This article was expert reviewed by Raina Cordell R.N./R.H.N.
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 goes 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.
Importance of Sleep During the First Trimester
While sleep should always be valued, it is especially important during pregnancy. When you’re in the first trimester of pregnancy1, your body is adjusting to so many changes.
Some of these changes include nausea, increased urination, fatigue, heartburn, constipation, and food cravings, along with emotional and hormonal changes1. Experiencing all of these changes can be exhausting, so sleep is so vital to the pregnant person’s health, along with the growing baby’s health.
Additionally, according to the American Academy of Sleep Medicine2, the first trimester of pregnancy induces extreme daytime and evening sleepiness, which is all the more reason to get a long, good night’s sleep.
How Does Sleep Change During the First Trimester?
During the first trimester of pregnancy, your body is experiencing lots of changes. Along with these changes, as an expecting parent, you’ll likely begin worrying about all things baby. Random questions like “What food should I be eating right now?” or “How many diapers does a baby go through in one day?” may start running through your head as you’re trying to sleep, which only keeps you up later into the night worrying.
In general, pregnant people sleep fewer hours, take longer to fall asleep, and wake up more in the night, whether it’s due to worry, discomfort, or need to use the restroom. In fact, a 2022 study3 found that 46-65 percent of pregnant people reported shorter sleep duration, and there was an increase from early to late pregnancy.
So, while your quality of sleep may start to deteriorate during the first trimester, you’ll likely continue struggling to sleep throughout the duration of your pregnancy. That’s why it’s so important to try to sleep whenever you can during this time of growth and change.
First Trimester: Sleep Positions
Sleeping on Your Side
According to the University of Rochester Medical Center4, side sleeping is the best position during pregnancy, whether it’s during 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, because the left side allows for better blood flow to the baby and also improves kidney function4.
Don’t feel like you’re restricted to one spot while you’re sleeping, though. During the first trimester5, you can safely lie on your left side, right side, or even your 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 percent6 of pregnant people experience insomnia during the first trimester due to hormonal changes, so it’s important to get some sleep, in whatever position you can.
Need more info? Check out our complete guide to sleeping during pregnancy.
Sleeping on Your Back
While back sleeping later on in pregnancy (particularly by the third trimester) should be avoided, research suggests that you can safely sleep on your back during the first trimester of pregnancy5.
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 size3. Back sleeping during late pregnancy has also been shown to increase the likelihood of having a stillbirth7. This sleeping position can also lead to hemorrhoids8, backaches, drops in blood pressure, dizziness, and vertigo.
During the first trimester, you shouldn’t have to worry about these medical issues, but it is important to know this information 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 position can make it harder to breathe.
Get More Info: Potential Dangers of Back Sleeping While Pregnant
Sleeping on Your Stomach
Research shows that it is perfectly safe for you and your baby if you sleep on your stomach during early pregnancy8. However, stomach sleeping might not be the most comfortable option, even in your first trimester.
As early as two weeks after conception, many pregnant people start to experience breast pain9. In fact, one study found that over 76 percent of pregnant people report breast pain at some point during the first trimester9. So, sleeping on your stomach might put too much pressure on your breasts during pregnancy.
As your baby continues to grow, sleeping on your stomach might also exacerbate lower back and pelvic pain10, though there are special pillows designed to help with this. Listen to your body during this time when it is ever-changing.
9 Tips for Better Sleep During the First Trimester
1. 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 Medicine11 , pregnant people often 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
2. Watch What You Eat
Our best advice is to avoid a large meal right before bed, especially one including spicy or greasy foods because they are known for causing heartburn11 . However, you don’t want to go to bed hungry either, as that can exacerbate symptoms of nausea.
Johns Hopkins Medicine12 recommends eating 300 extra 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. This may be difficult during the first trimester when food cravings and aversions are so strong and nausea is so prevalent, so just try your best. If you’re nauseous, saltine crackers with a glass of ginger ale can go a long way in providing relief.
Eating meals with a good amount of protein, fiber, and very little sugar or refined carbs will also keep your blood sugar stable13 , which is important during pregnancy as high blood pressure can be dangerous for you and your baby1 . 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 cord12 .
Want to learn more? View our guide for healthy late-night snacks.
3. Take a Nap During the Day
The sharp increase in the hormone progesterone during the first trimester can cause intense sleepiness and fatigue14 . Unfortunately, this intense fatigue doesn’t necessarily translate to sleeping soundly through the night, so if you need it, prioritize taking a nap.
A 2018 study15 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 nap15 .
4. Continue Exercising Throughout Pregnancy
Staying fit during your pregnancy can make your delivery faster and reduce the risk of complications16 like weight gain, gestational diabetes, and high blood pressure.
According to the American College of Obstetricians and Gynecologists17 , 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 forms of exercise 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 that it can help to improve sleep18 .
5. Practice Deep Breating
Deep breathing19 helps ensure you’re getting enough oxygen and staying relaxed.
The following is one type of breathing exercise we recommend:
- Place one hand on your belly and the other on your chest
- Deeply inhale
- Hold your breath for a count of three
- Exhale through your mouth
- 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.
6. Get a Massage
Research shows that getting massages can help people with low back pain20 and can improve blood circulation21 , anxiety levels, and sleep quality and duration. This is very useful for pregnant people as all of these factors can worsen during pregnancy.
