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Most couples planning a baby assume that it’s only after their newborn arrives that sleepless nights and exhausting days will plague them. A couple of weeks into a pregnancy, and this assumption changes as sleep patterns start changing for the worse. Even women who have never had any trouble sleeping or maintaining a regular sleep-wake pattern start observing that their routines have changed.

The simple fact is that pregnancy is both physically and emotionally demanding, which is why it’s quite likely to affect your sleep pattern. Usually, pregnant women tend to sleep a lot more during their first trimester, which is primarily because of their body adapting to the first lot of changes brought about by the pregnancy. 

Read more: Sleep chart by age and gender

As the pregnancy progresses and symptoms like round ligament pain, back pain, leg cramps, sciatic pain, etc. come up, sleep becomes more elusive. The baby bump - which continues to grow bigger and more ungainly as each trimester passes by - makes a lot of resting and sleep positions impossible. For example, a pregnant woman cannot sleep on her stomach or even her back through most of this period. This also majorly affects sleeping patterns.

Another factor most people forget about is the mental health aspect. Pregnancy can cause stress, anxiety, constant worry and even depression - all of which can also lead to sleep difficulties and insomnia. Whatever the cause of your sleep problems, you should not take this issue lightly because getting enough rest and sleep during pregnancy is just what you need to stay fit and to help your baby develop properly.

  1. Sleep by trimester during pregnancy
  2. Causes of sleep difficulties during pregnancy
  3. Sleep disorders that can get worse during pregnancy
  4. Tips to get better sleep during pregnancy
  5. Best sleeping positions during pregnancy
Doctors for Sleep during pregnancy

During pregnancy, it’s natural for sleep patterns to change every trimester as your pregnancy progresses. The following are some of the most common sleep patterns you’ll observe during each trimester.

  • First trimester: It’s quite normal for you to feel more sleepy during the first trimester because this is the time when your placenta is growing, and growing a fully-functional organ is no mean feat. This is also the time when your body first starts pumping 50% more blood, and you need to get used to that as well. Sleep is just one of the forms of rest your body can use at this point to adjust to these changes in your body.
  • Second trimester: Your baby and your baby bump are both growing, and your body has adjusted to the increased volume of blood. Your placenta is fully functional too. This makes the second trimester a time when your sleep pattern normalises a little, but don’t let this get you complacent. The second trimester is also the time when other symptoms will kick in and disrupt your sleep.
  • Third trimester: The baby becomes more active, and more symptoms of pregnancy start to interfere with sleep during the third trimester. Back pain, frequent urination, leg cramps, weight gain, etc make sleep more elusive than the first two trimesters. These weeks can be very exhausting, especially with your delivery date coming closer.

Read more: Symptoms of pregnancy

There are many reasons for disturbed or lack of sleep during pregnancy, but none are as important as the key one: the growing foetus inside your womb makes getting a comfortable enough position to sleep impossible. The other causes can intensify as the pregnancy progresses, but this primary cause does not change. The following are the other causes of sleep difficulties during pregnancy.

Read more: Foetal development during pregnancy

Increased heart rate

Your body is pumping 50% more blood when you’re pregnant, so naturally, your heart has to beat at a much faster rate. This also leads to an increase in blood pressure and often leads to gestational hypertension as well. An increased heart rate and high blood pressure are linked to sleep difficulties during pregnancy.

Frequent urination

As your body pumps more blood than before, your kidneys will have to work overtime to filter this increased volume of blood. This filtering process will inevitably create more urine than before. Add to this the fact that as your baby grows, your bladder will be under more pressure and this will also lead to frequent urination

Due to both these reasons, your bathroom trips will increase throughout the day and night. If your baby is more active during the night in the second and third trimesters, you’re likely to have more bathroom trips through the night, which can lead to disturbed sleep and even lack of sleep.

Shortness of breath

With your heart pumping more blood, and with the huge spike in pregnancy hormones, you’ll be breathing more deeply. As your pregnancy progresses and your uterus takes more space, your diaphragm - which is the muscle just below your lungs - will meet with more pressure from below. All this can lead to shortness of breath, which in turn can make you feel a lot more sleepless.

Cramps and aches

Pain is a part and parcel of pregnancy. Leg cramps, back pain, sciatic pain, leg pain, headaches and pain due to varicose veins are all likely to happen during the second and third trimesters of your pregnancy. Apart from the discomfort they cause, these aches and pains also lead to disturbed sleep. Pregnant women are also likely to be a little off balance because of constantly carrying more weight, which can also lead to minor injuries that hurt as well as make sleeping difficult.

