Sleep problems during pregnancy

Sleep problems are common during pregnancy. Sleep studies tell us that hormonal changes, plus the discomforts of later pregnancy, can break up a pregnant woman's sleep cycle.

• The first trimester can bring insomnia and night waking. Most women feel the need to take naps to battle daytime sleepiness and fatigue.
• The second trimester tends to feel more normal for many women, though about 20% continue to have disrupted, poor-quality sleep.¹ This is often a period of improved daytime energy and less need for naps.
• The third trimester is a time to expect increasing insomnia and night waking. Most women wake up 3 to 5 times a night, usually because of such discomforts as back pain, needing to urinate, leg cramps, heartburn, and fetal movement. Strange dreams are also common in the last few weeks of pregnancy. The need to take daily naps returns as the due date approaches.¹

Managing sleep problems during pregnancy

You can take a few simple measures to get the best possible sleep during pregnancy.

• Get regular exercise, 2 or more hours before you plan to go to sleep.
• Keep a regular sleep schedule.
• Keep your naps as short as possible.
• Use your bed only for sleep.
• Avoid caffeine.
• Practice relaxation techniques. (For more information, see the topic Stress Management.)
• Reduce your exposure to sounds that might wake you.
• Limit your fluid intake after 6 p.m. to reduce nighttime bathroom visits.
• Prop yourself with extra pillows to reduce aches and pains.

If you continue to have problems with insomnia, go to bed only when you're tired, and get out of bed when you're wide awake in the middle of the night.

Medications are seldom used to aid sleep during pregnancy, because most are dangerous to a growing baby. For obstructive sleep apnea that disrupts sleep and limits a mother's and baby's oxygen supply, continuous positive airway pressure (CPAP) or supplemental oxygen are considered safe during pregnancy.¹

Citations

1. Santiago JR, et al. (2001). Sleep and sleep disorders in pregnancy. Annals of Internal Medicine, 134(5): 396–408.