Whether you’re reeling from morning sickness or your head is spinning with baby names, it can be hard to fall asleep when you’re expecting. Of course, sleep is critically important to ensuring you have as healthy and stress-free a pregnancy as possible (and it gives you the chance to dream about your new bundle of joy!)
Below we’ll discuss how the different stages of pregnancy – from the first trimester to postpartum – affect your sleep. Then we’ll offer tips and guidance for pregnant mothers, as well as new moms and dads, to enjoy as much restful sleep as possible during this exciting time.
Pregnancy and Sleep: What to Expect
When a woman is pregnant, she undergoes many physical changes, and that includes how her body sleeps. Here’s how your sleep might change during each trimester.
During the first two weeks of pregnancy, the woman’s egg becomes fertilized, grows, and attaches itself to her inner uterine wall. During this time, she experiences a spike in progesterone, a soporific hormone that causes early sleep onset, excessive daytime sleepiness and feelings of fatigue, and disrupted sleep.
As the blastocyst grows throughout the first trimester, it applies pressure to the woman’s uterine wall, located next to her bladder. This increase in pressure, combined with her increased progesterone levels, makes her need to urinate more often, so she’ll wake up during the night to use the bathroom. Additionally, bladder pressure may cause lucid or vivid dreams.
During weeks three through eight, the embryo grows to 1 inch while the woman experiences severe pelvic cramping, breast swelling, and excessive nausea or morning sickness. The physical discomfort from any of these can further contribute to insomnia and disrupted sleep.
By week nine, the embryo becomes a fetus and the woman’s uterus grows to the size of a tomato. The cramping, swelling, and nausea continue through the end of the first trimester.
Tips for Getting Sleep in Your First Trimester
- Napping will help you combat the fatigue from increased progesterone levels during this time. Two power naps between 30 to 60 minutes in the afternoon are recommended, but take them early enough so you’re still able to fall asleep at night. Don’t combine these into one long nap, as then you’ll likely enter deep sleep, and feel groggy upon waking.
- Exercise in the morning – outside if possible – to help you wake up and feel more alert during the day. Exercise also helps your body feel more fatigued by nighttime.
- Avoid spicy and heavy meals before bed. Instead, light, salty snacks before bed like pretzels or crackers can help counteract morning sickness. Eating small meals throughout the day will also help prevent you from getting too full or too empty.
- Limit your water intake in the hours before bed to minimize awakenings due to need to urinate, but stay hydrated enough throughout the day to avoid dehydration and worsening morning sickness. It’s a delicate balance.
The second trimester lasts from the 13th to the 27th week, and symptoms can differ depending on whether or not this is your first pregnancy. For example, first-time mothers feel the baby move around 18 to 22 weeks, while others experience it earlier. By the end of the second trimester, the fetus has reached 10 inches in length and weighs over a pound.
There’s good news for sleep during the second trimester: your body has adjusted to all the changes and turbulence of the first trimester, so you’re less tired during the day, don’t have as much trouble falling asleep at night, and rarely experience morning sickness, if at all.
However, you may start to experience nocturnal leg cramps, especially in your calves, which will intensify during the third trimester. If you had lucid dreams during the first trimester, these will also intensify during the second trimester. Heartburn also pops up during the second trimester, and sensations worsen whenever you’re lying down.
Preeclampsia is a rare condition that can be fatal for the mom and baby. At around 20 weeks, if you start to experience high blood pressure, headaches, nausea, shortness of breath, sensitivity to light, and decreased urination, you should immediately speak to your doctor.
Tips for Getting Sleep in Your Second Trimester
- Establish a consistent sleep schedule so you’re prepared for the third trimester.
- Continue to avoid hot and spicy food, but do so all the time instead of just at night. These foods, as well as anything fried, can worsen acid reflux. Carbonated beverages should also be avoided as they can intensify leg cramps. Minimize heartburn by sitting or standing in an upright position for 4 hours or more after eating. This aids the digestive process.
- Flexing your legs and feet can help alleviate leg cramps.
- Extra pillows or special maternity pillows can relieve pressure on your hips and make it easier for you to fall asleep. Use pillows to help keep you on your side (the best sleeping position for pregnant women – more on this in a later section), and in between your knees to keep your legs and spine aligned.
