Many factors can get in the way of a good night’s sleep during pregnancy: a growing belly, heartburn, and aches and pains are among the most common.
It can feel impossible to get the rest you need during pregnancy, but with a few changes and symptom management, quality sleep is more than a dream. Below, we’ll review why it’s difficult to sleep comfortably while pregnant, what the most comfortable sleep position is, and how you can manage pregnancy-induced sleep discomforts.
Why Is It So Hard to Sleep Comfortably While Pregnant?
During pregnancy, your body goes through profound changes, many of which can interfere with sleep.
- Growing abdomen: As you progress through each trimester, your growing abdomen becomes heavier and shifts your center of gravity, pulling you forward. This can make it difficult to find a comfortable sleeping position.
- Back, pelvic, and hip discomfort: As your abdomen grows, you’ll likely experience back and pelvic pain from the added weight and stretching muscles. Ligaments also relax to prepare for birth, so hip discomfort is common.
- Hormonal changes: Pregnancy hormones direct your body as it grows your baby, but they can sometimes lead to more fragmented sleep.
- Heartburn: Heartburn is a common complaint during pregnancy as the digestive system slows down. In addition, the growing belly in the second and third trimesters can compress the stomach, which can push gastric contents toward the windpipe, creating a burning sensation.
- Shortness of breath: Pregnancy hormones can cause shortness of breath, and as your belly grows, you might experience added pressure on your diaphragm.
- Frequent urination: Your body creates more blood during pregnancy to support fetal development, and your kidneys filter this extra blood, increasing your need to urinate.
- Leg cramps and restless legs: Both are very common during pregnancy. Leg cramps are due to muscle contractions. While the cause of restless legs syndrome (RLS) in pregnant people isn’t fully understood, the rate of occurrence is higher than in the general population.
- Feeling flushed or increased body temperature: Due to hormonal changes, many pregnant people experience hot flashes at night or night sweats, similar to during menopause. In addition, body temperature rises slightly because of increased blood volume.
- Fetal movement: As your baby grows, its movements will become easier to sense, which can sometimes wake you up or keep you awake.
Don’t Just Test Your Sleep. Understand It.
Measure key sleep metrics and review your results with a licensed sleep-care provider. Discuss sleep issues and options to make restless nights a thing of the past.
What’s the Most Comfortable Sleeping Position During Pregnancy?
Side sleeping is often the most comfortable position, especially as your pregnancy progresses. Some providers recommend sleeping on your left side to optimize blood flow, but studies show that sleeping on either side is equally safe.
Sleeping on your back will likely become uncomfortable later in pregnancy, as the added weight in your abdomen can put pressure on your back. Some research suggests a small risk to back sleeping late in pregnancy, but those studies are somewhat limited. Most experts will assure you that it’s best to sleep in whatever position is most comfortable to you.
Stomach sleeping is considered safe as long as it remains physically comfortable.
How to Get Comfortable Sleeping on Your Side
Sleeping on your side can be difficult, especially if you’re used to sleeping in a different position. Below are some tips to help you get comfortable.
- Slightly bend your knees: Bending your knees slightly can reduce strain on your back.
- Place a pillow between your knees or thighs: A pillow between your knees or thighs can help align your hips, pelvis, and spine by elevating your top leg.
- Support your belly: As your belly grows, you might find it comfortable to place a small pillow or wedge under it.
- Place a pillow behind your back: The weight of your belly may push you to roll onto your back, and a pillow behind your back can help you feel supported.
- Keep your head and neck aligned: Instead of stacking several pillows, choose one with the correct loft. Side sleepers tend to need a pillow with a slightly higher loft to keep the spine aligned.
Do You Need a Pregnancy Pillow?
A pregnancy pillow can help, but it isn’t essential. Regular bed pillows can work just as well if you place them in the right spots. The benefit of a pregnancy pillow is that it can do the work of several pillows in one.
If you’re shopping for a pregnancy pillow, consider these varieties.
- U-shaped: These are the largest type and wrap around the entire body to support the head, neck, stomach, back, knees, and legs.
- C-shaped: C-shaped pillows are long with two shorter arms so you can customize support for your head, neck, back, or knees.
- J-shaped: This style is essentially half of a U-shaped pillow and offers cushioning for your head, belly, and knees.
- Wedge: A wedge pillow is shaped like a triangle and can fit under your belly or elevate your upper body.
- Straight: A long, straight pillow is versatile and can be hugged, tucked between your legs, or placed behind your back.
How to Manage Common Pregnancy Sleep Discomforts
There’s no getting around the fact that pregnancy is hard on your body, but there are ways to relieve common sleep discomforts and get the rest you need.
Back and Hip Pain
Hip and back pain are common due to the added weight in your abdomen and ligaments loosening to prepare for birth. Try the following to help relieve pain:
- Sleeping on your side with your knees slightly bent
- Placing a pillow between your knees
- Supporting your belly and lower back with small or wedge pillows
- Avoiding positions that twist the pelvis, keeping legs aligned instead
- Engaging in daytime stretching or other physical activity when medically appropriate
Heartburn
Your digestive system slows down during pregnancy, leading to common complaints like heartburn. You can take a few steps to help ease the discomfort.
