Safe ways to sleep during pregnancy

Sleeping During Pregnancy (for Parents)

Reviewed by: Larissa Hirsch, MD

en español El sueño durante el embarazo

Why Does Pregnancy Sometimes Make Sleeping Difficult?

When you're pregnant, it can be hard to get a good night’s sleep. As you get bigger, it gets tougher to find a comfortable sleeping position. You may need to pee in the middle of the night. And heartburn can wake you up.

Some women have leg cramps and backaches, especially as they begin carrying more and more weight. Many pregnant women report that their dreams become more vivid than usual, and some even have nightmares.

Stress can interfere with sleep too. Maybe you're worried about your baby's health, anxious about your abilities as a parent, or feeling nervous about the delivery itself. All these feelings are normal, but they might keep you (and your partner) up at night.

How Can I Get a Better Night’s Sleep?

Early in your pregnancy, try to get into the habit of sleeping on your side. Lying on your side with your knees bent is likely to be the most comfortable position as your pregnancy progresses. It also makes your heart's job easier because it keeps the baby's weight from applying pressure to the large vein (called the inferior vena cava) that carries blood back to the heart from your feet and legs.

But don't drive yourself crazy worrying that you might roll over onto your back during the night. Shifting positions is a natural part of sleeping that you can't control.

Try experimenting with pillows to find a comfortable sleeping position. Some women place a pillow under their abdomen or between their legs. Also, using a bunched-up pillow or rolled-up blanket at the small of your back may help to relieve some pressure. In fact, you'll see many "pregnancy pillows" on the market. If you're thinking about buying one, talk with your doctor first about which might work for you.

Over-the-counter sleep aids, including herbal remedies, are not recommended for pregnant women.

Instead, these tips may safely improve your chances of getting a good night's sleep:

Cut out caffeinated drinks like soda, coffee, and tea from your diet as much as possible. Restrict any intake of them to the morning or early afternoon.
Avoid drinking a lot of fluids or eating a full meal within a few hours of going to bed. (But make sure that you also get plenty of nutrients and liquids throughout the day.) Some women find it helpful to eat more at breakfast and lunch and then have a smaller dinner. If nausea keeps you up, try eating a few crackers before you go to bed.
Get into a routine of going to bed and waking up at the same time each day.
Avoid rigorous exercise right before you go to bed. Instead, do something relaxing, like reading a book or having a warm, caffeine-free drink, such as milk with honey or a cup of herbal tea.
If a leg cramp awakens you, it may help to press your feet hard against the wall or to stand on the leg. Some women find that stretching their calf muscles before bed helps. Also, make sure that you're getting enough calcium and magnesium in your diet, which can help reduce leg cramps. But don't take any supplements without checking with your doctor.
Take a yoga class or learn other relaxation techniques to help you unwind after a busy day. (Be sure to discuss any new activity or fitness regimen with your doctor first.)
If fear and anxiety are keeping you awake, consider enrolling in a childbirth class or parenting class. More knowledge and the company of other pregnant women may help to ease the fears that keep you awake at night.

What If I Still Can't Sleep?

Of course, there will be times when you just can't sleep. Instead of tossing and turning, worrying that you're not asleep, and counting the hours until your alarm clock will go off, get up and do something calm: read a book, listen to music, or look at a magazine. Eventually, you'll probably feel tired enough to get back to sleep.

And if possible, take short naps (30–60 minutes) during the day. Naps can help you have energy to get through the day and give your body the rest it needs.

Reviewed by: Larissa Hirsch, MD

Date reviewed: May 2022

Sleep position in pregnancy Q&A

Tommy's PregnancyHub

In the third trimester of pregnancy going to sleep on your side has been shown to help prevent stillbirth.

In the third trimester our advice is to go sleep on your side because research has shown that this is safer for baby. This includes night sleep and day time naps.

Can I sleep on my back during pregnancy?

