Key Points
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Good sleep during pregnancy is important for both mother and baby.
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There's evidence that too much sleep increases the risk of stillbirth, though causation isn't clear.
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Problems with sleep during pregnancy include nausea, heartburn, twitchy legs, frequent urination, stress, and breathing problems.
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Proper eating habits, sleeping positions, sleep hygiene, and stress-relief techniques help alleviate those problems.
Pregnancy is more than having something extra in your belly — it takes over your body, mind, and emotions. It's not surprising that sleep during pregnancy is different from sleep during other parts of your life. You might sleep more than you did since you were a baby yourself — or toss and turn with weird dreams or hourly wake-ups.
Sleep changes over the course of the pregnancy as well: the set of challenges you face in the third trimester isn't always the same as in the first. Read on to learn more about what to expect from your sleep during pregnancy and how to optimize it for both your health and your baby's.
Does Sleeping Affect the Baby During Pregnancy?
Pregnancy is exhausting even when the fetus is still more like a tadpole. It's hard work growing a baby! Your heart rate goes up and your whole metabolism increases to supply the newcomer with nutrients, so it's little wonder that you want more R&R.
Therefore, getting enough sleep during pregnancy is even more important than at other times. Deep sleep is when your body works hardest to repair and restore its tissues, and the strains of pregnancy make that process even more crucial.
Research has connected too little sleep to several pregnancy complications that endanger both parent and baby.
Preeclampsia
Preeclampsia is a type of hypertension that develops in late pregnancy or sometimes after birth. While high blood pressure alone isn't always extremely serious, preeclampsia makes the liver and kidneys start malfunctioning, which is dangerous and potentially fatal for both mother and baby.
The causes of preeclampsia aren't entirely known, but the association with poor sleep isn't surprising since lack of sleep also aggravates hypertension among non-pregnant people. The same goes for diabetes.
Gestational Diabetes
Gestational diabetes is a kind of insulin resistance that sometimes develops in pregnant women, with symptoms resembling the more familiar diabetes types. It's not as dangerous as preeclampsia, but it does create the risk that the baby has hypoglycemia (low blood sugar) and requires treatment.
Longer Labor and More C-Sections
More than one study has suggested that women who sleep less than six hours a night or have severely disrupted sleep have longer and more difficult labor pains, resulting in more frequent C-sections. The mechanism that connects the two isn't clear, but it's likely related to breathing problems during sleep (about which more below).
Is It Okay to Sleep Too Much During Pregnancy?
Because of the dangers of too little sleep, some doctors say adding to the recommended seven to nine hours of sleep per night is fine if you feel you need it. However, research in the last few years has called that into question.
One study from researchers Louise M. O’Brien et al. even found that getting more than nine hours of sleep in the third trimester preceded more stillbirths than shorter amounts of sleep. The authors suggested that the sleep disturbances pregnant people experience help prevent low blood pressure, which inhibits fetal growth. Other researchers have suggested that if something's already going wrong with the fetus, it's less active and disturbs the mother's sleep less.
The study emphasized that the amount of uninterrupted sleep was the key factor, so if you're getting the requisite sleep time at night but still feel tired during the day, a nap or two shouldn't do any harm.
What Causes Lack of Sleep During Pregnancy?
Pregnancy has many ways to mess up your sleep, but they differ in intensity depending on your physiology and how far along you are. Some of the most common sleep-disturbing pregnancy issues are as follows.
Nausea
"Morning sickness" is characteristic of early pregnancy, though it doesn't always confine itself to the morning or to the first trimester. Continued nausea into the nighttime makes sleep harder for obvious reasons, especially if you have to get up and vomit periodically.
Cramped or Restless Legs
Restless legs syndrome (RLS) is a condition causing a prickling or crawling sensation in the legs, which creates a strong urge to move them around. It usually appears in older women but is more frequent than average in pregnant women, perhaps because of the low iron levels that sometimes come with pregnancy.
A similar but distinct phenomenon is that pregnant women are more likely than average to get muscle spasms in their legs and feet, especially at night.
Acid Reflux
Sometimes called heartburn, this condition's technical name is gastroesophageal reflux disease (GERD), which is a more accurate description since it involves not the heart but the stomach. What happens is that stomach acid washes up into the esophagus, creating a burning sensation in the throat or chest.
The pressure that a swelling uterus puts on the stomach often causes this problem in pregnant women. Lying down also makes it more likely because gravity is no longer pulling the acid down toward the lower body. As a result, GERD often disturbs a pregnant person's sleep.
The Big Bulge
As your belly swells during the second and third trimesters, finding a comfortable position for sleeping often gets a lot more difficult. Sleeping on your stomach is a no-go, lying on your back puts the womb's full weight on your other organs, and rolling from side to side is much more awkward than it used to be. All that adds up to less restful nights.
