You expected sleep deprivation to come with having a baby — but you may not have expected it to really start until you'd had the baby. Now you know that it can be almost as hard to get enough quality shut-eye when you’re expecting as it is when you're a new parent.
If it’s any consolation, know that you’re not alone. More than half of pregnant women reported poor sleep and sleep disturbances while they were expecting, according to recent research.
As difficult as it might be, getting a good night’s sleep is essential for a healthy pregnancy. Sleep helps your brain to reset, your over-taxed blood vessels to replenish, your blood sugar levels to stabilize and your immune system to stay strong. That’s why doctors say you should aim to get at least seven hours of quality sleep a night.
But between finding a comfortable sleeping position to accommodate your growing baby bump and pregnancy symptoms like the frequent need to pee, heartburn, leg cramps, nasal congestion and overall discomfort, it’s no wonder that a full night’s rest can be so elusive. To add insult to injury, sleep disorders like insomnia and obstructive sleep apnea tend to be more common when you’re expecting.
Despite all that’s going on in your body and brain, a good night's sleep during pregnancy is possible. Here are a few of the most common pregnancy sleep problems, along with tips to help you overcome them so you can get the rest you need.
Frequent need to pee
When it happens
Usually in the first and third trimesters.
Why it happens
Higher levels of the pregnancy hormone hCG can mean having to run to the bathroom frequently, day and night. Your kidneys also have to filter up to 50 percent more blood than usual — which also means more urine (in other words, you’re peeing for two). In the third trimester, your growing uterus presses down on your bladder, increasing your urge to go.
More on Pregnancy Sleep Solutions
What you can do about it
Drink plenty of liquids throughout the day. Then cut back when it's closer to bedtime (in another words, it's probably best not to guzzle a 16-ounce bottle of water right before you go to sleep).
When you do need to get up to go, leave a night light on in the bathroom (or install a simple dimmer switch). Flipping on the overhead can be too much of a wake-up call and may make it harder to fall back to sleep.
General discomfort
When it happens
Throughout pregnancy, but especially in the second and third trimesters.
Why it happens
Many pregnancy sleep struggles come from just not being able to find a comfortable position to sleep in. In fact, according to one study, almost 80 percent of pregnant women couldn’t find a comfortable sleeping position.
Inveterate stomach-sleepers eventually can’t sleep in this position. Meanwhile, back sleepers also have to search for a new path to slumber, since it can interfere with circulation later in pregnancy.
What to do about it
Sleeping on your side — your left side, if possible — makes things easier on your circulatory system. It also results in less swelling in your feet, ankles and hands, since it enhances kidney function.
If you're not used to the position, it can make falling asleep harder. In that case, pregnancy pillows can help you get comfortable. Pile them up between your knees, under your stomach and behind your back (whatever works!).
Pregnancy Pillows to Help You Get Comfortable at Night
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Heartburn
When it happens
Anytime.
Why it happens
While you can experience heartburn at any time of day, it’s often worse at night when you’re lying down. You can thank pregnancy hormones for this painful sensation, as they relax the muscle that normally keeps stomach acid inside the stomach. You'll also feel a surge in heartburn late in the last trimester, when your baby bump pushes up on your abdomen.
What you can do about it
Heartburn-soothing strategies like these can help:
- Avoiding spicy, greasy and acidic foods
- Eating smaller meals and having dinner at least two hours before bedtime
- Propping your head up with a couple of pillows
- Popping antacids (like Tums and Rolaids)
- Talking to your doctor about proton-pump inhibitors, if nothing else works
Insomnia
When it happens
Anytime.
Why it happens
Anxiety, hormones and any of the above sleep problems can contribute to insomnia during pregnancy, the inability to fall or stay asleep. It’s super common and super frustrating, and it can make you feel even more tired, irritable and unable to function during the day.
What to do about it
Have a good wind-down routine before bed and practice good "sleep hygiene" (read more about how in the tips below). But if you’re still having trouble sleeping and it’s affecting how well you can function during the day, be sure to ask your doctor for help.
If you simply can’t sleep, a therapist might be able to help. Cognitive behavioral therapy for insomnia (CBT-I) is a type of talk therapy that involves pinpointing inaccurate or unhelpful thinking about sleep and learning habits to make things better.
A 2020 study of 2258 pregnant women with insomnia found that six weekly 20-minute sessions of online CBT-I with a therapist significantly improved most insomnia symptoms. These included how long it takes to fall asleep, sleep quality, interference with daytime functioning and distressing feelings about sleep.
Leg cramps
When it happens
Usually in the second half of pregnancy.
Why it happens
No one’s quite sure what leads to these painful spasms in the calves, but it might be compression of blood vessels in the legs and fatigue as you carry that extra pregnancy weight. Although you’ll sometimes experience leg cramps during the day, they’re typically more common — or at least more noticeable — at night.
What you can do about it
One theory attributes leg cramps to low calcium and magnesium levels. Upping your intake of those minerals in your diet may help. Yogurt and soy are good sources of calcium, while beans are a great source of magnesium.
Talk to your doctor about whether you should be getting more of these minerals, and if so, how much. Also ask about taking a magnesium supplement before bed.