- Wearing maternity bands during the day helps alleviate the stress from your back and growing belly so you’re less achy by bedtime.
The third trimester lasts from the 28th week until childbirth, which usually takes place around 40 weeks. During this time, the fetus will triple or quadruple in weight and undergo rapid development.
As a result, the mother experiences significant discomfort, aches, and pains, especially in her lower back because she’s carrying a greater weight around her middle. Leg cramps intensify. The fetus’s growth places greater weight on the bladder, causing increased need to urinate – many mothers urinate 3 to 6 times every night during the third trimester. In many ways, the third trimester is a more intense version of the first, without the morning sickness.
The increased physical discomfort during the third trimester can make sleep more elusive, as can new sleep disorders that arise during this time. For example, 20 percent of pregnant mothers suffer from restless leg syndrome (RLS). RLS causes painful and uncomfortable tingling sensations in the lower legs while laying down, that are only relieved from movement. Having to constantly move the legs to find relief interferes with one’s ability to fall asleep. In some cases RLS is due to an iron deficiency, and the solution can be as simple as taking a supplement. Either way, symptoms usually go away naturally after childbirth.
Snoring and obstructive sleep apnea (OSA) also crop up during the third semester. People with OSA literally stop breathing during sleep, due to their airways being blocked. For pregnant women, this is often due to swollen nasal passages. OSA is of particular concern for pregnant women because the reduced oxygen in the blood can create other hormones to increase and thus compromise the fetus’s health. OSA is also associated with a higher risk of preeclampsia. If you find yourself waking during sleep or you feel unrefreshed upon waking in the morning, or if your snoring rouses your partner, talk to your doctor or a sleep specialist.
Tips for Getting Sleep in Your Third Trimester
- Limit fluid intake in the evening, and urinate as completely as possible before bed. Leaning forward while urinating can help. Sleep close to the bathroom.
- Continue to avoid the foods you have been, but try to eat even more iron-rich foods as these can relieve RLS symptoms.
- Use pillows between your knees, behind your back, and under your stomach to keep you comfortable and on your left side. Sleeping this way alleviates pressure on your lower back, keeps your spine aligned, and maximizes your ability to breathe clearly and facilitate blood flow to your heart.
- Try relaxation, meditation, or deep breathing exercises to help you fall asleep and prevent insomnia. Light exercise such as yoga or stretching can also alleviate pressure and calm your body for sleep.
Sleeping Positions During Pregnancy
The physical changes to your body during pregnancy may make your preferred sleeping position less comfortable – or even unsafe – for you and your fetus. Heartburn, a growing belly, back pain, and shortness of breath all combine to make sleeping challenging for pregnant mothers.
The best position to sleep in while you’re pregnant is on your side, or SOS for short. Sleeping on your left side in particular boosts the flow of blood and nutrients to your fetus and the placenta.
Changing to sleep on your side can be challenging, and even for those who sleep on their side already, the bodily changes make it a bit more challenging. To make it as comfortable as possible, place a pillow under your abdomen, between your thighs, behind your back, and between your arms. The pillow under your abdomen relieves pressure, while the one between your thighs helps keep your spine aligned. A pillow between your arms keeps them from falling asleep. These should all combine to reduce back pain and enable you to breathe better at night – helping with heartburn, shortness of breath, and snoring or sleep apnea.
While you may change positions while you sleep, and that’s okay, you should avoid initially falling asleep on your back or your side. These positions put pressure on your stomach and your fetus, and impede circulation to your heart and the fetus. These also make your daytime hours less comfortable for you, since the added weight will intensify back pain, shortness of breath, and digestive issues.
Sleep Troubles for New Mothers
In the postpartum months after your baby is born, you will continue having sleep issues. This time, though, they’re often caused by your baby’s erratic sleep schedule, rather than physical changes to your body.
It can take 3 to 6 months for your baby to develop a regular sleep-wake cycle, and until and past that point, it will include a lot of napping during the day and breastfeeding during the night. So even though you may be getting the same, or even more sleep, then you did prior to childbirth, that sleep is fragmented and not restorative. The more waking you experience during the night, the less you’re able to experience full sleep cycles. Fortunately, as time goes by, you should experience less disrupted sleep and better overall sleep efficiency.
