Better Sleep for Moms-to-Be: Science-Backed Strategies That Actually Work

Are you counting sheep instead of counting kicks? You’re not alone. The irony of pregnancy isn’t lost on most expectant mothers—just when your body needs rest the most, sleep becomes frustratingly elusive.

Why Pregnancy Steals Your Sleep

The culprit behind your midnight awakenings isn’t just your growing belly. Early pregnancy brings a progesterone surge that causes daytime sleepiness but paradoxically relaxes your airway muscles, increasing snoring and sleep apnea risk. This hormonal rollercoaster continues throughout your pregnancy, creating the perfect storm for disrupted sleep.

According to the American Academy of Sleep Medicine, “Good sleep is one of the best ways to assure a healthy baby.” Yet the consequences of poor sleep during pregnancy extend beyond feeling tired—research shows that inadequate sleep can increase your risk of preeclampsia, gestational diabetes, and even lead to longer labors. Some studies suggest that getting less than 7 hours of sleep per night may even impact your child’s development.

Science-Backed Sleep Positions

After 28 weeks of pregnancy, your sleeping position matters significantly. Research published in the PMC shows that supine sleeping (on your back) is associated with increased risk of stillbirth compared to sleeping on your left side.

The good news? Both left and right side sleeping positions are considered safe during pregnancy, though left side is often recommended as the optimal choice to maximize blood flow to your baby. If you find yourself waking up on your back, don’t panic—simply roll to your side and continue sleeping.

Create Your Sleep Sanctuary

Your sleep environment plays a crucial role in how well you rest. The Sleep Foundation recommends keeping your bedroom cool (65-68°F), dark, and quiet. Invest in supportive pillows designed for pregnancy, establish a consistent bedtime routine, and consider using blackout curtains and white noise if needed.

Many expectant mothers find specialized pregnancy pillows transformative for sleep comfort as they support your growing belly, back, and hips simultaneously. These pillows can help maintain proper alignment throughout the night, reducing the strain on your changing body.

Manage Physical Discomfort

As your body changes, new discomforts emerge that can interrupt sleep. For heartburn, avoid spicy or acidic foods before bed, and elevate the head of your bed about 6 inches. This simple adjustment helps prevent stomach acid from flowing back into your esophagus while you sleep.

For leg cramps, stay hydrated during the day (but reduce liquids close to bedtime), and ensure adequate calcium and magnesium intake through your diet or prenatal supplements. When frequent urination disrupts your sleep, try emptying your bladder completely before bed and slightly elevating your legs in the evening to encourage fluid elimination.

Mindfulness and Relaxation Techniques

When racing thoughts keep you awake, evidence-backed approaches can help quiet your mind. Progressive muscle relaxation involves systematically tensing and releasing muscle groups from toes to head, signaling to your body that it’s time to relax. Guided imagery encourages you to visualize peaceful scenes that engage all your senses, transporting your mind away from anxious thoughts.

Deep breathing, particularly the 4-7-8 technique (inhale for 4 counts, hold for 7, exhale for 8), activates your parasympathetic nervous system, counteracting the stress response that keeps you alert.

The Beginning.com app offers specialized 3D sound journeys designed to improve sleep quality during pregnancy. These audio experiences help calm your nervous system and prepare your body for deep rest.

Stimulus Control Therapy

This evidence-based technique helps recondition your brain to associate your bed with sleep. Only go to bed when you’re genuinely sleepy, not just tired, and use your bed only for sleep and intimacy. If you can’t fall asleep within 20 minutes, get up and do something relaxing in dim light until you feel drowsy again.

Maintain a consistent wake-up time, even on weekends, to regulate your body’s internal clock. Avoid napping after 3 p.m., as late-day naps can interfere with nighttime sleep, especially if you’re already struggling with insomnia.

Safe Pharmacological Options

While natural approaches are preferable, sometimes additional help is needed. According to Johns Hopkins Medicine, diphenhydramine (Benadryl) is considered relatively safe for occasional use during pregnancy. Hydroxyzine is another medication sometimes prescribed for pregnancy insomnia, though animal studies show concerns at high doses.

Always consult your healthcare provider before taking any medication while pregnant. They can help weigh the potential benefits against any risks based on your specific health situation and stage of pregnancy.

When to Seek Help

If you’re experiencing excessive daytime sleepiness, loud snoring with gasping or choking, restless legs that prevent falling asleep, or insomnia that persists despite trying multiple strategies, discuss these symptoms with your healthcare provider.

Sleep disorders during pregnancy can be treated safely, but proper diagnosis is essential. Your doctor might recommend a sleep study or refer you to a sleep specialist who has experience working with pregnant women.

Your Personal Sleep Improvement Plan

Start by tracking your sleep with a simple diary for one week to identify patterns and triggers that might be disrupting your rest. This information can help you and your healthcare provider develop targeted solutions.

Prioritize consistency by setting a sleep schedule and sticking to it, even on weekends. Your body thrives on routine, and a regular sleep-wake cycle reinforces your natural circadian rhythm.

Create a wind-down ritual that signals to your body it’s time to rest. This might include gentle stretching, reading a book (not on a screen), taking a warm shower, or journaling to clear your mind.

Optimize nutrition by aiming for a small, protein-rich snack about an hour before bed to stabilize blood sugar. Stay active with regular daytime exercise (with your provider’s approval) to promote better sleep quality, but avoid vigorous activity within a few hours of bedtime.

Remember that investing in quality sleep now not only benefits your pregnancy but also prepares you for the postpartum period. While newborn care will inevitably disrupt sleep, starting parenthood well-rested gives you a valuable reserve of energy.

The journey to better sleep during pregnancy isn’t always straightforward, but with these evidence-based strategies, you can significantly improve both the quantity and quality of your rest. Start with one small change tonight, and gradually incorporate more strategies as you discover what works best for your unique needs.