Sleep in pregnancy

 

 

Key points about sleep in pregnancy

  • Pregnancy is a time in a woman’s life when good sleep can be hard to achieve.
  • At the beginning of your pregnancy tiredness can be overwhelming.
  • If you can find time to sleep during the day, do so.
  • Later on it can be much harder to get the sleep you need.

 

Pregnant woman lying in field

Being able to get enough sleep is an essential part of your pregnancy, but just when you need it you may find that you struggle to get a good night’s sleep.

There are many reasons why sleep may be disturbed during pregnancy. It begins in early pregnancy with soaring progesterone levels, which zap your energy and can cause you to feel overwhelmed by tiredness.

By the second trimester, these pregnancy hormones should have settled down; however, you still have to deal with other common pregnancy niggles that can affect your sleep. These include backache, leg cramps, heartburn, needing to pee frequently and vivid dreams. In the later stages of the pregnancy, you may struggle to get an uninterrupted night’s sleep.

1. Avoid fluids at bedtime

Your growing womb puts pressure on your bladder during pregnancy and it is common to need to go to the loo in the middle of the night. To reduce the number of times you wake, drink lots of fluids during the day to stay hydrated, but cut down before going to bed. Also avoid caffeine before bedtime, as this will both keep you awake and increase the urge to pee.

2. Settle your stomach

What you eat and when you eat it can affect your sleep. If you find yourself waking in the night because you are hungry, try having a small meal before bedtime. Suitable options include:

  • a small bowl of porridge or cereal with low-fat milk
  • yoghurt with oats sprinkled on top
  • crackers with peanut butter, cheese or chicken
  • an apple with a small slice of cheese.

Avoid eating big meals just before bedtime as this may make you more likely to have heartburn and indigestion. Also avoid spicy, acidic (eg, tomato products) or fried foods before bedtime.

3. Get comfortable

As your baby’s birth gets closer, you may find that your bump is too large for you to find a comfortable sleeping position. It’s safest to sleep on your side during the last 3 months of your pregnancy, as this reduces your risk of stillbirth. To make yourself more comfortable, support your bump with a pillow and put a pillow between your knees. This keeps the pressure off the muscles around your hips and pelvis.

In early pregnancy, going to sleep in any position you feel comfortable in is fine. However, during the last trimester of your pregnancy, you should try to go to sleep on your side, either your left or right. Lying on your back in the last 3 months of pregnancy presses on major blood vessels, which can reduce blood flow to the womb and oxygen supply to the baby, increasing the risk of stillbirth. 

 

(Cure Kids & Ministry of Health NZ, 2018)

If heartburn is a problem, you could try raising the head of your mattress a few centimetres to help keep stomach acids where they should be.

4. Wind down at bedtime

Take some time to relax as it gets close to your bedtime. Your antenatal classes(external link) may teach you some relaxation techniques, or you can find many relaxation videos, podcasts and apps online.

If you find yourself worrying at night about your pregnancy or the idea of becoming a mother, write down the things that are on your mind. Talk about them with your partner, a friend or your midwife. This can help you to feel less anxious about your concerns or help you to find practical solutions to them. 

5. Exercise

Exercising regularly during pregnancy will help improve your circulation and reduce leg cramps. It can also help you feel less tired. Try to do something active each day. If you were active before your pregnancy, you can continue with the same level of activity. Exercise during pregnancy has not been shown to create any problems for mother or developing child. See if there are any pregnancy yoga or pilates classes in your area.

Avoid vigorous activity for about 4 hours before bed, to give your body a chance to wind down. Read more about exercising during pregnancy.

6. Ask for help and rest when you can

Sleeplessness is very common during pregnancy. It won’t harm your baby, but it can make you feel run down and exhausted. Listen to your body when it tells you to slow down or rest. If you can find time to sleep during the day, do so.

If you find tiredness is really affecting your day-to-day life, try to get help where you can. If you are working, ask your employer about changing your hours or duties. If you already have children, see if family or friends can look after them for a bit so you can catch up on rest.

If lack of sleep continues to bother you, talk to your doctor or midwife.

  • Your sleep will be frequently interrupted.
  • Try to sleep when your baby sleeps – the dishes can wait!
  • And if you can share the baby’s care, especially during the night, do so to keep yourself physically and mentally on top of things.

Sleep times by age

Age Hours needed per night
0-2 months  10.5-18.5
2-12 months   14-15
 12-18 months  13-15
 3-5 years  11-13
 5-12 years  9-11
 Adolescents  8.5-9.5
 Adults  7-9

Sleep on side when baby's inside – brochure for health professionals(external link) Ministry of Health, NZ, 2018
An individual participant data meta-analysis of maternal going-to-sleep position, interactions with fetal vulnerability, and the risk of late stillbirth(external link) The Lancet 2019 1 Apr; 10:49-57.

Additional reading

  1. Sleep on side when baby's inside – brochure for health professionals(external link) Ministry of Health, NZ, 2018
  2. Stacey T, Thompson J, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LM. Association between maternal(external link)sleep practices and risk of late stillbirth: a case-control study(external link) BMJ 2011; 342:d3403.
  3. McCowan L, Thompson J, Cronin R, et al. 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(external link) PLOS One 2017; 12(6): e0179396.
  4. Gordon A, Raynes-Greenow C, Bond D, Morris J, Rawlinson W, Jeffery H. Sleep position, fetal growth restriction, and late-pregnancy stillbirth – the Sydney stillbirth study(external link) Obstet Gynecol 2015; 125(2):347-55.
  5. Heazell A, Li M, Budd J, Thompson J, Stacey T, Cronin RS, Martin B, Roberts D, Mitchell EA, McCowan L. Association between maternal sleep practices and late stillbirth – findings from a stillbirth case-control study(external link) BJOG 2018 125(2):254-262.
  6. Humphries A, Ali Mirjalili S, Tarr GP, Thompson JMD, Stone P. The effect of supine positioning on maternal hemodynamics during late pregnancy(external link) J Matern Fetal Neonatal Med 2018; Epub 17 May 2018: doi.org/10.1080/14767058.2018.1478958.
  7. Sone PR, Burgess W, McIntyre JP, Gunn AJ, Lear CA, Bennet L, Mitchell EA, Thompson JM. Effect of maternal position on fetal behavioural state and heart rate variability in healthy late gestation pregnancy(external link) J Physiology 2017; 595(4):1213-1221.
  8. O’Brien LM. Sleep-disordered breathing in pregnancy(external link) Current Sleep Medicine Reports 2016; 2(4):183-190. 

 

Continuing professional development

Podcast

Side-sleeping in late pregnancy(external link) Goodfellow Podcast, NZ, 2020

Professor Lesley McCowan discusses the impact of maternal sleep position on late stillbirth risk and how the public health message of side sleeping is best in late pregnancy.

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Credits: Healthify Editorial Team. Healthify is brought to you by Health Navigator Charitable Trust.

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