How to Sleep When Pregnant—and the Best Position

Pregnancy Sleep Primer

May 16, 2019

Pregnancy Sleep Primer

Pregnancy Sleep Primer
Pregnancy Sleep Primer

Exhaustion is one of the most common symptoms of pregnancy. So it’s normal if you feel more tired than usual—or if you’ve never felt so tired in your life.

Because your body chemistry shifts during pregnancy, you need more sleep than ever, right from the start. You’re pumping out more progesterone to build up the uterine lining and prevent miscarriage, and these higher levels can also can lower your blood pressure and blood sugar, making you feel lethargic and queasy.

The trouble is that at a time when sleep is so important—and so wanted!—it may be tougher than ever to get. One National Sleep Foundation poll found that 78 percent of women reported more sleep trouble during pregnancy than other stages of their lives. The reasons may be physical—back pain, sore breasts or other body changes keeping you up at night. Or they may be psychological, as you’re contemplating a major life change.

Hopefully, each night’s sleep will be restful, and you’ll never need this FAQ. But bookmark it today, just in case.

How Will My Sleep Change Throughout Pregnancy?

It all depends. Some women sleep well throughout pregnancy; others have more challenging stretches. In the first trimester, for example, that rise in progesterone may make you feel nauseous, and middle-of-the-night bathroom trips may become more frequent.

Later on in pregnancy, as your body continues to change, it can be harder to find a comfortable position. The symptoms and aches and pains of the third trimester can really do a number on the quality of sleep you get too.

Best Sleeping Positions During Pregnancy

There’s some pretty specific sleeping position guidance for when you’re pregnant. Here’s the best sleep position during pregnancy:

  • Sleeping on your side: Doctors recommend pregnant women sleep on their side to maximize blood flow to the placenta. In fact, sleeping on the left side may be even better for this than the right. Pregnancy pillows can be a mom-to-be’s best friend for getting comfy while in a side-lying position.

The facts on other sleeping postions:

  • Sleeping on your back: About midway through your pregnancy, you should try to stop sleeping on your back. That’s because your growing uterus could put pressure on major blood vessels, which can cause lower blood pressure and decrease circulation to your heart and your baby. Don’t freak out if you wake up in the middle of the night on your back though. Just adjust, and you and baby will be fine.
  • Sleeping on your stomach: Sleeping on your stomach is OK, but you’re not really going to be able to do it once your bump gets big and round.

How Much Sleep Do I Need During Pregnancy?

There’s no one magic number when it comes to sleep, though it’s recommended that adults get seven to eight hours nightly. But plenty of people run on much less (they’re sometimes powered by coffee, which might seem less appealing during pregnancy) or require much more. Your body should be your guide—if you’re more tired than usual, or you catch yourself nodding off during the day, you probably need more sleep. Try to get extra rest if and when you can.

Pregnant and Can’t Sleep?

There are many (totally normal) reasons you may have trouble sleeping during pregnancy. You may be dealing with some or all of these sleep disruptors:

  • Back pain: Backaches are common during pregnancy. Try placing a pillow under your abdomen and/or one between your legs to ease some pressure.
  • Heartburn: Pillows can help with this annoyance too. Try propping up your upper body to lessen heartburn discomfort.
  • Snoring: Between extra nasal congestion and your uterus pushing on your diaphragm, you might find yourself snoring. Tell your doctor about this symptom—they may be able to recommend some treatments, but it also could be a sign of sleep apnea, high blood pressure and/or preeclampsia, which is a pregnancy condition that can lead to complications.
  • Restless legs syndrome: Just can’t keep those legs still? If you feel leg discomfort or creepy crawlies that won’t go away, it might be restless legs syndrome. Sometimes iron and/or folate supplements can help, so talk to your doctor.
  • The need to pee: Some pregnant women have their sleep disrupted because they have to keep getting up to go to the bathroom, and it’s hard to settle back down afterwards.
  • Anxiety and/or stress: You (quite understandably) have a lot on your mind. After all, your life is going to change a lot once this baby comes and there are probably a lot of to-dos on your list. If anxiety is keeping you from falling or staying asleep, meditation sometimes can help. Apps like Calm and Headspace provide guided meditation sessions that may help quiet your mind.

Seven Things to Do for Better Sleep

If sleep trouble is an annoying but somewhat rare occurrence, you can try any number of techniques to more effectively power down. Some ideas:

  • Establish a regular bedtime. The same time, every day. Even weekends.
  • Eat a little, not a lot, before bed. And if you do drink caffeine, save it for the morning.
  • Create a sleep haven. You want cool, dark and comfortable.
  • Ditch the screens. The work, too. Smart phones, tablets, laptops and TVs right before bed can make it hard to fall asleep.
  • Heartburn. If you’re suffering from heartburn, avoid spicy, greasy and fried foods and wait at least an hour after eating before going to bed. If it’s bad, talk with your healthcare provider.
  • Nap when you can! Grabbing an hour here and there is great, as long as you can still fall asleep at night.
  • Exercise during the day. Gentle physical activity, like walking, swimming and yoga, can help you tire your body out and get more restful sleep.

If these techniques don’t help after a week or two, talk with your doctor about possibly getting treatment for insomnia, suggests Ina Becker, MD, PhD, a psychiatrist in New York City.

Relatively little is known about pregnancy and the medications that typically treat insomnia—mostly because of the danger of testing potentially harmful drugs on pregnant women. Your doctor may recommend certain over-the-counter medications, including Benadryl and Unisom. They are classified as a “Category B” by the Food and Drug Administration, which means that animal studies didn’t show a risk to the fetus, but there aren’t well-controlled studies in humans. (Here is more on how the FDA classifies drugs for use during pregnancy.)

“We use both (Benadryl and Unisom) with caution, after weighing risks of persistent severe insomnia versus risks—probably low risks—from medication,” Dr. Becker says.

There are also some options for prescription medication; talk with your doctor if you think you’re in need. Don’t be afraid to seek help if you’re struggling to sleep.

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