Pregnancy is a special time, full of excitement and change. But one of the biggest changes women notice is how they sleep. Even if you’re someone who usually sleeps well, pregnancy can make it harder to fall asleep, stay asleep, or feel rested in the morning.
Why does this happen? The short answer is that a lot is going on in your body and mind. Sleep is affected by physical, hormonal, and emotional changes and these can look different depending on what stage of pregnancy you’re in.
Let’s break it down by trimester.
First Trimester: So Tired, Yet Hard to Sleep
The first trimester (weeks 1–13) often brings extreme tiredness. Even if you’re getting enough sleep, you may still feel drowsy during the day. That’s because of a hormone called progesterone, which increases early in pregnancy to help support your growing baby. One of progesterone’s side effects? It makes you feel drowsy.
At the same time, many women deal with nausea, especially in the mornings (but it can happen any time of day). Some also need to pee more often, including at night. All of this can interrupt your sleep, leaving you low on energy.
Second Trimester: The Sweet Spot
The second trimester (weeks 14–27) is often called the “honeymoon phase” of pregnancy. Energy levels usually go up, nausea tends to ease, and many women find it easier to sleep again.
However, some people still wake up in the night or struggle with vivid dreams. Hormones are still changing, and your body is continuing to adjust. Still, compared to the first and third trimesters, the second tends to be the most restful time.
Third Trimester: The Sleep Struggle is Real
The third trimester (weeks 28–40) can be the most challenging time for sleep. By now, your belly has grown a lot, which can make it tough to find a comfortable sleep position. Getting used to sleeping on your side can be tough, especially if you’re someone who normally sleeps on your belly or back.
Additionally, your growing uterus presses on your bladder, making nighttime bathroom trips more frequent. It can also cause back pain and leg cramps, especially as you get closer to delivery.
Another common problem in the third trimester is snoring or breathing problems during sleep. Some women develop a condition called sleep-disordered breathing, which can include snoring and even sleep apnea, brief pauses in breathing while you sleep. This can happen because of weight gain and hormonal changes that affect the muscles in your airway.
Why Sleep During Pregnancy Matters
It’s normal for sleep to change during pregnancy, but poor sleep every night should not be ignored. Getting enough quality sleep is important for your health and your baby’s health. Research shows that not sleeping well during pregnancy may raise the risk for many complications including:
- Gestational diabetes
- High blood pressure
- Preterm labor
- Depression
What You Can Do
The good news is, there are safe and effective ways to improve sleep during pregnancy.
Here are some tips:
- Stick to a routine. Try to go to bed and wake up at the same time each day.
- Use pillows for support. Sleeping on your side with a pillow between your knees or under your belly can make you more comfortable.
- Stay active. With your healthcare provider’s approval, light exercise like walking can help you sleep better, but avoid working out too close to bedtime.
- Watch your drinks. Cut back on caffeine and drink less water in the evening to reduce bathroom trips at night.
- Try relaxation techniques. Breathing exercises, gentle stretching, or listening to calming music can help your body wind down.
If you snore loudly, feel very sleepy during the day, or are worried about your sleep, talk to your doctor or midwife. In some cases, you might be referred to a sleep study to check for conditions like sleep apnea.
If anxiety or racing thoughts are keeping you up, cognitive behavioral therapy for insomnia (CBTi) can be very helpful. This type of therapy is safe during pregnancy and has been proven to improve sleep without medication.
Working on sleep during pregnancy can make a big difference, not only for your health now, but also during the postpartum period.
Wrapping It Up
Sleep changes are a normal part of pregnancy, caused by physical discomfort, shifting hormones, and the emotional ups and downs of becoming a parent. These changes show up in different ways throughout each trimester. While you might not sleep like you used to, there are steps you can take to get better rest. If sleep becomes a serious issue, don’t wait to get help; reach out to your healthcare provider. During pregnancy more than ever, sleep isn’t a luxury, it’s a necessity.
Maristella Lucchini, PhD attended Politecnico di Milano in Italy where she obtained a PhD in Biomedical Engineering. Her research has focused on sleep in the perinatal period, both investigating upstream determinants of optimal sleep in this period and the downstream effect of poor sleep for maternal and infant health outcomes.” She was selected for the AASM Young Investigator Research Forum and awarded the AASM Focused Projects Grant for Junior Investigators.