Pregnancy and Sleep by the Trimester

Although you may have been used to jumping out of bed and grabbing a cup of coffee before heading to work for the daily grind, pregnancy changes every aspect of your life. With the usual complaints of nausea, vomiting, and exhaustion during the first trimester, you might be wishing it were acceptable to take naps during the workday. While the second trimester may offer some relief as you grow accustomed to your changing body, the third trimester may bring even more fatigue than the beginning of your pregnancy.

If the nausea, fetal movement, and back pain aren’t enough to disrupt your routine, some women also develop restless leg syndrome (RLS), vivid dreams, snoring, and insomnia. More than three-quarters of women report more disturbed sleep during pregnancy than at other times, according to a National Sleep Foundation poll.

Although the benefits of having a child outweighs the fatigue and sleep disturbances experienced during pregnancy, it is useful to understand what is happening to your body and what you can do to ease your sleep woes during pregnancy.

First Trimester and Sleep

The first trimester is marked by anticipation and surprises, particularly for women who have never been pregnant. Some women may feel excited and adjust well to the emotional, mental, and physical changes they experience, while others feel run down and exhausted. Women who plan for sleep the way they plan for other aspects of their lives may feel well-rested than women who don’t. Extra sleep can make pregnancy a more positive experience, and first time mothers may feel more energetic when they schedule sleep times.

One of the reasons pregnant women experience drowsiness is due to the rise of the hormone progesterone. The sleep-promoting and heat-producing hormone secreted from the placenta can cause fatigue and earlier onset of sleep. During the first trimester, women usually have a longer total sleep time, yet sleep more poorly than before they were pregnancy. Women may awaken more frequently at nighttime, which is also due to elevated levels of progesterone. Progesterone has an inhibitory effect on the smooth muscles which increases the need to urinate more frequently.

Women may also feel discomfort as a result of the changes in their bodies, which can make it more difficult to fall asleep and stay asleep. Tender breasts may make it challenging to sleep on your stomach. During the first trimester, it is a good time to start training yourself to sleep on your left side, as this has been proven to improve blood flow and nutrients to the uterus and fetus. Getting used to this position before the belly is larger is useful for later on in your pregnancy.

Morning sickness also cuts into sleeping time. However, contrary to its name, it can happen at any time of day. Nausea is a common problem for women, especially in the first twelve weeks of pregnancy.

First Trimester Sleep Tips

  • Make sleep a priority and schedule the best times for sleep.
  • Get extra sleep whenever you can and take brief 20-30 minute naps whenever you feel the need.
  • Stay hydrated during the day, but cut back on fluid intake in the hours closer to bedtime.
  • Try to eat bland foods such as plain oatmeal or crackers to combat nausea.
  • Use a nightlight in the bathroom if you have a problem with frequent nighttime urination. A dim light is less disruptive when trying to get back to sleep than if you were to turn on an overhead light or a lamp.

Second Trimester and Sleep

The second trimester may be somewhat of a relief, particularly for first-time mothers. During the second trimester, the fatigue and nausea will likely subside as hormones level off. Many women will feel more energetic and get more sleep during this time. One lingering problem from the first trimester is urinary frequency, as the expanding uterus compresses the bladder.

Heartburn may be another problem during the second trimester due to the changes in the body accommodating the enlarged uterus. Vivid dreams and nightmares are also common, with up to 70 percent of women experiencing frightening dreams or nightmares during the second trimester.

Overall, you can expect to sleep better during the second trimester of your pregnancy, but remember to schedule in as close to eight hours per night as you can.

Second Trimester Sleep Tips

  • To avoid nighttime heartburn, avoid eating large amounts of spicy, acidic, or fried foods.
  • Before going to sleep, position yourself on your side with your knees and hips bent. By placing a pillow between your knees, under your belly and behind your back, you can alleviate some of the pressure on your lower extremities.
  • If you are experiencing distressing dreams, it may be helpful to speak to a counselor or psychotherapist.

Third Trimester and Sleep

The most challenging state of pregnancy, the third trimester finds many women struggling to stay awake during the daytime as they try to keep up with the demands of work and daily life. The weight of the baby affects posture which may cause discomfort while walking, sitting, or lying down. During this time, it is difficult to find a comfortable sleeping position due to the enlarged uterus and resulting back pain. The aches and pain can be attributed to the loosening of the joints and softening of the ligaments between the pelvic bones in preparation for the birth. At nighttime, it is common for women to be disrupted further by the baby kicking and the frequent need to urinate.

Snoring may become a problem during the third trimester, as well. This may be due to nasal congestion, along with the uterus pressing on the diaphragm. Snoring can cause other problems, such as hypertension, which can put the mother and fetus at increased risk. Snoring with periods of stopped breathing during sleep is an indication of sleep apnea. Women should consider snoring as a red flag if it occurs alongside excessive daytime fatigue, headaches, and swollen legs. A recent study found that women who reported snoring during pregnancy had two times the risk of developing high blood pressure, preeclampsia, and intrauterine growth restriction versus non-snorers.

Another potential problem is restless leg syndrome, which may affect up to 15 percent of pregnant women, according to the National Sleep Foundation. RLS symptoms include an uncomfortable feeling in the feet and legs which is alleviated temporarily by movement. RLS may occur due to a deficiency of iron and/or folic acid before becoming pregnant. Fortunately, most women who experience RLS during pregnancy no longer have symptoms after giving birth.

Leg cramps are a common problem during the third trimester. These cramps may occur at night and disrupt sleep.

Third Trimester Sleep Tips

  • Sleep on your left side, as this improves blood flow and nutrients to the uterus and fetus.
  • Use a “pregnancy pillow” to help you sleep better.
  • Have your blood pressure and urine protein checked if you start snoring, particularly if you experience swollen ankles or headaches.
  • Talk to your doctor about iron deficiency if you develop symptoms of RLS.
  • Practice good sleep hygiene.
  • To alleviate leg cramps, straight your leg and flex the foot upwards. To avoid future cramps, do this movement several times before going to bed.

For more information about pregnancy and its influence on sleep quality, call The Los Angeles Sleep Study Institute at 1-855-690-0563.