Research has shown that in the third trimester (after 28 weeks of pregnancy) going to sleep on your back increases your risk of stillbirth. As the link has now been shown in four separate research trials, our advice is to go to sleep on your side in the third trimester because it is safer for your baby. The advice relates to any episode of sleep, including:

going to sleep at night
returning to sleep after any night wakenings
day time naps.

We don’t want you to become anxious about this. If your pregnancy is uncomplicated your risk of stillbirth is low (1 in 200 babies are stillborn). Going to sleep on your side will make it even lower.

How reliable is the research?

The research linking going to sleep on your back to stillbirth is very reliable. Four case control research studies (in which information from women who have had a stillbirth is compared with information from women who have not) have been carried out into maternal sleep position and stillbirth and all have shown that there is a link.

What if I wake up on my back during the night?

The research has been focused on position going to sleep, not position during the night. If you wake up on your back, just settle back to sleep on your side.

We cannot control our position when we are asleep and a large bump is likely to be uncomfortable enough to prevent you from being on your back for long during the night. We also know that the position we go to sleep in is the position we spend the longest amount of time in during the night.

What could cause the increased risk of stillbirth?

Sleep position in the third trimester is important because if you are on your back the combined weight of baby and womb puts pressure on other organs in your body.

Researchers do not know for certain what exactly is causing the increased risk of stillbirth, but we already know the following, which could play a part :

When sleeping/lying on your back the baby and womb put pressure on the main blood vessels that supply the uterus and this can restrict blood flow/oxygen to the baby.
Further recent studies have shown that when a woman lies on her back in late pregnancy (compared to lying on side) the baby is less active and has changes in heart-rate patterns. This is thought to be due to lower oxygen levels in the baby when the mother lies on her back.

Does it make a difference which side I sleep on in pregnancy?

There are many websites that tell you that the left side is best to sleep on during pregnancy. This is for the following reasons:

One of the smaller research studies, from Auckland, New Zealand, showed that women who sleep on their left side on the last night of pregnancy halved their risk of stillbirth compared to those who slept on their right. However, the same finding has not been seen in any other trial (there have been three other published research studies since then).
Sleeping on your left has been shown to help your kidneys to get rid of waste products and fluids from your body.

Therefore, while sleeping on your left side has not conclusively been shown to reduce your risk against sleeping on your right, there are reasons that you might choose to do so.

Tips for sleeping on your side in pregnancy

Put pillows behind you to prevent falling on your back. It won’t prevent you being on your back for certain but is likely to make it more uncomfortable.
If you have long hair, try tying it in a low bun, which may make it uncomfortable to sleep on your back for any length of time.
If you wake up for any reason during the night, check your position and go back to sleep on your side.
If you are likely to nap during the day pay the same attention to sleep position during the day as you would during the night.

If you're finding sleeping on your side difficult because of SPD/PGP, try these tips.

In the early days of pregnancy it is fine to sleep on your stomach. Your bump will not start showing until the second trimester and sleeping on your stomach is unlikely to be uncomfortable. In the third trimester, you will have a large bump and it is very unlikely that you would choose this position. However, if you do wake up on your stomach, don’t worry, just roll onto your side.

Heazell AEP, Li M, Budd J, Thompson JMD, Stacey T, Cronin RS, Martin B, Roberts D, Mitchell EA, McCowan LME. Association between maternal sleep practices and late stillbirth – findings from a stillbirth case-control study. BJOG2017; https://doi. org/10.1111/1471-0528.14967.

Stacey T1, Thompson JM, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LM.
Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ. 2011 Jun 14;342:d3403. doi: 10.1136/bmj.d3403.

Gordon A1, Raynes-Greenow C, Bond D, Morris J, Rawlinson W, Jeffery H. Sleep position, fetal growth restriction, and late-pregnancy stillbirth: the Sydney stillbirth study. Obstet Gynecol. 2015 Feb;125(2):347-55. doi: 10.1097/AOG.0000000000000627.

