Quality sleep is important for a healthy pregnancy. However, this can be a challenge for many women due to their changing bodies and other conditions1 that can arise during pregnancy such as restless leg syndrome, increased urinary frequency, and heartburn. In addition to that, some women have had to adjust their preferred sleep position because it was thought that certain positions, specifically back sleeping and lying on the right side, could cause health complications for the fetus or the mom by compromising blood flow to the uterus.
However, Dr. Robert M. Silver led a more recent study2 that included a larger test group than those performed in the past. This study found that back and right-side sleeping during the first two trimesters of pregnancy does not impact the health and safety of the mother or the baby.
The Background for the
Many experts, including the American Pregnancy Association3, have long recommended that pregnant women sleep on their left side to put less pressure on their organs and boost the flow of blood and nutrients to the baby. The thought was that sleeping this way could decrease the chances of pregnant women developing a life-threatening high blood pressure disorder known as preeclampsia4. Additionally, earlier research had linked sleeping on the back or right side to stillbirths and low birth weight in babies.2
However, Dr. Silver believed that earlier studies on sleep positions and pregnancy needed to be reevaluated because not only did they have a small number of participants, but those who were included in the study were asked about their sleeping positions after experiencing a stillbirth or other pregnancy complications. The timing of these questions brought about the possibility of recall bias because given what the women had recently endured they may hone in on their sleep position because they thought that it may have caused their complications.2
What the Study Tells Us
Dr. Silver’s study found that until your 30th week of pregnancy, sleeping on your back or right side doesn’t increase the risk of complications such as stillbirth and lower birth weight.2
This conclusion was formed after Dr. Silver’s team analyzed data collected from more than 8,700 women who took part in Nulliparous Pregnancy Outcomes Study5 during their first pregnancy. The goal of that study was to identify behaviors that may cause pregnancy complications.
The moms-to-be answered questions on their sleep habits during specific periods of their first and second trimesters. The answers revealed that around 1,900 of 8,700 (approximately 22 percent) of these women experienced pregnancy complications, but complications were no more likely to occur if the women had slept on their back or right side.2To further back up their findings in the event participants hadn’t accurately recalled sleep positions, the researchers did an additional analysis of 400 women who slept with a device that recorded their sleep position. The data from this smaller study group found that those who slept on their back more than 50 percent of the time were no more likely to have pregnancy complications than those who slept on their back less than 50 percent of the time.2
Sleep During Pregnancy
Although Dr. Silver’s research suggests that a mother-to-be’s sleep position during the first two trimesters of pregnancy doesn’t cause health complications for her or the fetus, a lack of sleep6 during pregnancy can cause issues. Sufficient sleep is paramount to everyone’s well-being, but pregnant women, in particular, need quality sleep7 for their physical and mental well-being, as well as that of their baby.
Pregnant women, like all adults, should aim for 7-9 hours of sleep a night. However, pregnant women typically get less sleep than the non-pregnant population8.
Hormonal changes9 during the gestation period can cause sleep challenges that moms-to-be hadn’t faced before they were pregnant. These include:
- Gastroesophageal Reflux Disease (GERD) – The increase in hormones during pregnancy can affect the digestive system. This leads to nine out of 10 pregnancies being affected by GERD10. Most women who have GERD will experience heartburn, but some may develop severe cases that lead to nausea and vomiting.10
- Restless Legs Syndrome (RLS) – The uncontrollable urge to move your legs when sleeping can affect many pregnant women, and RLS is often linked to anemia, a common complication during pregnancy.1 Anemia11 can often be kept under control by prenatal vitamins. However, you should always consult your medical professional before taking vitamins or supplements.
- Sleep Apnea – When you are pregnant, you have a higher chance of experiencing sleep apnea12, a condition that can cause people to repeatedly stop and start breathing while they sleep. An increased level of hormones can cause the mucus membranes in your nose to swell. This can make you feel congested, which can lead to snoring. The levels of the hormone, progesterone, are also higher during pregnancy and this can create an obstructed airway13.
- Insomnia – The hormonal shifts14 during pregnancy may make women more prone to insomnia, a common sleep disorder that affects a person’s ability to fall and stay asleep.
Learn more: Sleeping While Pregnant
How to Improve Your Sleep During Pregnancy
While pregnant people can experience different challenges to their sleep, there are steps you can take to help you feel more comfortable and rest easier.
- Adjust the temperature – A room that is too hot or too cold can negatively affect your sleep. The optimal temperature15 for sleeping is between 60 and 67 degrees Fahrenheit. This temperature range is thought to create more stable REM sleep.
- Invest in a quality mattress – During pregnancy your body will be going through many changes that can affect your sleep. Investing in a well-built bed that provides comfort and support may improve your slumber.
- Manage noise – Most sounds and restful sleep don’t usually go hand in hand. To not have your sleep disturbed during pregnancy (or anytime) by sounds, consider earplugs or a soothing white noise machine.
- Stick to a regular sleep schedule – Develop the habit of going to bed and waking up at the same time every day so that your body gets accustomed to a sleep schedule.
- Avoid screens before bed – The blue light that emits from screen devices like phones and tablets can block nighttime melatonin production and leave you feeling more alert.
- Pay attention to your diet – Some foods you crave during pregnancy can bring comfort, but some may also cause heartburn or other digestive problems. To limit your chances of indigestion and heartburn16 avoid the following: spicy foods, onions, citrus, tomatoes, ketchup, peppermint, chocolate, caffeine, and carbonated drinks. It is also advisable to eat smaller meals that don’t contain a lot of fat.