- Avoid large meals close to bedtime: If you eat a large meal and then lie down shortly afterward, your full stomach can put pressure on your esophagus and cause acid reflux.
- Identify foods that trigger symptoms: Sometimes spicy, acidic, or fatty foods can trigger heartburn.
- Elevate the upper body: Use pillows to elevate your entire upper body, not just your head.
- Consult your doctor: If your heartburn is persistent, talk to your healthcare provider before trying medication.
Frequent Urination
Many pregnant people awaken several times a night to use the bathroom. That’s because your kidneys have to filter extra blood during pregnancy. As your abdomen grows, it also places extra pressure on your bladder.
While you can’t completely eliminate extra trips to the bathroom, you can make changes to minimize nighttime interruptions. Stay adequately hydrated during the day so you don’t feel the need to fill up on water before bed. Try reducing fluids close to bedtime (as long as it doesn’t interfere with overall hydration) and use the bathroom right before bed.
Leg Cramps and Restless Legs
Leg cramps and restless legs syndrome (RLS) are very common during pregnancy. RLS is a sleep disorder that causes an urge to move your legs when you lie down, accompanied by uncomfortable tingling or burning sensations.
Leg cramps usually occur because of muscle contractions, so gentle stretching before bed can help prevent them. You can also try toe raises while a cramp is occurring to help relieve discomfort.
If your provider approves it, regular physical activity during the day can help alleviate both leg cramps and RLS. It has the added benefit of helping to relieve the symptoms of mental health conditions like anxiety and depression, which can make RLS worse.
RLS is sometimes associated with iron deficiency during pregnancy, so talk to your provider if your RLS is frequent.
Feeling Too Hot
Hormonal changes can raise your body temperature during pregnancy, especially at night. Here are a few suggestions to cool down at night.
- Keep your bedroom comfortably cool: The ideal sleep temperature is 65 to 68 degrees Fahrenheit (18 to 20 degrees Celsius), so turn down the thermostat if needed.
- Choose lightweight pajamas and bedding: Breathable fabrics include cotton, linen, and rayon.
- Utilize air circulation: Whether it’s a fan or air conditioning, circulating air can help cool you down while you sleep.
- Avoid excessively heavy bedding: Even if you like to be covered up while you sleep, a light blanket quilt may be a better choice than a heavy comforter.
Shortness of Breath
Pregnancy hormones can make you take deeper breaths, which can, ironically, make you feel out of breath. As your belly grows, it can also put pressure on your diaphragm.
Elevating your upper body can help alleviate shortness of breath, and sleeping on your side may also feel more comfortable.
Some shortness of breath is normal during pregnancy, but if you have significant breathing difficulty, seek medical attention right away.
Tips for Getting Better Sleep While Pregnant
While relieving physical discomfort will help you sleep better during pregnancy, improving your overall sleep hygiene will also go a long way toward a better night’s rest.
- Maintain consistent sleep and wake times: Going to bed and waking up around the same time each day helps your body prepare for sleep each night.
- Build a relaxing bedtime routine: Try calming activities like journaling, yoga, or listening to quiet music.
- Get regular daytime activity: If your provider has cleared you for exercise, moving your body during the day can help you feel ready to sleep at night.
- Get daylight exposure: Light exposure helps regulate your circadian rhythm, which in turn controls your sleep cycle. Signaling to your body in the morning that it’s daytime can help you fall asleep when night falls.
- Limit caffeine: Caffeine is a stimulant that keeps you awake, so avoid it later in the day.
- Keep naps relatively short: Naps can help you catch up on sleep if your nighttime sleep is fragmented. However, keep naps relatively short so you can still fall asleep at bedtime.
- Create the right bedroom environment: Make sure your bedroom is dark, quiet, and cool.
- Give yourself enough opportunity for sleep: Pregnancy involves a great deal of preparation and some stress, but make sure you have plenty of time to fall asleep and stay asleep.
When to Talk to Your Doctor
Discomfort and mild sleep troubles are unfortunately normal parts of pregnancy. However, if you experience any of the following, you should talk to your doctor.
- Persistent insomnia: Sometimes sleep issues can turn into full-fledged “pregnancy insomnia.” If you frequently have trouble falling or staying asleep, talk to your doctor about treatment options like CBT-I (cognitive behavioral therapy for insomnia).
- Loud snoring, gasping, or breathing pauses: Some pregnant people develop sleep apnea, a sleep disorder that causes you to stop breathing while you sleep. Tell your doctor about any symptoms like loud snoring or gasping.
- Severe daytime sleepiness: If you’re excessively sleepy during the day, it could signal sleep apnea or another sleep disorder.
- Frequent restless legs: RLS can sometimes be due to an iron deficiency during pregnancy, and your provider may prescribe an iron supplement.
- Severe or worsening pain: Alert your doctor right away if you experience severe pain.
- Significant shortness of breath: If you frequently or suddenly struggle for air, talk to your doctor as soon as possible.
- Sleep problems affecting daily functioning: If your sleep issues interfere with your daily life, see your doctor to see whether you have an underlying sleep disorder.
