The pregnancy sleep guide: why you’re tossing and turning—and how to fix it (backed by science)
Can’t remember the last time you slept through the night? You’re not alone—and you’re not doing anything wrong. Up to 78% of pregnant women report disturbed sleep, with problems peaking in the third trimester. Here’s what’s going on in your body, how it affects your health, and practical, science-backed ways to sleep better.
Why sleep gets harder during pregnancy
Sleep changes are common, expected, and multifactorial. Knowing the “why” makes solutions much easier to target.
Hormonal shifts play a major role in pregnancy sleep disruption. Early pregnancy brings a surge in progesterone, which can make you sleepy by day but also relaxes airway muscles, increasing snoring and risk of sleep apnea at night. These effects intensify sleep fragmentation as pregnancy progresses, according to research on hormonal mechanisms.
Your changing body creates physical sleep barriers too. Frequent bathroom trips, nausea, reflux, back and hip pain, and baby movements all disrupt consolidated sleep—especially later in pregnancy. These typical physical causes affect most pregnant women to some degree.
Insomnia symptoms—trouble falling or staying asleep, or waking too early—affect about 41% of expectant parents in North America, with higher rates when mood symptoms are present, according to global and regional prevalence studies.
Restless legs syndrome (RLS) emerges in roughly 15% of pregnancies, most commonly in the third trimester. That irresistible urge to move your legs—often worse in the evening—can significantly disrupt sleep quality, as noted in RLS in pregnancy research.
Snoring and sleep apnea become more common too. About 17.7% of people report frequent snoring in early pregnancy; progesterone-related muscle relaxation and weight gain can narrow airways and fragment sleep. Short sleep (less than 7 hours) in early pregnancy is also relatively common at 17.1%, according to sleep duration and snoring data.
How common is all of this? Very. Sleep disturbances rise across pregnancy—from about 40–63% in the first trimester to 80% in the second, and as high as 84% in the third trimester according to trimester progression studies and National Sleep Foundation data.
Why better sleep during pregnancy matters
Sleep isn’t just a comfort—it’s a health essential.
For mood and mental health, prenatal sleep disorders are associated with a higher risk of postpartum depression in the first 6 weeks after birth, as shown in research linking prenatal sleep disorders and PPD. Studies also show that insomnia symptoms are more prevalent when depression symptoms are higher, creating a significant correlation.
Cardiometabolic risks increase with poor sleep too. Short sleep (less than 7 hours) has been associated with increased risk of preeclampsia in some studies, highlighting the connection between sleep duration and pregnancy complications.
Daytime functioning suffers from fragmented sleep, fueling fatigue, brain fog, and irritability—tough when you’re working, parenting, or preparing for birth. No wonder 60% of pregnant people nap on weekends according to pregnancy napping pattern research.
Good news: science-backed adjustments to your sleep position, environment, and daily habits can make a real difference.
Science-backed pregnancy sleep tips you can start tonight
Small, consistent changes add up. Use these pregnancy sleep tips to address the most common sleep disruptors.
1) Choose safe sleep positions in pregnancy
Prioritize the left side in the second and third trimesters. Side-sleeping, especially on your left, promotes blood flow and reduces back and hip strain. If you wake on your back, simply roll back to your side—no need to panic.
Support your body with a firm pillow between your knees and another under your belly. A wedge behind your back can prevent rolling and ease reflux by keeping your torso slightly elevated.
For heartburn, elevate your head and upper torso 6–8 inches with a wedge and avoid eating 2–3 hours before bed.
Why it works: Side-sleeping helps circulation and airway patency; elevation reduces reflux—two frequent sleep disrupters during pregnancy, as explained by research on pregnancy sleep mechanisms.
2) Optimize your sleep environment
Keep it cool and dark. Aim for a cooler bedroom and use blackout shades to support deeper sleep.
Layer for temperature swings. Hot flashes and night sweats can follow hormonal shifts—use breathable sheets and keep a light blanket handy.
Add white or pink noise. A steady sound can mask nighttime noises and help you fall back asleep quickly after bathroom trips.
3) Adjust daytime habits that impact night sleep
Front-load fluids and taper in the evening. Hydrate well earlier in the day, then reduce intake 2–3 hours before bedtime to cut down on nocturnal bathroom trips.
Nudge your body clock by getting morning daylight and keeping a consistent wake time, even after a rough night.
Move daily with gentle exercise and stretching to improve sleep quality and ease back pain and RLS discomfort. Just avoid vigorous workouts within 2–3 hours of bedtime.
If you use caffeine, keep it earlier in the day and avoid it late afternoon and evening to prevent sleep disruption.
