Introduction

From why our rest is so important to common reasons it gets disrupted, and from sleeping positions to sleep aids, what follows is the ultimate guide to sleeping during pregnancy. We hope you find it helpful!

The importance of sleep

Good sleep is important for everyone’s health, yet the majority of people don’t get it – at least, not consistently. According to the National Sleep Foundation(NSF) an approximate 60% of adults report having problems sleeping a few nights a week or more – and this percentage rises steeply during pregnancy, with 78% of women experiencing more disturbed sleep when expecting a child than at any other time in their lives.

According to psychologist and sleep expert David F. Dinges, Ph.D., sleep deprivation can be linked to irritability, moodiness and disinhibition in its earlier stages; but when left unattended, it can also lead to impaired memory, an inability to multitask, flattened emotional responses and hallucinations.Dr. Timothy Roehrs, the Director of Research at the Detroit Sleep Disorders and Research Center, has shown that sleepiness negatively affects our decision-making; and it’sno surprise that the Department of Transportation blames a frightening 1-4% of all highway crashes on driver’s fatigueaccording to the American Psychological Association.

Of course, sleep deprivation is a common problem in pregnancy and parenthood –I can’t be alone in having yelledin the night, while my husband slept and our baby fussed:“Sleep deprivation is a form of torture in some countries, you know!”However, at this time in our lives and particularly when we are expecting a child, it’s even more important that we get some rest. There are numerous reasons why; poor sleep in pregnancy has been linked to depression, elevated blood pressure, preeclampsia, longer labors, the need for a Caesarean-section and a weakened immune system – but there are also many factors that can hold rest to ransom when you’re expecting (see ‘Common culprits’ below).

how to sleep when pregnant

How sleep changes during pregnancy

In general, your first trimester will probably involve more, but less deep sleep than previously, with a sense of feeling sleepier during the day than before you conceived. Even in the first few months you could already find that your sleep is disturbed by a constant need to visit the bathroom at night.

During the second trimester you may experience more night waking,although as your baby moves above the bladder nocturnal urination isn’t such a problem. You will also typically begin to find it uncomfortable to sleep on your stomach.

During the third trimester you can expect to experience frequent bathroom visits as your baby shifts position to exert pressure on the bladder once again. You could begin to suffer from heartburn or leg cramps, and sinus congestion may make its appearance too. In the final three months, your sleep is likely to be disturbed by more and more diverse factors; pre-existing medical conditions like asthma often worsen when you are expecting, and baby’s cycle of activity in the womb can also disturb your sleep (although this is ultimately a good thing if you are planning to breastfeed, as it allows you to get into synch with one another).

Your emotional journey as you experience natural excitement and anxiety (plus a multitude of other feelings, some without a discernible name) will also change and evolve throughout the three trimesters and beyond, and this is true whether it is your first pregnancy or your tenth. Indeed, anxiety over impending motherhood canactually be greater the second-time round – particularly if the mom-to-be has previously experienced a difficult birth or miscarriage or is worried about how sheandher family will cope (physically, emotionally, financially) with another child. Along with certain physiological factors, this could mean that her sleep is actually affected more.

Common culprits

At any time while pregnant, you may experience poor quality or duration of sleep thanks to the following conditions:

  • Insomnia, often caused by excitement or anxiety (see above)
  • General bodily discomfort as the uterus expands, the breasts become sore and tender and it becomes more and more difficult to find a comfortable position in which to sleep (common pregnancy side-effects like nausea, leg cramps, frequent urination, haemorrhoids and more can also play a part here)
  • Back painin pregnancy (which will affect 50-80% of expectant mothers according to Spine-Health)
  • Nocturnal gastroesophageal reflux (GERD), otherwise known as heartburn (affecting 30-50% of mamas-to-be)
  • Changing hormone levels, the most significant of which are oestrogen, progesterone, oxytocin, endorphins and prolactin. Although estrogen is a sleep-regulator, hormonal imbalances during pregnancy may negatively affect your sleep patterns giving you a rise in energy one day and making you extremely tired the next
  • Restless legs syndrome (RLS) (affects 26% of all pregnant women)
  • Snoring and sleep apnea, both of which are more likely to occur during pregnancy (the latter can be dangerous)
  • A tendency to overheat (this is experienced by many, but not all, pregnant women)
  • Previously poor sleeping habits, if left unchecked, can also become more problematic during pregnancy, and various other factors may play a part as well.