The problem is – sleep deprivation is highly correlated with worsened mood, increased anxiety, and trouble concentrating. Your immune system is compromised and you feel weaker, during a time when you need to be at your best.
Meanwhile, your progesterone levels drop back to normal, and you’re dealing with the stress of a new baby. Sleep deprivation can trigger postpartum depression (PPD), or worsen PPD symptoms. The extreme anxiety and depression associated with PPD can cause insomnia: up to 80 percent of women with PPD also have comorbid insomnia. Anxiety about your baby, waking up to their crying, nighttime breastfeeding, and lack of routine all spell trouble for sleep.
The “baby blues” are extremely common during the first 2 weeks, but for 10 to 15 percent of women this develops into postpartum depression. Check with your doctor before using any drugs or sleep aids, especially if you are breastfeeding. You want to ensure these don’t affect your baby or get into your breastmilk. Longer-acting sleep aids can also completely knock you out, so you won’t be able to tend your child who needs breastfeeding or has another emergency during the night.
Getting Your Rest – How New Mothers Can Cope
While this certainly won’t be a restful period if in your life, there are things you can do to maximize the amount and quality of your sleep during postpartum.
- Breastfeed if possible. It’s best for your baby, strengthens your bond, and also induces sleepiness through the release of prolactin. Mothers who nurse get more deep sleep, which is essential for muscle restoration.
- Keep your baby close by, but not in the bed with you as it increases their SIDS risk. However, a bassinet that attaches to the bed keeps them close, reducing your anxiety so it’s easier for you to fall asleep, and lessening the energy and time you have to spend waking up and walking over to them for nighttime feedings.
- Keep electronics out of your bedroom and avoid using your computer or watching TV in the hour before bed or whenever you wake up to breastfeed. The blue light from electronics is especially energizing and will make it tougher for you to fall back asleep.
- Avoid stimulants like caffeine, especially later in the day.
- Exercise, especially in the morning, will help you get energized for the day, and fall asleep easier at night.
- Nap when your baby naps. Try to nap for at least 90 minutes to ensure you undergo a full sleep cycle.
- Create a bedroom that promotes sleep. If your mattress is old or showing signs of wear and tear, invest in a new mattress that’s comfortable and feels great to sleep on. Reduce noise and light in the bedroom from electronics, and consider getting blackout curtains or white noise machines.
- Follow a soothing bedtime routine that helps you settle down. This might include drawing a warm bath, reading a book, or drinking a cup of tea. Deep breathing and relaxation techniques can help too.
- Alternate sleep duties with your partner. You may decide that one of you wakes up if the baby cries on certain nights, or split the night into two shifts. You can prepare milk ahead of time so your partner can bottle feed the baby.
Never Fear, Dad is Here; Helping Your Partner Get Better Sleep
One of the best ways new mothers can catch up on sleep is by sharing nighttime and early morning feeding shifts with their partner. When partners work together, they ensure they maximize sleep during this unavoidably sleep-deprived time. Having each other’s back and continuing to love and support each other also minimizes the anxiety and tensions that can contribute to postpartum insomnia.
Here are some ways fathers and partners can help mothers so they can get what they’re missing out on most: sleep.
- Help with nighttime feedings. While breastfeeding, moms can nurse the baby and then hand them off to their partner to soothe the baby back to sleep. Pumping breast milk for bottle feeding allows moms to skip a shift entirely. Dads can practice skin-to-skin contact while bottle feeding the baby, important for healthy emotional development and strengthening their parent-child bond. Besides bottlefeeding, dads and partners can practice hand offs during the day and soothing the baby during the daytime, so it’s easier to do so at night.
- Take on the host duties. People love to visit a new baby, but that can increase emotional strain and demands on the host. Dads can help by entertaining guests and preparing food.
- Be understanding. Recognize that mood swings and irritability are part and parcel of sleep deprivation, so go easy on each other during this time and don’t take things personally.
- Ask how you can help. Dads and partners can also help in other areas – keeping the house clean, letting mom take a night off, and taking time off work to stay home and help with feeding or diaper changing. Don’t wait to be asked – offer to help in various ways, or ask specifically how you can help.
Partners who get involved early on and stay involved ensure happier, healthier moms, dads, and babies.