Lesley ME, McCowan LME, Thompson JMD, Cronin RS et al (2017) Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PLOS One https://doi.org/10.1371/journal.pone.0179396

Jeffreys RM, Stepanchak W, Lopez B, Hardis J, Clapp JF, 3rd. Uterine blood flow during supine rest and exercise after 28 weeks of gestation. BJOG : an international journal of obstetrics and gynaecology. 2006 Nov;113(11):1239-47

Khatib N, Weiner Z, Beloosesky R, Vitner D, Thaler I. The effect of maternal supine position on umbilical and cerebral blood flow indices. European journal of obstetrics, gynecology, and reproductive biology. 2014 Apr;175:112-4.

Stone PR, Burgess W, McIntyre JP, Gunn AJ, Lear CA, Bennet L, et al. Effect of maternal position on fetal behavioural state and heart rate variability in healthy late gestation pregnancy. The Journal of Physiology. 2017 Feb 15;595(4):1213-21.

Murray I, Hassall J. 2014. Change and adaptation in pregnancy. In: Marshall J, Raynor M. eds. Myles Textbook for Midwives. 16th ed. Edinburgh: Churchill Livingstone, 143-177

How to sleep during pregnancy

It is difficult to overestimate the role of sleep in the life of every person. A complete healthy rest allows you to fully restore the functioning of the nervous system, relieve stress, improve performance and increase activity. Chronic sleep deprivation is the cause of many diseases. What can we say about a woman who is at the stage of bearing a baby. During this period, more than ever, she needs a healthy, long and full sleep. However, unfortunately, it is during this period that one can only dream of a restful sleep.

As soon as a woman finds out about her new position, she has to give up a lot for the sake of the health of her unborn baby. And you need to give up not only bad habits: alcohol, cigarettes, coffee, but also from a comfortable sleep.

The cause of insomnia can be :

Anxiety;
Frequent urination;
Fears and phobias before a new stage of one's life;
Nervousness and irritability;
Digestive disorder;
Toxicosis;
Physical indisposition;
Uncomfortable posture.

During the period of bearing a child, the female body experiences an extraordinary load, especially in the last trimester. The need for more sleep increases, because the body expends much more energy. Therefore, healthy sleep and pregnancy are inextricably linked.

Let's try to figure out how to sleep during pregnancy, so as not only not to harm the health of your unborn baby, but to sleep well.

Looking for a comfortable sleeping position

Each person has his own favorite position, in which it is easy to fall asleep and sleep. Many do not imagine a comfortable rest on their backs, accustomed to sleeping on their stomachs. This habit will have to be sacrificed, as it is unsafe for the normal development of the fetus. If in the first three months of pregnancy a woman can still sleep in the position in which she is used to and feels comfortable, then after the first trimester the growing belly will not allow her to lie safely in this position. Despite the natural protection of the baby in the form of amniotic fluid, there is a high probability of injuring the baby in a dream, squeezing it. But what is the right way to sleep during pregnancy?

Back position

Even if you are used to sleeping in a Spartan position, on your back, with your arms spread wide, from the 28th week you will have to radically change your lifestyle. The fact is that as the fetus grows, the load on the intestines and vena cava will increase significantly, blocking the access of oxygen to the baby.

If you sleep on your back during pregnancy, you may experience the following problems:

Dizziness;
Nausea;
Convulsions;
Numb limbs;
Pressure reduction;
Hemorrhoids;
Heaviness of breathing.

If you feel these symptoms or the baby gives persistent signals, you need to urgently change your position, so squeezing the vena cava is fraught not only with poor health for the mother, but also with a lack of oxygen supply to the fetus.

Stomach position

One of the most beloved positions for many people, which allows you to quickly fall asleep while hugging a pillow. Many women, as soon as they find out about the change in their lives, are interested in the question, is it possible to sleep on your stomach during pregnancy? Doctors recommend abandoning this position already in the first weeks, even before the enlarged belly makes it impossible to fall asleep peacefully.

If you are afraid during sleep, without controlling your movements, to arbitrarily roll over on your stomach, you can put a large pillow that does not allow you to change position.

