How Does Pregnancy Affect Sleep?


Pregnant woman holds bare belly.

A good night’s sleep can be hard to come by at the best of times, but it can be especially challenging during pregnancy. Physical discomfort, leg cramps, sleep apnea, heartburn and anxiety are some of the common reasons pregnant women are awake at night.

Read on to learn how pregnancy affects sleep and our top 5 tips to help you get better rest.

How Pregnancy Affects Sleep in Each Trimester

Between 66% and 94% of expectant mothers experience sleep disorders. These are often more prevalent as pregnancy progresses. Below, we break down common sleep experiences women have by trimester, all of which are affected by pregnancy hormones.

First Trimester

Early in pregnancy, the progesterone in your body increases, which can cause excessive sleepiness. Although you may be more tired and sleep longer in the first trimester, the sleep may not be restorative. About 13% of women have interrupted sleep because of nausea, vomiting, back pain and increased urination.

Second Trimester

About 19% of pregnant women report sleep disorders in the second trimester. As the baby grows, you may have aches in your back, abdomen and groin, and you may have difficulty finding a comfortable sleeping position. You may also experience symptoms, such as acid reflux, leg cramps and shortness of breath. The average amount of sleep during this period decreases compared to the first trimester.

Third Trimester

Nearly two-thirds of women have sleep disturbances in the last trimester. One-quarter of women have difficulty falling asleep, seven out of 10 have trouble staying asleep and more than one-third wake up early.

By 39 weeks, almost 74% of pregnant women have insomnia. Sleeplessness during the third trimester may be due to fetal movement, strain on your body from the growing baby, heartburn, sleep apnea and restless legs syndrome. Increased levels of oxytocin, particularly at night, can cause uterine contractions as labor gets closer.

Common Causes of Sleep Problems During Pregnancy

Leg Cramps

Increased lactic and pyruvic acids in the body can make leg cramps common in the second half of pregnancy. Cramps often occur at night as acid builds up and makes muscles contract. Usually, the best way to ease cramping is to get out of bed and walk around.


Between 17% and 45% of pregnant women experience heartburn, also known as gastroesophageal reflux. Heartburn occurs when stomach acids move back up the esophagus, creating a burning sensation in the chest and throat. During pregnancy, acid reflux can be caused by relaxed muscle tissues and slower digestion. It’s often worse at night.

Frequent Urination

When you’re pregnant, your body produces almost 50% more blood to help the baby’s growth. Your kidneys filter the extra blood and produce more urine. When you’re lying down, your uterus puts pressure on your bladder, causing you to wake more frequently to go to the bathroom.

Sleep Apnea

Obstructive sleep apnea (OSA) occurs when you have sleep disruptions, such as snoring, gasping and pauses in breathing. OSA occurs in 2% of nonpregnant women and 10-25% of pregnant women, becoming more prevalent over the course of pregnancy. Sleep apnea symptoms in women can be caused by weight gain, uterine pressure on the diaphragm and nasal congestion from swelling of the mucous membranes. Risk factors for OSA include age and BMI.

Restless Legs Syndrome

Restless legs syndrome (RLS) is a sensorimotor disorder that often occurs in the evening or at night when you’re resting. It results in a tingling sensation that causes a strong urge to move the legs, making it hard to sleep. RLS occurs in 3-10% of the population and 27-30% of pregnant women. Symptoms tend to worsen during the third trimester.


Pregnancy can be stressful, especially if you’re going to be a first-time mother. Common worries include the health of the baby, labor, medical safety and financial security. Anxiety can keep your mind racing at night and interfere with restorative sleep. Research shows that women who tend to worry may be more affected by sleep changes during pregnancy.

5 Tips for Getting Better Sleep During Pregnancy

Now that you’re aware of how pregnancy affects sleep, try some of the following strategies to get better rest at night. Remember not to take over-the-counter medicines and supplements, such as sleep aids, without consulting with your physician.

1. Sleep on Your Side

If you’re having trouble getting comfortable at night, sleeping on your left side may help. This eases pressure on the inferior vena cava, which is the large vein that carries blood to your heart. When you’re on your side, tuck a pillow between your legs, behind your lower back or under your belly to relieve pressure and for extra support.

2. Limit Fluids

If visits to the bathroom are keeping you up at night, try not to drink too many fluids in the evening before bed. You need to stay hydrated though, so you may want to increase your fluid intake during the day.

3. Avoid Large Meals Before Bed

To help with digestion, eat lightly at night and avoid rich or heavy foods. A few crackers before bed may help settle your stomach. You can even keep a box of crackers on your bedside table in case you’re nauseous during the night.

4. Take a Prenatal Class

If you’re feeling anxious about the baby and worrying at night, consider taking a prenatal class to help you feel more prepared. Group classes are a great way to connect with other pregnant women and find support in the community. Prenatal yoga can help you get exercise and learn relaxation techniques.

5. Practice Good Sleep Hygiene

All the usual best practices for sleep hygiene still apply when you’re pregnant.

  • Limit caffeine intake
  • Establish regular sleep and wake times, even on weekends
  • Avoid exercising too close to bedtime
  • Put away your smartphone and other devices before bed
  • Start winding down in the evening by dimming the lights and taking a warm bath

Have you gotten a better night’s rest from trying some of these tips? How have you improved your quality of sleep while being pregnant? Sound off in the comments below!

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