The American Pregnancy Association22 reports that 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 an increased risk of miscarriage23 during early pregnancy. The best way to go about this is to talk to your OB-GYN and be sure you’re seeing a prenatal massage therapist rather than a regular massage therapist.
7. Practice Progressive Muscle Relaxation
Progressive muscle relaxation24 is an 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 these muscles while breathing slowly and deeply. Then tense and relax the muscles in your neck, then down to your shoulders, arms, back, legs, and feet24 .
8. 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 sleep25 . 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 International26 :
- 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
9. Do Some Guided Imagery
Visualization is scientifically proven27 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 relaxed27 .
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.
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 progesterone28 . When progesterone increases in your body, you’ll feel warmer and drowsier due to its heat-producing and sleep-inducing effects28 . Thus, you’ll feel more tired than usual, especially during the day. Progesterone can also affect your sleep cycle, reducing the time spent in deep sleep28 .
You feel physical discomfort
You might think of the third trimester as the most uncomfortable, once your baby has significantly grown and your belly is bigger, 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 pregnancy29 . This soreness 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 urinate30 , 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.
Something else to note is that caffeine increases the need to urinate, so we recommend that you 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 consumption31 to less than two 6-ounce cups per day.
It’s also advised that if you aren’t a caffeine drinker before pregnancy, pregnancy is 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 so they can avoid it affecting their sleep.
You feel constant nausea
The term “morning sickness”32 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. For some people, nausea and vomiting only occur in the first trimester, but for others, 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.
Ginger33 in natural or tablet form is a natural solution that works wonders for nausea during pregnancy. There are also bands you can wear on your wrists that apply pressure to specific points of your body, which can ease the nausea symptoms.
You have heartburn
As we mentioned, the source of heartburn and acid reflux34 is the relaxing of the smooth muscle that opens into the stomach from the esophagus.
Again, progesterone is the culprit here, along with estrogen34 . 80 percent of pregnant people will experience gastroesophageal reflux disease (GERD) during their pregnancies, according to a study conducted in 201034 .
To alleviate heartburn symptoms and retain your beauty sleep, try to eat small and frequent snacks and avoid big meals right before bed.
You feel stress and anxiety
Pregnancy is an exciting time but can also be scary. The physical changes you’re experiencing are just a small representation of how your life is going to change when your baby arrives. You may be feeling overwhelmed, concerned about delivery, or wondering how you’re going to manage it all when the baby comes. Furthermore, hormonal changes associated with pregnancy have been known to cause generalized anxiety disorder35 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
When to See a Doctor About Sleep During the First Trimester
If you’re consistently getting very little sleep during your first trimester, we suggest contacting your doctor. As we’ve mentioned, there are risks associated with too little sleep during pregnancy, such as high blood pressure1 .
How to Manage Insomnia During Pregnancy
Here are some ways we recommend managing your insomnia during pregnancy:
- Stay hydrated
- Create a calm, cool, dark sleeping environment
- Establish a consistent bedtime routine
- Avoid blue light before bedtime
If you’re still having trouble sleeping, consider using a magnesium supplement before bed. Magnesium could help you sleep, is safe during pregnancy, and research36 shows that it may reduce the risk of some birth complications.
Frequently Asked Questions
Can lack of sleep harm the baby during pregnancy?
Yes, a lack of sleep could harm the baby during pregnancy. Not only will you feel drained if you’re not sleeping enough, but your immune system could also become compromised, which will thereby compromise the health of your baby. In addition, sleep deprivation could negatively impact your ability to function, leading to drowsy driving and other dangerous circumstances that could put your baby at risk.
Is it normal to experience insomnia during pregnancy?
Yes, it is normal to experience insomnia during pregnancy. The good news is that you’re not alone. According to research37 , a staggering 78 percent of pregnant people reported trouble sleeping during their pregnancy. Use our tips outlined earlier to try to manage your insomnia
Why is it hard to fall asleep during the first trimester?
It is hard to fall asleep during the first trimester of pregnancy due to a variety of reasons such as nausea, stress, increased daytime sleepiness, heartburn, general discomfort, and increased frequency of urination. All of these changes occurring to your body make it more uncomfortable and difficult to fall and stay asleep.
What are some comfortable sitting positions during pregnancy?
One of our favorite sitting positions during pregnancy is to sit on the couch with your legs propped up on a pillow and a pillow nestled under your 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 Medicine38 advises that during pregnancy you should get up every hour and walk around to keep your blood circulating well.
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.
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.
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- “Pregnant Women: Good Sleep is One of the Best Ways to Assure a Healthy Baby”. American Academy of Sleep Medicine. https://aasm.org/pregnant-women-good-sleep-is-one-of-the-best-ways-to-assure-a-healthy-baby/. 2011.
- Al-Musharaf, Sara. “Changes in Sleep Patterns during Pregnancy and Predictive Factors: A Longitudinal Study in Saudi Women”. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9268456/. 2022.
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- “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. https://www.nichd.nih.gov/newsroom/news/092019-pregnancy-sleep-position.
- Román-Gálvez, R.M., 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. https://www.ejog.org/article/S0301-2115(17)30546-8/fulltext. 2017.
- Robertson, Nicole., Okano, Satomi., Kumar, Sailesh. “Sleep in the Supine Position during Pregnancy Is Associated with Fetal Cerebral Redistribution”. Journal of Clinical Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356729/. 2020.
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Emma is an Editorial Intern for Sleep Advisor. She collaborates with the editor and staff writers to come up with article ideas, create article outlines, and write for the website.