Side position

In order to normalize your sleep and not harm the health of the baby, experts recommend sleeping on your side during pregnancy. And if at first this option seems unacceptable to many, after the second trimester, lying on your side is the only possible one. But here the question arises, on which side to sleep in order to ensure the safety of the fetus?

Sleeping on the right side can cause squeezing of the kidney, which can have dire consequences. The ideal posture is lying on the left side. Thus, you not only do not injure the unborn baby, but also improve blood flow along with oxygen to the placenta.

But one should not ignore the individual characteristics of each organism and the position of the fetus in the uterus. When the baby is in a transverse position, choose the side where the baby's head is. And with a breech presentation, doctors recommend changing the position several times a night.

If you still cannot improve your sleep, you feel unwell and you are tormented by insomnia, then it is better to consult a specialist. A good gynecologist will analyze the situation and help solve the problem. If necessary, he will prescribe a safe sedative that stabilizes the emotional state and helps to fall asleep calmly, resting and restoring the nervous system in a dream.

Help pillow

Fortunately, now modern manufacturers help women survive the pregnancy period with great comfort by offering special pillows. They are made taking into account the physiological characteristics of a woman in this period and allow you to find a comfortable position for relaxation.

You can buy two pillows and put one under your stomach and the other under your knees, looking for your best option. And you can buy a long banana-shaped pillow, which allows you to throw your leg on it while sleeping, which improves well-being and relieves the main load from the lower back and abdomen. Already in the last weeks of pregnancy, when the growing belly does not allow you to breathe normally, the pillow will allow you to take a comfortable half-sitting position.

Remember that pregnancy is your opportunity to gain strength and fully relax before the most crucial period in your life. Childbirth and the first weeks of caring for your baby will require a lot of energy from you, so good luck and sound sleep!

Insomnia during pregnancy and how to deal with it

At first you don’t sleep because you are anxious and sick, then it becomes stuffy at night and you want water, then your stomach starts to interfere with sleeping in your favorite position, the baby arranges night dances, and, finally, heartburn, which does not allow you to fall asleep in the last weeks before childbirth . But still, insomnia during pregnancy can be dealt with.

Drink enough water during the day

Night thirst during pregnancy is often associated with a lack of water during the day. At the same time, drinking a lot before bedtime and at night is not recommended. So you run the risk of getting swelling of the legs, and besides, you get up at least once at night to go to the toilet, which can also interrupt sleep. Doctors recommend drinking water during the day, several sips every 30-40 minutes. So the load on the kidneys will be uniform, and at night you will not suffer from thirst.

Avoid spicy foods and carbonated drinks

Of course, you should not categorically refuse your favorite dishes, especially since during pregnancy, new taste preferences can determine the menu. But you need to remember that if you ate spicy or drank a carbonated drink during the day, then there may be problems with sleep at night. And after the twentieth week, your menu will be reflected in the activity of the child, and “non-childish” food will immediately make itself felt with night dances in the stomach.

Comfortable bed

You should be able to completely relax before going to bed. Perhaps you need to move to another room, to another bed, buy a pillow for pregnant women, hang dark curtains, remove the clock that makes obsessive ticking.

Try to eat in the evening about three hours before bedtime

Insomnia in a pregnant woman may appear as a result of heartburn after dinner. This often happens already starting from the second trimester: the uterus rises higher and changes the position of the stomach and intestines. If you suffer from heartburn before going to bed, then lie down with your head up and on your left side: this way, acid from the stomach will not enter the esophagus. You will also have to give up a heavy dinner in favor of a light snack, and a few weeks before giving birth, do not eat anything three hours before bedtime.

Take a safe sedative

Increased anxiety in a pregnant woman is quite common. Hormonal adjustment, concern about the health of the child, fear of antenatal clinics, dissatisfaction with one's body - all this leaves an imprint on the psychological state of a woman. At the same time, advice to “calm down” can only exacerbate internal tension. Therefore, during pregnancy, drugs are often prescribed that reduce the excitability of the nervous system. But the safety of such drugs is of particular concern to the expectant mother, and is another cause for concern.