How to Sleep When Pregnant: First Trimester

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The body goes through many changes during pregnancy; after all, during this time a human is forming from what was once a fertilized egg. This radical transformation demands a lot from the pregnant person, and the huge shift in hormones that go into creating a baby can result in a slew of side effects.

Throughout the first trimester, pregnant people can feel everything from exhaustion and insomnia to physical discomfort and nausea. To help you improve your sleep, we’ll go over reasons why your sleep might be impacted in the first trimester– and what to do about them.

First Trimester: Sleep Positions

Sleeping on the side

According to the University of Rochester Medical Center[1], side sleeping is the best position during pregnancy, whether it’s the first 12 weeks or the last 12 days. Particularly, sleeping on your left side should be the most comfortable and the most beneficial for both you and your baby, health-wise. This is because the left side allows for better blood flow to the baby and also improves kidney function[1].

Don’t feel like you’re restricted to one spot, though. During the first trimester[2], you can safely lie on your left side, right side, or even stomach or back if that is comfortable for you. Later in your pregnancy, you’ll have to be more careful about sleep positions for the health and safety of you and your baby, but during the first trimester, your sleep position can be more flexible. Over 44 percent[3] of pregnant people experience insomnia during the first trimester due to hormonal changes, so it will be important to get some sleep, in whatever position you can.

Need more info? Check out our complete guide to sleeping during pregnancy.

A Woman Flipping from Her Back to Her Side Over-and-Over Animated Illustration

Sleeping on the back

While back sleeping later on in pregnancy, particularly by the third trimester, should be avoided, research suggests that sleeping on your back is safe during the first trimester[2].

The reason you should avoid back sleeping later in your pregnancy is that it puts pressure on the blood vessels, back, and spine as your uterus increases in size[1]. Back sleeping during late pregnancy has also been shown to increase the likelihood of stillbirth[4]. It can also lead to hemorrhoids5; back aches, drops in blood pressure, dizziness, and vertigo[5].

During the first trimester, you shouldn’t have to worry about these things, but it is important to know as your baby gets bigger and your pregnancy progresses. With that being said, if you tend to snore, experience congestion, or have sleep apnea, we recommend not sleeping on your back during any point of your pregnancy as this posture can make it harder to breathe.

Get More Info: Potential Dangers of Back Sleeping While Pregnant

Sleeping on the stomach

Research shows that it is perfectly safe for you and your baby if you sleep on your stomach during early pregnancy[2]. However, it might not be the most comfortable option.

As early as two weeks after conception, many pregnant people start to experience breast pain[6]. In fact, over 76 percent of pregnant people in one study reported breast pain at some point during the first trimester[6].

As your baby continues to grow, sleeping on your stomach might also exacerbate lower back and pelvic pain[7], though there are special pillows designed to help with this.

Tips for Better Sleep During the First Trimester

Use pillows

There are special pregnancy pillows that you can adjust to place between your knees or to support your stomach. The key is to keep your lower back supported, and having a pillow between your legs at the knee level does wonders for this.

As your pregnancy progresses, you may also want a full-body pillow or curved pillows to support your belly. According to Stanford Medicine[8], oftentimes pregnant people get heartburn because changing hormones relax the esophagus, which allows partially digested foods and stomach acids to backflow. If you find that your heartburn is getting worse through the first trimester, grab a wedge pillow and elevate your head to prevent the flow of acid upward.

Find Out More: 7 Benefits of Sleeping With Head Elevated

Illustration of Pregnancy Pillows

Watch what you eat

Our best advice is to avoid a large meal right before bed, especially one including spicy or greasy foods. These foods are known for causing heartburn[8]. However, you don’t want to go to bed hungry either, as that can exacerbate symptoms of nausea.

Johns Hopkins Medicine[9] recommends adding 300 calories per day while pregnant, but as we know, not all calories are created equal. You’ll want a healthy balance of foods rich in protein, fruits, vegetables, and whole grains.

