Pregnancy and Sleep: A Contradiction in Terms?
by Elizabeth Peterson, MFA
Pregnancy is an exciting and physically demanding time. There are so many changes happening in your body all at once. But while many mothers-to-be anticipate the sleepless nights that will come once the baby is born, many are unprepared for the sleeplessness they experience during the pregnancy itself. One reason for this is that changing levels of hormones (primarily estrogen and progesterone) can affect your sleep patterns.
Hormonal swings during pregnancy aren’t the only culprits. Physical symptoms, such as body aches, nausea, need to urinate at night, leg cramps, fetal movements, and heartburn, as well as emotional changes, like depression, anxiety, and worry can interfere with sleep. And unfortunately, these sleep–related problems may become more prevalent as your pregnancy progresses. Some may even develop sleep apnea.
First Trimester (Months 1-3)
During the first trimester, your body is working hard to protect and nurture your developing baby. The placenta (the organ that nourishes the fetus until birth) is forming, your body is making more blood, and your heart is beating faster. High levels of progesterone are also produced, increasing feelings of sleepiness. Indeed, many women sleep more than usual during their first trimester of pregnancy. Unfortunately, more doesn’t necessarily mean well. There are 3 common sleep stealers during your first trimester:
Second Trimester (Months 4-6)
During your second trimester, progesterone levels continue to rise, but more slowly. This allows for better sleep than during your first trimester. Your growing baby moves above the bladder and decreases the pressure on it, thereby decreasing your need for frequent visits to the bathroom. You still may not be sleeping as well as you did before you became pregnant, but you’re less exhausted and many women report having a general sense of well being during their second trimester.
Progressing heartburn will be more of an issue as the stomach and esophagus becomes displaced. It may be more of a problem if you are sleeping on your back.
Third Trimester (Months 7-9)
The third trimester is when you may experience the most sleep disturbances. As your pregnancy progresses, you’ll likely find that lying on your left side with your knees bent will be the most comfortable sleeping position. Common causes of sleep disturbance in the third trimester include:
If you have any concerns about symptoms you are having, make sure you talk to your healthcare provider to see if they are normal or a sign of a problem.
Because you’re pregnant, over-the-counter sleep aids, including herbal remedies are not recommended. However, there are some things you can do to improve your chances of getting a good night’s sleep:
If you still can’t sleep, try reading or catching up on correspondence. Eventually, you should feel drowsy enough to fall back to sleep.
American Congress of Obstetricians and Gynecologists
National Sleep Foundation
Canadian Sleep Society
The Society of Obstetricians and Gynaecologists of Canada
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Updated October 2016. Accessed October 23, 2017.
Sleep tips for pregnant women. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-news/sleep-tips-pregnant-women. Accessed October 23, 2017.
Sleeping by the trimesters: 1st trimester. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-news/sleeping-the-trimesters-1st-trimester. Accessed October 23, 2017.
Sleeping by the trimesters: 2nd trimester. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-news/sleeping-the-trimesters-2nd-trimester. Accessed October 23, 2017.
Sleeping by the trimesters: 3rd trimester. National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-news/sleeping-the-trimesters-3rd-trimester. Accessed October 23, 2017.
Sleeping positions during pregnancy. American Pregnancy Association website. Available at:
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Updated March 2, 2017. Accessed October 23, 2017.
Women and sleep. The National Sleep Foundation website. Available at: https://sleepfoundation.org/sleep-topics/women-and-sleep. Accessed on October 23, 2017.
Last reviewed October 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 12/4/2015
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