For many pregnant women, getting a good night’s sleep can be quite challenging. The body undergoes significant physiological and hormonal stages throughout the pregnancy, and these adjustments can wreak havoc on one’s routine sleep schedule. Cramps and aches, frequent trips to the bathroom and other distractions can disrupt sleep patterns, leaving women feeling tired and sluggish the next day. Pregnant women are also more susceptible to certain sleep disorders, including insomnia, sleep apnea and restless legs syndrome.
This post will look at sleep expectations for all three trimesters of a standard pregnancy, as well as some tips for getting healthy, comfortable sleep on a nightly basis.
What to Expect: First Trimester
The first trimester covers the 12 weeks following initial conception. As the fertilized egg evolves into an embryo, a hormone called progesterone is released into the body. Progesterone is a sleep-inducer; the first trimester is often marked with sleepless nights and groggy days. In some cases, insomnia symptoms may develop. Some women experience sleep-onset insomnia, or trouble falling asleep, while others experience sleep-maintenance insomnia, or trouble staying asleep.
Daytime nausea known as ‘morning sickness’ will begin to occur a few weeks after fertilization. Incontinence is another issue during the first trimester, since the embryo is attached to the uterine wall next to the bladder. Additionally, embryonic growth and early stages of lactation can cause aches and pains in the pelvic region and breasts, respectively. Between these bodily discomforts and the progesterone spike, expect some level of nighttime sleep disruption during these first 12 weeks.
Tips: Try napping regularly to counteract the effects of the increased progesterone levels. Two 30-minute naps or one nap no longer than one hour should relieve some of the daytime fatigue without affecting nightly sleep. Some light exercise in the morning can also induce tiredness at night; exercising too close to bedtime can actually disrupt sleep patterns. Women in their first trimester should drink as little water as possible before going to bed to curb their nighttime urination, as well.
What to Expect: Second Trimester
The second trimester is the longest of the three, spanning between the 13th and 27th weeks. The embryo will begin growing into a fetus during this period. For many pregnant women, this is the best trimester for sleeping. Their bodies have adapted to the progesterone, and bouts of morning sickness come much less frequently (if they still occur at all).
There are, however, some bodily issues that can affect sleep cycles to some degree. One is heartburn, especially right after eating. Leg cramps are another common complaint, though these will usually worsen in the third trimester (see below). Pregnant women in their second trimester may also be prone to preeclampsia, a spike in blood pressure that can trigger dizziness, confusion, headaches and light sensitivity.
Tips: The second trimester is the best time to catch up on sleep lost during the first ― and prepare the body for the rigorous demands of the third. Women who experience heartburn should lay on their backs until the unpleasantness passes. Medication may be needed if these feelings become too intense; consult with your physician to decide on which medication will be best. Stretching and flexing the leg and foot muscles can also help with nighttime cramping.
What to Expect: Third Trimester
Otherwise known as the ‘scourge of sleep’ , the third trimester begins in the 28th week and lasts until childbirth, typically in the 40th to 42nd week. The fetus will grow considerably during this stage, from roughly one pound and 10 inches in length to its full size at the time of delivery. Aches, pains and frequent urination will occur as the fetus slowly develops, causing the stomach region to swell considerably.
In addition to these discomforts, the third trimester is typically when serious sleep disorders begin to develop in some pregnant women. These include restless legs syndrome (RLS), a condition that involves painful itching or tingling sensations beneath the skin on one or both legs; the symptoms tend to be strongest at night. Another common disorder associated with third-trimester pregnancy is obstructive sleep apnea (OSA), characterized by temporary loss of breath during sleep. OSA is caused by blockages that restrict the airway and cause shallow breathing and/or snoring; for most pregnant women, this occurs due to swollen nasal passages.
Tips: Like with the first trimester, limited fluid intake ― particularly before bedtime ― can cut down on nighttime urination. Before heading to bed, pregnant women should empty their bladder as much as possible; lean forward on the toilet seat for best results. Since RLS may occur in part due to iron deficiency, physicians often prescribe supplements to relieve some of the symptoms. Iron-rich foods can also help.
Most doctors recommend the ‘sleep on side (SOS)’ sleep position for pregnant women during all three trimesters. The left side is considered best, since this helps prevent the uterus from putting pressure on the liver. This can also a improves circulation to the heart, kidneys and fetus, which can help cut down on snoring, gagging and other effects of sleep apnea. For extra comfort, place pillows between the knees, under the stomach and behind the lower back.
Women who choose the SOS sleep position may want to reconsider their mattress choice. Traditional innerspring mattresses have a bouncy feel, which minimizes spinal support and can lead to back pain. Alternatively, mattresses made of ultra-soft materials like latex or memory foam are designed to conform to the sleeper’s body and form a cradle-like impression in the sleep surface that targets pressure points, aligns the spine and alleviates back and shoulder pain. Memory foam and latex mattresses are also recommended for side sleepers, as opposed to innersprings, which are usually the most comfortable option for people that sleep on their backs.
The right dietary choices can greatly improve a pregnant woman’s sleep cycle. If morning sickness arises, some light salty foods like pretzels, popcorn and nuts can reduce the nausea symptoms. Cutting out spicy and fried food can reduce the risk of heartburn; additionally, avoiding carbonated drinks may prevent early leg cramps.
The sleep issues will not necessarily end after childbirth. Newborns not only require constant attention and care, but they also follow a sporadic sleep cycle that causes them to doze and wake up throughout the day and night. Allowing the baby to sleep in a crib or bassinet near the parents’ bed allows mom and dad to tend to their baby with less fuss; keeping the lights out can also help them fall back asleep more easily. Natural breastfeeding can also help newborns get sleepy, since breast milk triggers a soporific hormone in babies called prolactin. Parents should also tag-team nighttime baby duties in order for both of them to get enough sleep throughout the week.
About the author: Ben Murray is a writer and researcher for sleep science hub Tuck.com. He can usually be found running, hiking, biking or kayaking around the Pacific Northwest ― though he enjoys a good nap as much as the next person.