Sleep Troubles and Coping Strategies for Fathers
Due to nighttime feedings, new mothers experience the most disturbed sleep. However, it may surprise some to learn that fathers are actually the ones who get less sleep during the postpartum months, according to studies in 2004 and 2013.
Researchers believe this may be due to fathers being unable to take time off from work, so even though moms can play catch up on sleep during the day while the baby naps, fathers can’t. As a result, they suffer from the same sleep deprivation new mothers do, including poorer mood, reduced ability to concentrate, and higher levels of fatigue.
Getting good sleep helps you be a better parent, and a better partner. New fathers and partners can follow the following advice to increase their alertness, and squeeze in better, higher-quality sleep when possible.
- Avoid relying on caffeine to stay awake. Instead, give yourself a boost by chewing ice, splashing cold water on your face, or pointing a cold fan towards you. Your body will work harder to regulate your body temperature, and that energy will help you stay alert.
- Eat well and exercise. Avoid junk foods high in sugar and unhealthy fats. Avoid alcohol as it interferes with sleep quality and may cause you to wake up earlier than expected. Exercise in the morning if possible to wake you up and energize you for the day.
- Ask for help. If you and your wife are tired to the point that it’s interfering with your relationship, your ability to take care of your child, or your performance at work, discuss it with each other and brainstorm if your friends, family, or workers can help. People love to help the ones they love.
- Create a sleep zone that helps you and your wife sleep whenever you’re on the “off shift.” Get a sleep mask and earplugs so sleep comes easy for during naptime.
- Baby Shusher is both an app and a product, designed to mimic the rhythmic shushing many parents use to help their babies fall asleep. The app works in intervals of 15 minutes to 8 hours of continuous shushing, and the Sound Equalizer feature adjusts the shushing volume according to how loud the baby is crying.
- Baby Snooze is another shushing app that lulls your baby to sleep by recreating the sounds from the womb.
- Lightning Bug is a white noise library for babies and toddlers, featuring sounds from nature, white noise, and instrumentation. The app includes a visual display to accompany the sounds and calm the baby, similarly to a mobile.
- The Bump app is a pregnancy and baby tracker that helps moms track the growth of their fetus, stay organized with an appointment agenda, and browse FAQ content to answer all their questions.
- The Leachco Snoogle is a highly-rated body pillow that supports side sleepers, eliminating the need for multiple pillows to create a comfortable and supportive sleep situation.
- The Boppy Pregnancy Wedge pillow creates belly and back support and fits between the knees, under the belly, and behind the back.
- The Project Nursery Parent + Baby SmartBand is a wearable wrist device that tracks the mother’s fitness stats, tracks fetal movements, and creates reminders for tasks like feeding and doctor’s appointments. It syncs wirelessly with iOS and Android phones.
- The MedSlant Acid Reflux Wedge pillow elevates your torso by 7 inches so moms can still sleep comfortably on their side and reduce heartburn. Better yet, it can also be placed in a crib if your baby develops acid reflux.
Online Communities/Support Groups:
- Mamapedia is a massive online support group with over 3.5 million expecting, new, and current mothers who lean on each other for support and share tips.
- There are several subreddits dedicated to pregnancy and motherhood, including the Pregnant, BabyBumps, Predaddit, and NaturalPregnancy subreddits.
- BabyCenter shares advice on finding and connecting with a local moms group.
- The Spruce offers a guide to local and online support groups for all stages of motherhood, from infancy to teenagers.
- Parents Magazine’s Pregnancy & Birth section shares advice for a variety of needs, including solutions for better sleep and understanding sleep deprivation during postpartum.
- This Seleni Institute article suggests how new parents can get better sleep. The site also publishes articles on maternal mental health and help finding local support groups.
- The American Pregnancy Association explains contributing factors to pregnancy insomnia, in addition to posting other informative content and tools for expecting mothers, including a local provider directory and ovulation calendar.
- An increasing amount of research indicates there may be a connection between sleep deprivation during pregnancy and postpartum, and preterm birth and postpartum depression. Read more in this study from Sleep Medicine Reviews.
- This NPR article reviews multiple studies analyzing the postpartum sleep patterns of fathers and mothers, and how it affects their relationships.
- Harvard Medical School provides an overview to postpartum depression, including risk factors and potential treatment options.