Impatient Bladder
Another common phenomenon of pregnancy is more frequent urination. This usually starts in the first trimester due to hormonal changes, eases during the second trimester, then comes back in the third as the swollen uterus presses on the bladder. Pregnant women also often feel thirstier because of their bodies' increased fluid needs. This leads to more nighttime bathroom visits.
Stress
Pregnancy is an exciting but stressful time, and stress often disturbs sleep, notes Johns Hopkins professor Grace Pien.
"It's clearly a time when there are a lot of biological changes going on, but, in addition, expectant parents may be moving homes or just trying to figure out what they’re going to do after the baby is born,” Pien said. “There can be a lot of other stressors, and sometimes the first chance that people get to think about it is when the lights go out."
A 2023 study by Yuqing Guo et al. found that depression and anxiety during pregnancy correlated to less deep sleep and more REM sleep, the sleep stage associated with vivid dreams. This possibly explains the phenomenon of "pregnancy dreams," which seem more dramatic and colorful than normal.
Sleep Apnea
Like RLS, sleep apnea is a condition that usually appears in older people, but pregnancy is a risk factor for it. With this condition, the airway closes up during sleep and breathing stops for a few seconds, half-waking the sleeper until breathing starts again. These frequent interruptions to both sleeping and breathing are bad for your health in multiple ways.
There are a few possible reasons that sleep apnea might develop in pregnancy: swelling of the neck tissue that narrows the trachea; the aforementioned gestational hypertension and diabetes; and hormonal changes to breathing patterns.
Sleeping Tips for Pregnancy
Given all those obstacles to a good night's sleep, is there any way to ensure you're getting enough shuteye for your and your baby's health? Yes! Check out these tips.
Get the Right Nutrients
Leg cramps and RLS during pregnancy likely have roots in how pregnancy taxes your body's reserves of nutrients, especially minerals. Upgrading your diet and taking prenatal supplements might help prevent nighttime leg discomforts that disturb sleep.
Sleep on Your Side With Pillows
Sleeping on the side is the best posture for the latter half of pregnancy. That way, you aren't bearing the full weight of your fetus as you would on your back, but you aren't pressing down on your baby bump either. Bend your knees slightly for extra support. Doctors recommend sleeping on the left side, as it keeps your weight off your liver (which is on the right side) and possibly helps prevent acid reflux.
If that position still feels awkward, a pregnancy pillow gives extra support and comfort to key body parts during side sleeping. If you don't want to buy new pillows, try creating the same effect with existing pillows and blankets: a thin pillow or thick blanket between the knees, a rolled-up blanket at the small of the back, or rows of pillows in front of and behind you to hold you in position.
Be sure to have a thick enough pillow under your head so your neck doesn't bend sideways. Some specialists recommend raising the whole head end of the bed by putting its feet on risers so that your head tilts upward slightly; this helps prevent both acid reflux and sleep apnea.
Avoid Eating and Drinking Too Close to Bedtime
Having heavy meals shortly before bedtime aggravates several sleep problems. It sets your stomach churning and increases the odds of nausea and acid reflux. It gives your body energy right when you want it to wind down. It makes nighttime bathroom visits more likely.
It often helps to space out your eating — instead of three big meals per day, try breaking up the same amount of food into five or six mini-meals, with the last one about three hours before bed. Avoid spicy and acidic foods, and cut out the alcohol and caffeine.
Make Your Bedroom Sleep-Friendly
While keeping your bedroom on the cool side is almost always good for sleep, you probably need it even cooler when you're pregnant because of your jacked-up metabolism. Keeping it dark and free of electronic devices also reduces stimulation and lowers your stress level.
Another bedroom adjustment to consider, especially if you're prone to nasal congestion, is a humidifier. Moisture in the air sometimes helps prevent breathing disorders like apnea by reducing irritation and swelling in the mucous membranes that narrow the airways.
Practice Stress-Relieving Techniques
There are many ways to have a relaxing night to ease yourself into sleep, even when you're expecting. Some of Snooze's favorite methods include:
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Listening to calming music
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Meditation (also perhaps with calming music)
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Writing your feelings in a journal
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Doing a craft or puzzle
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Getting a massage (this also helps leg cramps)
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Light stretching (ditto)
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Yoga
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Taking a bath
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Cuddling with a spouse or furry pet
Pien notes that another way to avoid stress is to simply take the pressure off yourself and put self-care and baby care above other people's expectations. “Set priorities around getting enough sleep, and know that it’s going to take a few months.”
Get the Sleep You Need While You Still Can
Everyone knows that sleep goes out the window when the baby comes, so don't let sleep problems during pregnancy make you start your parental life already sleep-deprived. With proper methods, you can counteract at least some of the disruptions to your body and mind that pregnancy brings and get the deep slumber you need to keep you and your baby healthy.
If you're still having significant trouble sleeping during pregnancy, especially related to breathing, don't hesitate to consult your doctor. Sleep problems sometimes signal an underlying health issue that needs your attention. The first part of caring for your baby is caring for yourself!
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