A few other tips to banish leg cramps during the day include drinking plenty of water, stretching your legs and wearing support hose. When you get a cramp, try straightening your leg, then gently flexing your foot and ankle toward your nose (without pointing your toes).
If the pain is severe and persistent, definitely check in with your doctor. Although it’s rare, it’s possible cramps may actually be a sign of a blood clot in the leg.
Nasal congestion
When it happens
Anytime.
Why it happens
Higher estrogen and progesterone levels increase blood volume everywhere — including to the membranes in your nose. This causes them to swell and produce more mucus than ever, leading to a perpetually stuffy nose as well as postnasal drip later on in your pregnancy that might cause you to cough at night.
What you can do about it
Saline nasal sprays and nose strips are safe and can ease nighttime stuffiness. If those don’t work, check with your doctor about other options, including some decongestants or steroid nasal sprays that may be okay to take after the first trimester. Propping your head up with a couple of pillows might help too.
Snoring and sleep apnea
When it happens
Anytime.
Why it happens
You can blame that perpetually stuffy nose for the new noisier-at-night you. Gaining too much weight can make the problem worse.
Snoring is more than just annoying to you and your partner. Sometimes it indicates sleep apnea (when you briefly stop breathing while you sleep). Since apnea has been linked to high blood pressure and gestational diabetes, be sure to discuss snoring with your doctor and ask if you should be evaluated.
What you can do about it
Try strategies for snoring, including propping your head with pillows, sleeping with a nasal strip on and using a cool mist humidifier.
Restless leg syndrome (RLS)
When it happens
Usually in the third trimester.
Why it happens
While experts aren’t exactly sure what causes RLS, an estimated 15 percent of pregnant women suffer from this condition in the third trimester. If you have RLS, you'll feel an uncomfortable, sleep-sapping sensation of crawling or tingling in your legs, with an urge to move them.
What you can do about it
Since RLS has been linked to an iron deficiency (anemia), ask your doctor about getting your levels tested. If your stores are low, he or she will recommend supplements. A test may also reveal you're low in magnesium or vitamin D, both of which can also trigger RLS and can be treated with supplements.
Otherwise, a few other tactics for RLS include:
- Daily exercise
- Acupuncture
- Yoga
- Meditation and other relaxation techniques
- Avoiding too much caffeine, which is always a good idea for sleep (and necessary during pregnancy)
- Applying hot or cold packs to your legs before bed
Solutions to your pregnancy sleep problems
These healthy pregnancy sleep tips can apply to many sleep-stealers, so try them to see if they help you:
- Avoid caffeine in all its forms — including chocolate — in the afternoon and evening.
- Stay away from sugar at night, which will give you an energy boost when you least want one and leave your blood sugar levels unstable.
- Get your eight glasses of water (or other fluids) every day, but taper off at night. Drink if you're thirsty, but don't down a giant glass of water or cup of tea right before bedtime.
- Work out daily, but only up until the early evening. Regular exercise during pregnancy is great for you and your baby and helps tire you out to improve sleep. Just remember that it could actually energize you and sabotage sleep if it comes too close to bedtime.
- Eat dinner early on in the evening, since a heavy meal right before bed can keep you from sleeping.
- Have a light snack before hitting the hay to stave off overnight hunger pangs. Healthy pregnancy snacks include protein and a complex carb, like a whole grain muffin washed down with a glass of warm milk (almond milk if heartburn’s a problem).
- Vent about your stress to your partner or a friend or write in a journal to help clear your mind of worries that might keep you up at night.
- Stay away from screens for at least one hour before bedtime, since the light they give off can mess with levels of melatonin, the hormone that regulates sleep.
- Follow a bedtime routine, which can feel comforting and put you in the mood for sleep.
- Take a warm bath just before bed. It will soothe and relax you, and can help summon the sandman sooner.
- Try relaxation exercises — visualization, deep breathing, meditation, yoga or even chanting, possibly with a sleep or meditation app. Counting sheep can work the same way — the monotony of watching those little guys jump over the fence really can send you off to dreamland (unless you associate them with insomnia).
- Hit the sheets if you're in the mood, or ask your mate for a massage. Both can relax you.
- Crack a window if you feel hot and stuffy and it's not cold outside. If the weather's not cooperative, keep your room comfortably cool.
- Pile on the pillows, which can help create a comfortable sleep environment. Pregnancy sleep pillows, in particular, are designed to address your unique needs and help you find the best sleep position.
- Don't watch the clock. It's a surefire way to make you more stressed. And don’t just lie there, either. Instead, try doing something else to unwind (read, listen to music, meditate) until you feel sleepy.
- Try not to stress. Worrying about your lack of sleep only makes things worse. Sometimes just letting go is all it takes to nod off.
- Talk to your doctor. Mention any sleep problems to your practitioner; he or she might be able to suggest more sleep solutions or even medications that are safe during pregnancy. Never pop any sleep meds (prescription, herbal or over the counter) without talking to a doctor first.
- Consider therapy. Research suggests that insomnia during pregnancy may be a sign of another mental health condition, including prenatal depression and anxiety. Studies also suggest that seeing a therapist via telehealth can help reduce symptoms of anxiety, depression and insomnia in expecting women.
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