Eating meals with a good amount of protein, fiber, and very little sugar or refined carbs will also keep your blood sugar stable[10], which is important during pregnancy as high blood pressure is potentially dangerous[11] for you and your baby. The exact food choices will vary based on your dietary preferences, but we recommend the following items:

  • Proteins like salmon (never raw) and chicken breast
  • Fiber-rich grains like oatmeal, quinoa, and brown rice
  • Fiber-rich vegetables like carrots, sweet potatoes, pumpkins, spinach, kale, and asparagus
  • Nutritious fruits like oranges, bananas, berries, and apples.
  • Healthy fats like olive oil, avocado, nuts, dark chocolate, and Greek yogurt

When you’re newly pregnant, you want to get more than your normal amount of folic acid9, which can help prevent birth defects in the brain and spinal cord.

If you’re nauseous, saltine crackers with a glass of ginger ale can go a long way in providing relief.

Want to see more? View our guide for healthy late night snacks.

Take a nap during the day

The sharp increase in the hormone progesterone during the first trimester can cause intense sleepiness and fatigue[12]. Unfortunately, this intense fatigue doesn’t necessarily translate to sleeping soundly through the night, so if you need it, prioritize taking a nap.

In fact, a 2018 study[13] found that regular afternoon naps in pregnant people were tied to a healthy birth weight. Normally, experts advise shorter naps lasting only 10-30 minutes, but this study showed the best results were obtained with a daily 90-minute nap.

Continue exercising

Staying fit during your pregnancy can make your delivery faster and reduce the risk of complications[14] like weight gain, gestational diabetes, and high blood pressure.

According to the American College of Obstetricians and Gynecologists[15], if you were active before your pregnancy, it is safe to remain just as active during your first trimester. Of course, as your body changes, certain things might become less comfortable or accessible, and you should always talk to your doctor if you have specific questions about an exercise or activity.

Overall, though, a moderate level of exercise is highly recommended for pregnant people for a variety of reasons, including improving sleep[16].

Deep breathing

Deep breathing helps ensure you’re getting enough oxygen and staying relaxed.

The following is one type of breathing exercise we recommend:

  1. Place one hand on your belly and the other on your chest
  2. Deeply inhale
  3. Hold your breath for a count of three
  4. Exhale through your mouth
  5. Repeat until you feel your body and mind relax.

The rise and fall of your belly, along with the influx of oxygen, are very calming and relaxing, which can help get you to sleep.

Full Body Massage- Illustration

Get a massage

Research shows that getting massages can help people with low back pain[17] and improve[18] blood circulation, anxiety levels, and sleep quality and duration. This is very useful for pregnant people as all of these things can worsen during pregnancy.

The American Pregnancy Association[19] says it is safe to get a massage at any point during your pregnancy, including the first trimester, but some prenatal massage therapists won’t recommend or even do this, due to the increased risk of miscarriage[20] during early pregnancy. The best thing you can do is talk to your OB-GYN, and be sure you’re seeing a prenatal massage therapist rather than a regular massage therapist.

Practice progressive muscle relaxation

This is a relaxing activity you can do in bed or any time you need to reconnect with your body. To do progressive muscle relaxation, lie on your back, close your eyes, and focus on the muscles in your face. Tense and relax them while breathing slowly and deeply. Then tense and relax the muscles in your neck, then down to your shoulders, arms, back, legs, and feet.

Do yoga and stretch

Yoga is a practice that allows you to get more in touch with your body, slow your mind, and ultimately, get better sleep[21]. It is generally safe to keep up with your regular yoga or fitness routine in the first trimester, but here are some first-trimester tips from Yoga International[22]:

  • Avoid poses that twist your lower torso
  • Avoid overstretching or hyper-extending your joints. During early pregnancy, relaxin is produced, which loosens up your joints and can make it easier to hyper-extend or injure yourself
  • Avoid hot yoga
  • Avoid headstands or handstands if you are inexperienced and might fall
  • Rest or sit in child’s pose when you need to
  • Sit by the door in case you need to duck out because of morning sickness

Do some guided imagery

Visualization is scientifically proven[23] to help people fall asleep faster. The key is to visualize something that makes you feel calm and happy, such as an activity you do well or a place that makes you feel relaxed.