How to get better rest during pregnancy

So what can you do to fight off the need for counting sheep? Lying awake in the dark waiting for Morpheus to appear is extremely unhelpful, but sleeping pills are a big no-no during pregnancy unless your doctor explicitly states otherwise. Here are a few hints and tips; see also ‘Recommended sleep aids’, below:

1)    Cut down on the coffee (and soda, and tea, and…)

You may have already given up your morning fix thanks to a perceived link between the popular beverage coffee and a low birth weight in babies, although not every mom-to-be chooses to cut it out entirely (and 200mg of caffeine a day is generally believed to be safe). If you are struggling with sleep, you should avoid ingesting coffee from midday on – and don’t forget that caffeine is found in other drinks and foods as well, with green tea, cola and even chocolate all being regular culprits.

Don’t panic about the chocolate– Babycenter had worked out that you would need to enjoy eight bars of the tasty treat per day to reach your recommended 200mg maximum, and you’d never eat eight chocolate bars in one day…would you?

2)    Increase your fluid uptake during the day

In other words, drink less as you move closer to bedtime – but ensure your daily fluid intake remains close to the recommended dose, approximately 64 fluid ounces per day according to dietician Julie Redfern (even more when you’re active).

Hopefully, you’ll experience less nocturnal bathroom visits – and thus get more rest – as aresult.

3)    Change your mealtime (and your naptime, too)

Spicy, acidic foods and large meals close to bedtime have both been known to cause GERD, so try to avoid the chilli and give your stomach a few hours’ grace to digest dinner properly prior to allowing your head to hit the pillow.

Similarly, while naps are welcome during pregnancy (one NSF study showed that 60% of pregnant women enjoy a daytime nap every weekend), napping for too long or too close to bedtime is likely to interfere with your sleep patterns at night.

4)    Exercise (but not too late)

Contrary to what your Great Aunt Edith might tell you, it’s fine to continue exercising during pregnancy. In fact some gentle cardio can be very beneficial to both baby and mama-to-be – improving circulation, helping your body to build a more efficient placenta and (especially in the case of certain activities, such as prenatal yoga) easing potential pain in the lower back and joints. Moderateexercise, as recommended by your health care provider, can also help regulate your sleep patterns, but don’t do it too late in the day since (like late meals/naps) it could disturb your rest.

5)    Develop a bedtime ritual

You’re probably used to reading about bedtime routines in the context of infant care – don’t wait to put your baby down until they’re over-tired, why the atmosphere in the nursery is important, and so on. In fact, these tips all also apply to you, and developing an excellent bedtime ritual(for yourself!) could be great practice for when your child finally arrives.

Mamas-to-be, like babies (and every human being too) will usually benefit from a predictable sleep schedule – we should all be getting up and going to bed at the same time each day – as well as a safe, comfortable space in which to sleep that has been disassociated from other more wakeful activities like work, computer-gaming etc. Obviously, sex gets to stay in the bedchamber, but move the computer/TV out!

A warm (but not hot), relaxing bath, dim lights and a favourite bedtime story (your infant’s literary tastes may differ somewhat from yours) can also help both mama and child to reach a restful state. You could try a guided meditation CD or deep breathing to encourage relaxation; and if you, like me, find that you often wake with a sudden worry or “to-do” thought during the night, a notepad and pen by the side of the bed may work wonders in helping you put your anxieties aside until morning, allowing you to drift back into a dreaming state.

6)    Support your sleep

The comfort of your sleeping conditions is extremely important and may be marred by the room being too hot or too cold, an uncomfortable mattress or an unsupported bump (to name but a few of the most common problems). If you find yourself stuffing pillows under your body at various points or your back aches in the morning from the strain of lying on your side (see ‘Sleeping Positions’ below), it is recommended that you invest in a good maternity pillow to support, elevate and cradle your ever-changing body.

You’ll be glad you did – until baby comes, you are likely to feel less and less comfortable without adequate support, and many pregnancy pillows can also be used postpartum to ease C-section soreness and as nursing aids.

7)    If you cannot go to sleep at night, try not to angst

Although it may seem counter-productive, it’s better to get up and do something relaxing until you are actually ready to hit the pillow than to just lie in bed worrying about how much rest you’re not getting or how important it is that you sleep (yes, I’ve been there too). Note the word “relaxing” above – try not to switch on an exciting film, or begin writing that epic novel, just yet.

It’s perfectly natural to experience a little sleep disturbance during pregnancy, and the vast majority of us will suffer no ill effects other than plain fatigue – it’s only when the problem persists and becomes chronic (less than six hours’ sleep per night every night, for example) that it might become a more serious issue.

8)    …but if all else fails, don’t be afraid to ask your doctor.

He or she willprobably be very happy to offer you advice (or write you out a prescription), particularly given the increased potential risks if your sleep becomes even worse over time.

Sleeping Positions during Pregnancy

According to Natural Child Magazine, the main sleeping position can affect the place in the womb where the baby’s placenta implants, so it is never too early to start thinking about sleeping positions in pregnancy. While you used to sleep however you wanted, there is now a medically recommended position (honestly, you’ve already given up coffee and your eight daily bars of chocolate, how many more aspects of life can your baby dictate before he or she is even born? Hmm, don’t answer that).