Digestive problems

Gastrointestinal problems tend to increase during pregnancy, and heartburn, indigestion, diarrhea and constipation are quite common too. These happen because the entire digestive system slows down during pregnancy. If you have hemorrhoids as well as constipation, these problems can be a lot more difficult to manage. All types of digestive issues during pregnancy can contribute to lack of sleep or disturbed sleep.

Depression

A lot of pregnant women might also feel increasingly anxious, stressed and worried about their pregnancy. This apart, there are a number of other reasons why depression during pregnancy is a common occurrence, though it is not diagnosed or treated properly if it does emerge. It’s very important to remember that depression is related to the mental health of a pregnant woman, but it can equally contribute to lack of sleep during pregnancy.

Read more: Postpartum depression

Women who already suffer from certain sleep disorders are likely to suffer more during pregnancy. These disorders are also likely to show up for the first time during pregnancy, and make it much more difficult to get enough rest. The following are three such sleep disorders that can occur during pregnancy.

It’s not completely possible to avoid the things that cause disturbed sleep during pregnancy. In fact, most of those issues are part and parcel of pregnancy and cannot be gotten rid of until well after you deliver your baby. However, there are a few things you can do to ease these symptoms and get better sleep during pregnancy.

  • Develop a relaxing bedtime routine. If you make this a habit, even your baby might get a cue and move or kick less during nighttime, allowing you to get more zzz’s. 
  • Maintain a regular sleep and wake pattern. Even if you do take a nap during the day, make sure it is around the same time and for the same duration every day.
  • Limit or avoid caffeine consumption during pregnancy.
  • Avoid using electronics and staying on your phone at least an hour before going to sleep.
  • Relieve your stress and anxiety by practising yoga, meditation and getting enough exercise during the day. (Read more: Exercises during pregnancy)
  • Drink enough water throughout the day to reduce leg cramps.

Read more: How to fall asleep

Getting to that sweet spot to get a good night’s sleep might be more difficult than you think during pregnancy. You have an ever-growing belly apart from all the physical discomfort you have to deal with. Using the following sleeping position tips might just help you sleep better by providing better support while you’re pregnant.

  • Sleeping on your side - particularly the left side - is the best thing you can do. Favouring the left side can improve blood circulation and avoid some of the discomfort and pain through the night. 
  • Keep your knees bent, but not so bent that they constrict your belly in any way. A foetal position for sleep is best during pregnancy, and you can even place a pillow between your knees to feel more comfortable.
  • Get enough pillows soon after you get pregnant because these will be needed to support your back and belly as your pregnancy progresses.
  • Elevate your head. This will reduce gastrointestinal issues as well as other digestive disorders that might keep you awake. 
  • Don’t go to sleep on your back. It’s quite natural to roll to your back while sleeping. If you wake up and find yourself sleeping on your back, shift to the left side again before going to sleep.
Dr. Sonam Yadav

Dr. Sonam Yadav

Obstetrics & Gynaecology
7 Years of Experience

Dr. Priyanka Gupta

Dr. Priyanka Gupta

Obstetrics & Gynaecology
10 Years of Experience

Dr. Vrinda Khemani

Dr. Vrinda Khemani

Obstetrics & Gynaecology
6 Years of Experience

Dr Megha Apsingekar

Dr Megha Apsingekar

Obstetrics & Gynaecology
4 Years of Experience

References

  1. Nemours Children’s Health System [Internet]. Jacksonville (FL): The Nemours Foundation; c2017. Sleeping During Pregnancy
  2. SleepFoundation.org [Internet]. National Sleep Foundation. Washington D.C. United States; Pregnancy and Sleep Image.
  3. National Health Service [Internet]. Hertfordshire. UK; Tiredness in pregnancy
  4. Sleep.org [Internet]. National Sleep Foundation. Washington D.C. United States; The Best Position for Sleep During Pregnancy.
  5. Cleveland Clinic. [Internet]. Cleveland. Ohio; 8 Best Ways to Improve Sleep During Your Pregnancy
  6. Cleveland Clinic. [Internet]. Cleveland. Ohio; Sleep During Pregnancy
  7. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; Get a Good Night's Sleep During Pregnancy
  8. Reichner, Cristina A. Insomnia and sleep deficiency in pregnancy. Obstet Med. 2015 Dec; 8(4): 168–171. PMID: 27512475
  9. MedlinePlus Medical Encyclopedia [Internet]. US National Library of Medicine. Bethesda. Maryland. USA; Problems sleeping during pregnancy
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