Sleep and pregnancy: Why rest matters more than ever

During pregnancy, your body undertakes the remarkable task of creating new life. While sleep has always been essential for wellbeing, it becomes absolutely critical during these transformative nine months. Quality rest isn’t just about combating fatigue—it directly supports both your health and your developing baby’s growth.

Why pregnancy makes sleep more challenging

If you’re struggling to sleep well during pregnancy, you’re in good company. Many women experience significant changes to their sleep patterns throughout these nine months.

During the first trimester, despite overwhelming fatigue, sleep can be disrupted by nausea, frequent bathroom trips, and anxiety about your changing body and new role. Research shows that total sleep time typically increases to about 8.2 hours during this period, though studies using objective measurements reveal pregnant women sleep about 30 minutes less than they self-report.

The second trimester often brings welcome relief as morning sickness subsides. Sleep time generally decreases to around 8.0 hours, but many women report this as their most restful period.

By the third trimester, finding comfort becomes the primary challenge. Physical discomfort, back pain, heartburn, and restless legs can make quality sleep elusive. Using actigraphy measurements, researchers found mean sleep hours were 7.3, 7.6, and 7.3 at the seventh, eighth, and ninth months respectively.

Why quality sleep matters during pregnancy

Quality sleep during pregnancy isn’t just about feeling rested—it plays a crucial role in supporting both maternal and fetal health.

For your own wellbeing, adequate sleep helps reduce the risk of pregnancy complications, strengthens immune function when you need it most, and supports mental health by regulating mood and reducing the risk of prenatal depression and anxiety. Your body also needs rest to manage the significant physical demands pregnancy places on virtually every system.

For your developing baby, your sleep quality matters too. During deep sleep, your body directs more resources to supporting fetal development. Better maternal sleep means fewer stress hormones reaching your baby, and research suggests connections between maternal sleep quality and healthy birth weight.

Safe sleeping positions during pregnancy

As your pregnancy progresses, how you sleep becomes increasingly important for both comfort and safety.

During your first trimester, you can generally sleep in whatever position feels most comfortable. However, as you move into the second and third trimesters, side sleeping (particularly on your left side) becomes the recommended position.

According to research from the National Library of Medicine, sleeping in the supine (back) position after 28 weeks approximately doubles the odds of stillbirth compared to the left lateral position. Back sleeping in later pregnancy can also compress the vena cava, a major blood vessel that returns blood to your heart, potentially causing dizziness and reducing blood flow to your baby.

The American College of Obstetricians and Gynecologists recommends side sleeping during the second and third trimesters, keeping one or both knees bent for optimal comfort and circulation.

Practical tips for better pregnancy sleep

Create a sleep-friendly environment

Your sleep environment becomes even more important during pregnancy. Keep your bedroom cool (65-68°F/18-20°C) to counteract the increased body temperature pregnancy often brings. Use blackout curtains and remove electronic devices to minimize light exposure, which can interfere with your body’s natural sleep signals.

If you’re sensitive to noise, consider using white noise machines to create a consistent sound backdrop. Most importantly, invest in supportive bedding—your changing body needs proper support for quality rest.

Pregnancy sleep aids

Specialized pillows can make a world of difference during pregnancy. A pregnancy pillow supports your growing belly, back, and hips simultaneously, while strategic placement of regular pillows between your knees, under your belly, and behind your back can also help maintain comfortable alignment.

For additional support, specialized sleep apps can help with pregnancy-specific relaxation techniques and guided meditations designed to address the unique mental and physical challenges of pregnancy sleep.

Establish a relaxing bedtime routine

Consistency becomes your ally for better sleep. Set a regular sleep schedule that allows for the additional rest your body needs. Incorporate relaxing elements into your evening routine: a warm (not hot) bath or shower can ease muscle tension, while gentle prenatal yoga or stretching helps prepare your body for rest.

Many women find meditation or deep breathing exercises particularly helpful for quieting racing thoughts. Reading something calming or listening to soothing music can also signal to your body that it’s time to wind down.

Manage common sleep disruptors

Heartburn often intensifies during pregnancy, particularly in later stages. Eat smaller, more frequent meals to reduce pressure on your stomach, and avoid spicy, acidic, and fatty foods that can trigger reflux. Try not to eat within 2-3 hours of bedtime, and use extra pillows to elevate your upper body when sleeping.

For frequent urination, stay hydrated during the day but reduce fluids close to bedtime. Empty your bladder completely before sleep, and use nightlights for bathroom trips to avoid turning on bright lights that can fully wake you.

Restless legs syndrome affects many pregnant women. Have your healthcare provider check your iron levels, as deficiency can worsen symptoms. Gentle stretching before bed, warm (not hot) baths, massage, and compression socks may provide relief.

For anxiety and stress, try journaling worries before bed to “release” them from your mind. Pregnancy-specific mindfulness techniques can help manage both physical discomfort and emotional concerns. Consider talking with a therapist or joining a pregnancy support group if anxiety significantly impacts your sleep.

When to seek help

While some sleep challenges are normal during pregnancy, certain symptoms warrant medical attention. Contact your healthcare provider if you experience excessive daytime sleepiness, loud snoring, gasping, or choking during sleep (potential signs of sleep apnea), severe insomnia that significantly impacts daily functioning, debilitating symptoms of restless legs syndrome, or signs of depression or anxiety related to sleep problems.

Your provider can help determine if you’re experiencing a sleep disorder that requires treatment during pregnancy and offer safe, effective interventions.

Preparing for postpartum sleep changes

Looking ahead to postpartum sleep challenges can help you prepare mentally and practically. Discuss nighttime feeding plans with your partner or support person before baby arrives. Consider sleep arrangements that support breastfeeding if that’s your plan, and learn about safe infant sleep practices.

In the United States, approximately 3,500 infants die annually from sleep-related deaths, according to the American Academy of Pediatrics. Understanding proper infant sleep positioning and environment is essential knowledge for new parents.

Prioritizing sleep is self-care

Getting quality sleep during pregnancy isn’t selfish or a luxury—it’s essential healthcare for both you and your baby. By understanding sleep’s importance and implementing practical strategies, you can improve your rest during this transformative time.

Remember that every pregnancy is different, and what works for someone else might not work for you. Be patient with yourself as you navigate these changes, and don’t hesitate to discuss persistent sleep issues with your healthcare provider. Your body is doing remarkable work—give it the rest it deserves to support this incredible journey.