For example, perhaps you feel especially calm at the beach. Imagine all of the details of the scene – the smells, sounds, textures, and sights. This sort of detailed imagining can shift your focus from intrusive, stressful thoughts to calmer ones that should help you fall asleep.

A Woman Laying Down Imagining She is Hiking Illustration

Symptoms That Affect Sleep in the First Trimester

You feel drowsy in the daytime

Your body is flooded with hormones during pregnancy, and the first trimester is a significant adjustment period. You may feel as though you have flu-like symptoms thanks to a spike in the hormone progesterone[24]. When it increases in your body, you’ll feel warmer and drowsier due to its thermogenic and soporific effects. Those are just fancy words for heat-producing and sleep-inducing.

The effect is feeling tired, especially during the day. The hormone can also affect your sleep cycle, reducing the time spent in deep sleep.

Illustration of a Tired Lady Yawning

You feel physical discomfort

You might think of the third trimester as the most uncomfortable, once your baby has significantly grown, but there is physical discomfort in the first trimester as well, which can make it harder to sleep.

For example, most people will experience sore and swollen breasts, which is often cited as the very first sign of pregnancy[25]. This can make it very difficult to find a comfortable position to sleep in, especially for the first several weeks until your body adjusts to the new hormones.

You experience frequent urination

Progesterone is also responsible for your need to frequently urinate[26], and as your body prepares for the baby to grow, your uterus expands, putting pressure on your bladder.

This can increase the urge to go to the bathroom, becoming worse as the baby gets bigger.

You may be tempted to drink less fluid to limit bathroom trips, but you need liquids now more than ever. If you don’t relish the idea of getting up frequently during the night, drink less at night and more during the day.

Woman in Need to Urinate Illustration

Another thing to note is that caffeine increases the need to urinate, so limit your intake, or even better, don’t drink it at all. The American College of Obstetricians and Gynecologists recommends pregnant people limit their caffeine consumption[27] to less than two, 6-ounce cups per day. It’s also advised that if you aren’t a caffeine drinker before pregnancy, it’s not a good time to introduce it. Caffeine should be safe, though, for those who already drink it, as long as they drink a low or moderate amount in the mornings only to avoid it affecting their sleep.

You feel constant nausea

The term “morning sickness” should really be changed to “all-day sickness.” In fact, many professionals now refer to it as “NVP”, which stands for “nausea and vomiting during pregnancy,” since it is not limited to the mornings[28]. For many people, nausea and vomiting only occur in the first trimester, but for some, it lasts the entire pregnancy.

Not only can nausea make your days unpleasant, but you may also experience it at night while you’re trying to sleep.

Ginger in natural or tablet form is a natural solution that works wonders for nausea during pregnancy[29]. There are also bands you can wear on your wrists that apply pressure to specific points of your body, which can ease the symptoms.

You have heartburn

As we mentioned, the source of heartburn and acid reflux[30] is the relaxing of the smooth muscle that opens into the stomach from the esophagus.

Again, progesterone is the culprit here, along with estrogen. 80 percent of pregnant people will experience gastroesophageal reflux disease (GERD) during their pregnancies[30].

To alleviate the symptoms and retain your beauty sleep, try to eat small and frequent snacks and avoid big meals right before bed.

Illustration of a Woman Having Heartburn

You feel stress and anxiety

You’re going through an exciting time but also a scary one. The physical changes you’re experiencing are just a small representation of how your life is going to change. You may be feeling overwhelmed, concerned about delivery, or wondering how you’re going to manage it all when the baby comes. Furthermore, these hormonal changes have been known to cause generalized anxiety disorder[31] during the first trimester.

It is a lot to take in, and it makes sense that you’ll need some good coping strategies to manage the stress and anxiety, especially before bedtime. Journaling, relaxation techniques like meditation, and childbirth classes, can all help calm you down and prepare you for the journey ahead.

Learn More: Meditating Before Sleep

Frequently Asked Questions

Can lack of sleep harm the baby?

