says Dr. Langdon, “If that happens, then the cardiac output could be reduced, which could impair blood flow to the placenta/baby. Best to put a pillow under your right hip and side to prevent this.”

When you sleep on your back, the weight of your uterus can compress this vein and decrease blood flow, leading to dizziness and shortness of breath.

For more comfort, try adjusting a pillow between your legs or prop up your belly using another pillow. Many pregnant people swear by body pillows and pregnancy wedges for comfort.

FAQs

Q: When should I stop sleeping on my stomach during pregnancy?

A: It is generally recommended to avoid sleeping on your stomach during pregnancy, as it can put pressure on your back and abdominal muscles. It is best to start sleeping on your side as soon as you become pregnant.

Q: How to sleep with pelvic pain during pregnancy?

A: To sleep with pelvic pain during pregnancy, it is recommended to sleep on your side with a pillow between your legs to support your hips and pelvis. Avoid sleeping on your back, as this can put additional pressure on your lower back.

Q: How to sleep with a pregnancy pillow?

A: A pregnancy pillow is designed to support the unique needs of pregnant women and can be used in various positions. Try placing the pillow behind your back for support while sleeping on your side, or between your legs to alleviate pressure on your hips.

Q: Why can’t I sleep on my right side while pregnant?

A: Sleeping on your right side while pregnant may be uncomfortable due to your uterus’ weight on your liver. It is generally recommended to sleep on your left side during pregnancy to improve blood flow to the placenta.

Q: can I sleep on my stomach while pregnant?

A: Sleeping on your stomach while pregnant is not recommended as it can put pressure on your back and abdominal muscles. It is best to start sleeping on your side as soon as you become pregnant.