- Limit the length of your naps – Pregnancy can be tiring and an afternoon nap can help you recharge, but you should limit the duration so that it doesn’t interfere with your nightly bedtime schedule. Although there is not a general consensus on how long pregnant women (or anyone) should nap17, some experts believe that you should cap naps at 30 minutes, and most believe that they should top out at no more than 60 minutes.
- Manage stress – Activities such as meditation and yoga can help relax you and help you fall asleep. We also recommend establishing a relaxing nightly routine for yourself. Along with meditation or yoga, this might include a warm bath, reading a book, or drinking chamomile tea, for example.
- Stay well-hydrated – Proper hydration can keep issues such as headaches and cramps that can disrupt your sleep at bay. However, be careful not to drink too much close to bedtime as this may disrupt your sleep with bathroom trips.
- Use pregnancy pillows – Pregnancy pillows are an excellent way to provide additional support and comfort to the stomach, back, hips, and legs. These accessories reduce pressure on the stomach, back, hips, and legs, and they can decrease stress on the lower lumbar region, an area that typically receives more strain during pregnancy.
- Add a mattress topper – As your body changes during pregnancy, you may find that your mattress isn’t as comfortable as it was before. If you don’t want to invest in a new mattress, a mattress topper can be a great way to make your bed more accommodating to your pregnant body.
Frequently Asked Questions About Sleeping During Pregnancy
Why do I feel so tired during pregnancy?
Fatigue is common during pregnancy, particularly in the first and third trimesters. A sluggish feeling18 during pregnancy can begin as early as the first few weeks of pregnancy. It normally wanes by the second semester but can return in the third, and the severity and longevity of a pregnant woman’s fatigue varies from person to person.18
During the first 12 weeks of pregnancy, fatigue is likely caused by increased progesterone levels that are taking place.18 Furthermore, blood sugar levels and blood pressure are also lower at this time, and a pregnant woman’s body is carrying more nutrients — all of which can make an expectant mom tired.18
As you reach the tail end of your pregnancy, you may find yourself tired again due to your extra weight, frequent urination throughout the night, and general restlessness.
Is there anything I can do about restless legs syndrome during pregnancy?
As mentioned, earlier, pregnant women may develop restless legs syndrome1. Experts say this may be attributed to pregnant women having a lack of folic acid, iron, and Vitamin D19, along with rising estrogen levels. While prenatal vitamins may help, we advise first consulting your doctor before taking any supplements.
Can a certain sleep position help with heartburn during pregnancy?
In addition to propping your head up with a pillow to help ease heartburn symptoms, research suggests that sleeping on your left side20 can help clear acid buildup.
Sosha Lewis is a staff writer for Sleep Advisor. Lewis is happy that she is able to combine her love of sleep with her love of writing.
- “Get a Good Night’s Sleep During Pregnancy”. Johns Hopkins Medicine. Webpage accessed September 19, 2024.
- “Science Update: Sleeping position during early and mid pregnancy does not affect risk of complications, NIH-funded study suggests”. Eunice Kennedy Shriver National Institute of Health and Human Development. Webpage accessed September 19, 2024.
- “Best Sleeping Position During Pregnancy”. American Pregnancy Association. Webpage accessed September 29, 2024.
- “Preeclampsia”. Mayo Clinic. Last modified April 15, 2022.
- “Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b)”. Eunice Kennedy Shriver National Institute of Health and Human Development. Last modified October 26, 2021.
- Chang PhD, Jen., et al. “Sleep Deprivation during Pregnancy and Maternal and Fetal Outcomes: Is There a Relationship?”. National Library of Medicine. 2010.
- Anbesaw, Tamrat., et al., “Sleep quality and associated factors among pregnant women attending antenatal care at Jimma Medical Center, Jimma, Southwest Ethiopia, 2020: cross-sectional study”. National Library of Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8466397/ 2021.
- Cannon, Summer., Hayman, Melanie., Lastella, Michele. “Pregnant Women’s Attitudes and Beliefs towards Sleep and Exercise: A Cross-Sectional Survey”. National Library of Medicine. 2024.
- Won MD, Christine, H.J. “Sleeping for Two: The Great Paradox of Sleep in Pregnancy”. National Library of Medicine. 2015.
- “GERD and Pregnancy”. University of Chicago Medicine. Webpage accessed September 19, 2024.
- “Iron deficiency anemia during pregnancy: Prevention tips”. Mayo Clinic. Last modified February 9, 2022.
- “Obstructive sleep apnea”. Mayo Clinic. Last modified July 14, 2024.
- Balserak, Bilgay Izci. “Sleep disordered breathing in pregnancy”. National Library of Medicine. 2015.
- “Insomnia”. Mayo Clinic. Last modified October 15, 2016.
- “What’s the Best Temperature for Sleep?” Cleveland Clinic. 2021.
- “Heartburn”. Mayo Clinic. Last modified May 13, 2022.
- LeWine MD, Howard E. “Should I take afternoon naps?” Harvard Medical School. 2024.
- “Fatigue During Pregnancy”. American Pregnancy Association. Webpage accessed September 29, 2024.
- Gupta, R., et al. “Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment”. National Library of Medicine. 2016.
- Godman, Heidi. “What’s the best sleep position to combat heartburn?”. Harvard Health. 2022.