Yes, a lack of sleep could harm the baby. Not only will you feel drained, but your immune system could also become compromised. In addition, sleep deprivation could negatively impact your ability to function, leading to drowsy driving and other dangerous circumstances.

Is it normal to experience insomnia?

Yes, it is normal to experience insomnia during pregnancy. The good news is you’re not alone. According to research[32], a staggering 78 percent of pregnant people reported trouble sleeping during their pregnancy.

What are some comfortable sitting positions during pregnancy?

One of our favorite sitting positions during pregnancy is to sit on the couch with the legs propped up on a pillow and a pillow nestled under the lower back.

For more office-friendly arrangements, you may want to sit on a giant exercise ball at your desk. Sitting this way keeps your spine in alignment and encourages proper posture. If you’re in a chair, make sure you have a towel rolled up and placed in the hollow space between your back and chair to support your lumbar spine.

Avoid slouching, dangling your legs, and sitting without a backrest, and while you may want to do nothing more than sit back and relax, Stanford Medicine[33] advises you to get up every hour and walk around to keep your blood circulating well.

Last Word of Advice

Remember, getting proper sleep during your pregnancy is vital for the health of you and your baby. Side sleeping is best, especially on your left side. However, in your first trimester, our recommendation is to find whatever position makes you the most comfortable.

If you’re in your first trimester and having trouble sleeping, try utilizing pillows to feel more comfortable, practicing relaxation techniques, and keeping up with daily exercise or movement. If you’re still having trouble sleeping, consider using a magnesium supplement before bed. Magnesium could help you sleep, is safe during pregnancy, and research[34] shows that it may reduce the risk of some birth complications.

We want to remind you that we’re not medical professionals at Sleep Advisor, so before you introduce anything new during your first trimester, consult with your OB-GYN.

References:

