Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
What Causes Changes in Sleep During Pregnancy? | Common Sleep Disorders Linked to Pregnancy | Why is Adequate Sleep Important in Pregnancy? | Tips for Better Sleep During Pregnancy
Overview
Many women struggle to get enough sleep during their pregnancy. Some studies estimate that as high as 80 percent of pregnant women experience sleep problems.[1]
A plethora of physical and hormonal changes associated with being pregnant and the excitement of being a new mother could all contribute to difficulties getting a good shut-eye during this critical period.
If you are having trouble sleeping during pregnancy, you are not alone. This article will provide some advice you could follow to improve your sleep. It will also discuss some of the sleep changes associated with pregnancy.
What Causes Changes in Sleep During Pregnancy?
Many factors cause sleep changes during pregnancy. More often than not, these factors vary with the different trimesters.
For instance, in the first trimester, rising levels of pregnancy hormones, especially progesterone, cause drowsiness and daytime sleepiness.[2]
This hormone rise makes it challenging to get appropriate sleep hours at night. Progesterone also relaxes smooth muscles, including those in the digestive tract. This event allows corrosive acidic contents of the stomach to flow up the food pipe, potentially leading to heartburn, ulcers, and GERD (Gastroesophageal reflux disease), which can disrupt sleep.[5]
These symptoms often subside in the second trimester as the body adjusts to the pregnancy hormones.
By the third trimester, pregnant moms may start experiencing back pain and having difficulty finding a comfortable sleeping position due to the growing baby bump.
Worrying over the impending childbirth, balancing work and household commitments, or other concerns may cause insomnia during pregnancy.
Furthermore, studies have shown that many pregnant mothers experience disturbing dreams in the third trimester.[3] These vivid and often frightening dreams make maintaining a good rest at night challenging and worsen anxiety.
Common Sleep Disorders Linked to Pregnancy
Aside from the usual sleep changes associated with pregnancy, some specific sleep disorders have also been linked to pregnancy. Some of the common ones include;
1) Obstructive Sleep Apnea
Many women start snoring during pregnancy because of weight gain and nasal inflammation, which is caused by surging sex hormones.[4]
In some instances, these women get obstructive sleep apnea later on. Sleep apnea impedes oxygen delivery to both the mother and the growing baby.
This reaction significantly increases the risk of unwanted outcomes like poor fetal development, preeclampsia, and even mortality in pregnancy.
2) Restless Legs Syndrome (RLS): Studies have shown that a third of women experience RLS during pregnancy.[6]
RLS symptoms are best described as a creeping, tickling, or itching feeling that results in an overwhelming need to move the legs.
People with this condition find it difficult to fall asleep because the symptoms worsen when one is resting.
Why is Adequate Sleep Important in Pregnancy?
Quality sleep during pregnancy is essential for both the mother and the baby. Long-term sleep deprivation weakens the immune system, which some experts believe is one reason why a lack of sleep is so detrimental to both the baby’s and the mother’s health.[7]
Furthermore, sleep deprivation early in pregnancy has been linked to hypertension in pregnancy and preeclampsia.[8]
Poor sleep may also contribute to other adverse pregnancy outcomes like preterm birth, low birth weight, cesarean delivery, and postpartum depression.[9]
Tips for Better Sleep During Pregnancy
While avoiding some sleep disruptions in pregnancy may not be entirely possible, adopting certain practices might help reduce their severity and maintain the quality of your sleep during pregnancy. Some of these sleep-promoting habits include;
1) Adopting a Comfortable Sleep Position
Getting a comfortable sleep position during pregnancy can be daunting. Experts have recommended lying on one’s side (left or right) as the ideal sleep position.[10]
This position increases blood flow to the vital organs and womb, ensuring adequate oxygen and nutrient delivery to the fetus. In contrast, sleeping on your back impedes blood flow to the organs.
Research has indicated that sleeping supine during pregnancy doubles the risk of fetal death.[10]
If you wake up on your back, don’t worry; turn over to your side and go back to sleep on your side. You can also support your bump with cushions, placing one between your knees.