Sleeping on your back

This can become uncomfortable long before your bump makes an appearance, thanks to a surge in pregnancy hormones designed to make the body more relaxed and flexible – but which also, in some women, may cause back pain. Even if it doesn’t, do bear in mind that lying on your back in the later stages of pregnancy can make your blood pressure go up (or drop) and neither is good for baby for an extended period of time. It’s also not good for you, and lying on your back during pregnancy has been associated with snoring, sleep apnea and hemorrhoids as well as having the potential to make you faint!

Sleeping on your side

Sleeping on your side – especially your left side – is most recommended by doctors during pregnancy due to the fact that it promotes optimal levels of blood flow, helps with the elimination of body wastes and encourages best nourishment to the placenta. It also has the potential to decrease swelling in your ankles, but it can be difficult to get truly comfortable on your side with a growing bump – and that’s why many doctors also recommend the use of a pregnancy pillow to prop you up (see ‘Your pregnancy pillow’, below).

Sleeping on your front

Sleeping on your front can become more and more uncomfortable as the bump grows or the breasts become tender, although it’s not as potentially dangerous as lying on your back provided that no extra pressure is being exerted on the uterus.

Sleeping upright

And finally, sleeping upright (you will need to prop yourself up) can help with heartburn and snoring issues and is also beneficial for mamas experiencing shortness of breath. It’s a valuable alternative if you hate sleeping on your side but can no longer sleep on your back thanks to the weight of your growing bump and again, a versatile full body pregnancy pillow can help you reach the best level of comfort in this position.

Recommended sleep aids

You know that over-the-counter sleep aids (without your doctor’s express permission, and yes itdoes include herbal sleeping pills) are out – but that doesn’t mean that all sleep aids are a no-no.

  • If snoring or sleep apnoea is your issue, the Macks AIRMAX Nasal Device, a drug-free product recommended by ENT doctors, has some extremely favourable Amazon reviews and works by gently opening the nasal passages to ease congestion and prevent morning tiredness.
  • Rescue Sleep Liquid Melts, which according to the manufacturer are safe during pregnancy (although “all medications should be at a doctor’s direction”), are a non-drowsy, alcohol-free holistic alternative to sleeping-pills suitable for all the family.
  • Certified Organic Badger Sleep Balm uses all-natural and low dosage essential oils to “clear thoughts and calm the mind” rather than force sleep along – and in this way, slumber can come more naturally. Containing Rosemary, Bergamot, Ginger and Balsam Fir essential oils as well as the queen of relaxation, Lavender, this remedy certainly smells wonderful and makes you feel very pampered if nothing else – and it’s a very popular product for good reason.
  • Just because you gave up caffeine doesn’t mean all tea is out. Stash Tea Chamomile Nights Herbal Tea, which is known to be safe during pregnancy, is often recommended to soothe and relax the body and mind before sleeping. If chamomile isn’t your thing, other herbal teas are also available – but make sure they’re not contraindicative to pregnancy (raspberry tea, for example, is only recommended in the third trimester if at all, as it is believed to strengthen contractions) and that they do actually help relax your body and mind.
  • A hypnotherapy, deep breathing or guided meditation CD can also prove highly beneficial to your sleeping capabilities. Many women use a pregnancy-specific CD like the B’Mums Pregnancy Relaxation to aid deep relaxation and prepare them for the birth.
  • By far the most useful sleep aid, however, is the pregnancy pillow…

Your pregnancy pillow

The perfect maternity pillow for you will:

1)    Be comfortable, cradling your body in all the right places and leaving you with the feeling of “sleeping on a cloud”;

2)    Ease and alleviate pregnancy symptoms and health issues, including back pain and pelvic girdle pain, RLS, gastroesophageal reflux,night-time urination, snoring and sleep apnoea, leg cramps, joint pain and much more;

3)    Be completely drug-free and require no action on your part other than to lie down (although if you wish to listen to a relaxation CD while using it, please feel free);

4)    Promote the optimal sleeping position in pregnancy, while also being versatile enough to allow you to sleep in other positions (e.g. propped up on your back) or as a nursing pillow, with many users reporting a need to fight off beloved family members who also want to use the pillow.

For help choosing your pregnancy pillow, see our Reviews page.

Conclusion

There are many reasons why your sleep will be disturbed during pregnancy, but it’s also crucial that you rest as much as you can. This guide will hopefully give you some ideas on how to cope with sleep disturbances – from hints and tips, to sleeping aids, to positions – but ultimately if you are still struggling to sleep it’s best to speak with your doctor. You don’t need to grapple this problem alone, and there are many potential avenues to explore. Good luck, and sweet dreams…