  1. Sleeping Positions During Pregnancy”. University of Rochester Medical Center. Webpage accessed January 23, 2023. 
  2. Science Update: Sleeping position during early and mid pregnancy does not affect risk of complications, NIH-funded study suggests”. National Institute of Child Health and Human Development. Last modified September 20, 2019. 
  3. Roman-Galvez, RM, Amezcua-Prieto, C, Salcedo-Bellido, I., et. al.  “Factors associated with insomnia in pregnancy: A prospective Cohort Study”. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017. 
  4. Robertson, Nicole., Okano, Satomi., Kumar, Sailesh. “Sleep in the Supine Position during Pregnancy Is Associated with Fetal Cerebral Redistribution”. Journal of Clinical Medicine. 2020. 
  5. Best Sleeping Positions During Pregnancy”. American Pregnancy Association. Webpage accessed January 23, 2023. 
  6. Nazik RN, Evsen., Eryilmaz RN, Gulsen.“Incidence of pregnancy-related discomforts and management approaches to relieve them among pregnant women”. Journal of Clinical Nursing. 2013.  
  7. Hollenbach, Dana., Broker, Riley., Herlehy, Stacia., Stuber, Kent. “Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review”. The Journal of the Canadian Chiropractic Association. 2013.  
  8. Pregnancy and Heartburn”. Stanford Medicine. Webpage accessed January 23, 2023. 
  9. Nutrition During Pregnancy”. Johns Hopkins Medicine. Webpage accessed January 23, 2023. 
  10. Carbs, Protein and Fats – Their Effect on Glucose Levels”. Joslin Diabetes. 2021.  
  11. Pregnancy week by week”. Mayo Clinic. Last modified July 23, 2022. 
  12. Klemin MD, Peter. “First trimester fatigue: How long it lasts, how to ease it”. Sanford Health. 2022.  
  13. Song, Lulu., Shen, Lijun., et. al. “Afternoon napping during pregnancy and low birth weight: the Healthy Baby Cohort study”. Sleep Medicine. 2018.  
  14. Rodríguez-Blanque, Raquel., Sánchez-García, Juan Carlos., et. al. “Physical activity during pregnancy and its influence on delivery time: a randomized clinical trial”. The Open Access Journal for Life and Environment Research. 2019.  
  15. Exercise During Pregnancy”. American College of Obstetricians and Gynecologists. Last modified March 2022. 
  16. Yang, Shu-Ya., Lan, Shou-Jen., e. al. “Effects of Exercise on Sleep Quality in Pregnant Women: A Systematic Review and Meta-analysis of Randomized Controlled Trials”. Asian Nursing Research. 2020.  
  17. Allen, Laura. “Case Study: The Use of Massage Therapy to Relieve Chronic Low-Back Pain”. International Journal of Therapeutic Massage and Bodywork. 2016. 
  18. Hsu, Wen-Chi., Guo, Su-Er., Chang, Chia-Hao. “Back massage intervention for improving health and sleep quality among intensive care unit patients”. National Library of Medicine. 2019.  
  19. Prenatal Massage Therapy”. American Pregnancy Association. Webpage accessed January 23, 2023. 
  20. Patel MD, Shivani. “Is massage safe during pregnancy?”. University of Texas Southwestern Medical Center. 2018.  
  21. Wang, Wei-Li, Chen, Kuang-Huei., et. al. “The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis”. National Library of Medicine. 2020. 
  22. Morris, Nishita. “Safe Prenatal Yoga Tips for Each Trimester”. Yoga International. Webpage accessed January 23, 2023.
  23. Harvey, Allison G., Payne, Suzanna. “The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction”. National Library of Medicine. 2002.  
  24. First Trimester Fatigue”. Johns Hopkins Medicine. Webpage accessed January 23, 2023.  
  25. What are some common signs of pregnancy?”. National Institute of Child Health and Human Development. Last modified January 31, 2017. 
  26. Lin, Kun-Ling., Shen, Ching-Ju., et. al. “Comparison of low urinary tract symptoms during pregnancy between primiparous and multiparous women”. BioMed Research International. 2014.  
  27. Moderate Amounts of Caffeine Not Linked to Maternal Health Risks”. Penn Medicine News. 2021.  
  28. Morning Sickness”. Stanford Medicine. Webpage accessed January 23, 2023.  
  29. Maitre MD, Sarah., Neher MD, Jon., Safranek, Sarah. “Ginger for the Treatment of Nausea and Vomiting in Pregnancy”. American Family Physician. 2011.  
  30. Law, Ruth., Maltepe, Caroline., Bozzo, Pina., Einarson, Adrienne. “Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy”. Canadian Family Physician. 2010.  
  31. Collier MD, Stephanie. “How can you manage anxiety during pregnancy?” Harvard Health Publishing. 2021.  
  32. Hashmi, Ali M, Bhatia, Shashi K, et. al. “Insomnia during pregnancy: Diagnosis and Rational Interventions”. Pakistan Journal of Medical Sciences. 2016.  
  33. Pregnancy and Posture”. Stanford Medicine. Webpage accessed January 23, 2023. 
  34. Zarean, Elaheh., Tarjan, Amal. “Effect of Magnesium Supplement on Pregnancy Outcomes: A Randomized Control Trial”. Advanced Biomedical Research.  2017. 

Our team covers as many areas of expertise as we do time zones, but none of us started here as a so-called expert on sleep. What we do share is a willingness to ask questions (lots of them), seek experts, and dig deep into conventional wisdom to see if maybe there might be a better path towards healthy living. We apply what we learn not only to our company culture, but also how we deliver information to our over 12.7M readers.

Sleep research is changing all the time, and we are 100% dedicated to keeping up with breakthroughs and innovations. You live better if you sleep better. Whatever has brought you here, we wish you luck on your journey towards better rest.

Registered Nurse, Registered Holistic Nutritionist, and Certified Health Coach

As a nurse, Raina has worked in pediatrics, neonatal intensive care, and oncology. She is also a Registered Holistic Nutritionist and Certified Health Coach, whose true passion in life is helping others live well through her website, www.holfamily.com.

Her holistic approach focuses on the whole person, honing the physical body and spiritual and emotional well-being. Raina believes health is a life-long endeavor and requires a balance of mind, body, and spirit.

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