2) Prioritize Sleep
Always make time to sleep. Create a consistent sleep schedule by going to bed and getting up at a fixed time daily. Make a calming sleep routine, such as having a warm bath, reading, or doing deep breathing exercises.
3) Go to Bed with a Clear Mind
Worrying about your baby or other things can impair your sleep. Before bedtime, write your thoughts in a notepad to clear your mind. Speaking with your partner, friends, or doctor about your concerns may help.
4) Diet
Adopt a healthy diet plan to improve your health and sleep. However, you should avoid large meals and coffee near bedtime. Take as much water as possible during the day, but restrict fluid intake in the evening to decrease midnight toilet trips.
5) Exercise
Exercise can help relieve stress. You can go for a lunchtime walk or swim during the day to improve your sleep at night.
References:
- Hashmi, A. M., Bhatia, S. K., Bhatia, S. K., & Khawaja, I. S. (2016). Insomnia during pregnancy: Diagnosis and Rational Interventions. Pakistan journal of medical sciences, 32(4), 1030–1037. https://doi.org/10.12669/pjms.324.10421
- Won C. H. (2015). Sleeping for Two: The Great Paradox of Sleep in Pregnancy. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 11(6), 593–594. https://doi.org/10.5664/jcsm.4760
- Lara-Carrasco, J., Simard, V., Saint-Onge, K., Lamoureux-Tremblay, V., & Nielsen, T. (2014). Disturbed dreaming during the third trimester of pregnancy. Sleep Medicine, 15(6), 694–700. https://doi.org/10.1016/j.sleep.2014.01.026
- O’Brien, L. M., Bullough, A. S., Owusu, J. T., Tremblay, K. A., Brincat, C. A., Chames, M. C., Kalbfleisch, J. D., & Chervin, R. D. (2013). Snoring during pregnancy and delivery outcomes: A cohort study. Sleep, 36(11), 1625–1632. https://doi.org/10.5665/sleep.3112
- Malfertheiner SF, Malfertheiner MV, Kropf S, Costa SD, Malfertheiner P. A prospective longitudinal cohort study: evolution of GERD symptoms during the course of pregnancy. BMC Gastroenterol. 2012 Sep 24;12:131. doi: 10.1186/1471-230X-12-131. PMID: 23006768; PMCID: PMC3499455. https://pubmed.ncbi.nlm.nih.gov/23006768/
- Dunietz GL, Lisabeth LD, Shedden K, Shamim-Uzzaman QA, Bullough AS, Chames MC, Bowden MF, O’Brien LM. Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy. J Clin Sleep Med. 2017 Jul 15;13(7):863-870. doi: 10.5664/jcsm.6654. PMID: 28633715; PMCID: PMC5482577. https://pubmed.ncbi.nlm.nih.gov/28633715/
- Palagini, L., Gemignani, A., Banti, S., Manconi, M., Mauri, M., & Riemann, D. (2014). Chronic sleep loss during pregnancy as a determinant of stress: impact on pregnancy outcome. Sleep Medicine, 15(8), 853–859. https://doi.org/10.1016/j.sleep.2014.02.013
- Preeclampsia and high blood pressure during pregnancy. (n.d.). Acog.org. Retrieved July 18, 2024, from https://www.acog.org/womens-health/faqs/preeclampsia-and-high-blood-pressure-during-pregnancy
- Reichner CA. Insomnia and sleep deficiency in pregnancy. Obstet Med. 2015 Dec;8(4):168-71. doi: 10.1177/1753495X15600572. Epub 2015 Sep 21. PMID: 27512475; PMCID: PMC4935047. https://pubmed.ncbi.nlm.nih.gov/27512475/
- National Guideline Alliance (UK). (2021). Maternal sleep position during pregnancy. National Institute for Health and Care Excellence. https://www.ncbi.nlm.nih.gov/books/NBK573947/