4) Tame pregnancy insomnia with CBT-I strategies
Cognitive behavioral therapy for insomnia (CBT‑I) is the first-line, non-drug approach to insomnia and can be adapted for pregnancy:
Keep a consistent schedule with a similar wake time daily to regulate your sleep-wake cycle.
Reserve your bed for sleep and intimacy; do not work or scroll in bed to maintain healthy sleep associations.
If you can’t sleep after about 20 minutes, get up, do a calm activity in dim light, and return to bed when sleepy rather than lying awake frustrated.
Build a pre-sleep wind-down routine with 20–30 minutes of gentle stretches, breathwork, or a guided relaxation to signal your body it’s time for rest.
You can access guided breathwork and soothing audios in Beginning’s 3D sound journeys to help you downshift your nervous system before bed.
5) Ease restless legs syndrome (RLS)
Check iron status with your clinician. Iron deficiency can worsen RLS; supplementation should be guided by lab results.
Develop an evening routine with calf stretches, a warm bath, or a brief leg massage to reduce symptoms.
Light movement helps. Short, gentle walks during the day can reduce evening symptoms.
Limit late-day caffeine and heavy, high-sugar meals that can intensify sensations.
RLS commonly emerges in late pregnancy, so proactive routines can pay off, as confirmed by RLS prevalence research.
6) Address snoring and possible sleep apnea
Favor positional sleep techniques: sleep on your side and use a body pillow to maintain this position.
Improve nasal comfort with saline rinses and humidification to ease congestion.
Watch for red flags to discuss with your clinician: loud snoring with witnessed pauses, waking gasping, severe daytime sleepiness, or morning headaches.
Snoring and sleep apnea risk rise during pregnancy due to airway changes and reduced muscle tone from hormones like progesterone, according to snoring prevalence data and pregnancy physiology research. Timely evaluation can improve sleep and overall health.
What’s normal vs. what deserves a check-in
Most people experience more night wakings as pregnancy progresses—but some patterns merit a medical conversation:
Severe insomnia lasting weeks despite good sleep hygiene could require additional support.
RLS symptoms that are painful, nightly, or disrupt function may need medical evaluation.
Snoring with choking/gasping, or extreme daytime sleepiness could indicate sleep apnea.
Persistent reflux unrelieved by lifestyle measures might need medical intervention.
Mood changes (persistent sadness, anxiety, or hopelessness), especially alongside poor sleep, should be discussed with your healthcare provider.
Prenatal sleep disorders can raise the risk of postpartum depression, so early support matters according to PPD risk research. If short sleep is your norm, discuss blood pressure and preeclampsia risk management with your provider, based on sleep duration and preeclampsia findings.
Your 10-minute wind-down routine for better sleep during pregnancy
Try this sequence nightly for two weeks and adjust based on what feels best for your body.
3 minutes: dim lights, set phone aside, cool the room to prepare your environment.
2 minutes: gentle neck and hip stretches; two calf stretches per side for RLS relief.
2 minutes: get into a supported side-lying position—left side, pillow between knees, wedge behind back.
2 minutes: practice diaphragmatic breathing (inhale for 4 counts, exhale for 6–8) or a brief guided body scan.
1 minute: focus on gratitude or reassuring self-talk to reduce pre-sleep worry.
You can follow a calming audio from Beginning’s 3D sound journeys during the breathing or body scan segment for a smoother transition to sleep.
How Beginning supports better sleep during pregnancy
Science-based relaxation: Our transformative 3D sound journeys are designed to reduce stress, ease pain, and improve sleep quality—perfect for a soothing wind-down.
Expert-led masterclasses: Learn practical, evidence-informed strategies to manage pregnancy insomnia, RLS, reflux, and mood challenges.
Personalized guidance: Our Inspirational Feed surfaces tips and practices tailored to your stage and symptoms.
Better sleep is possible, even in the third trimester. Start tonight with a few small changes—and let us support you along the way. Try Beginning free to access calming sleep journeys and expert guidance whenever you need it: Explore Beginning.
References
- Prevalence of sleep disturbances across pregnancy and association with postpartum depression: Sleep Medicine Research review
- Global and North American insomnia prevalence and depression correlation: Frontiers in Psychiatry meta-analysis
- Trimester-specific increase in sleep problems: Review of sleep disorders in pregnancy
- Short sleep and snoring in early pregnancy, and preeclampsia association: American Journal of Epidemiology study
- Mechanisms and common causes (progesterone, reflux, pain) and RLS prevalence: Comprehensive review on sleep and pregnancy