Sleep Changes: Pregnancy Sleep by Trimester

One of the best things you can do for yourself when you’re pregnant is to get adequate sleep. It’s recharging and restorative for a body – yours! – that’s working harder than it ever has before on the complex and important task of creating a life. But ironically, pregnancy can also make it tough to get the sleep you need. Here are some sleep changes you can expect in each trimester of pregnancy:

First Trimester

The first trimester can be a time of heightened nerves and trepidation. So much is going on in your body, and you’re looking down the long road of the weeks and months ahead. Just that alone can interfere with your sleep time and quality. But there’s more than can disrupt sleep the first 12 weeks:

• Morning sickness. The queasiness that frequently accompanies the early stages of pregnancy can be triggered by an empty stomach – so if you suffer from morning sickness, you may wake up earlier than you need to thanks to that combination of hunger and nausea.
• Early in pregnancy, your progesterone levels skyrocket. But one side effect of the progesterone surge is that it can make you drowsy and draggy, as well as interfere with the quality of nighttime sleep (that is, you don’t spend enough time in the restorative, restful phases of sleep).
• Tender breasts. Even before your belly swells, the first trimester brings changes to your body – sore, full, tender breasts – that can make your usual coziest sleeping positions harder to achieve.
• Urinary frequency. Time to blame progesterone again! Another effect this hormone has is to relax smooth muscle throughout your body – and that includes the muscle that helps hold urine in your bladder.

Second Trimester

These second 12 weeks bring pretty dramatic changes to your body, and it stands to reason that second trimester sleep is affected. The good news here is that your hormones have settled down and you will probably be less bothered by nighttime trips to the bathroom, as your uterus is still too small and high up in your pelvis to press on your bladder much. Here’s what you might encounter:

• Size matters. No denying it now – you’re getting big enough that the positions in which you may usually settle for sleep are either uncomfortable (such as stomach sleeping) or unadvisable (back sleeping). To increase your chances for a good night’s rest, experiment with pillows – sleep on your side with a pillow against your back and another between your knees.
• This is the reflux or backup of stomach acid into the esophagus. What happens is that your growing uterus restricts the diaphragm, which interferes with normal digestion. This is made worse when you lie down and try to sleep.
• Leg cramps or restless leg syndrome. Some pregnant women are susceptible to muscle cramps, which may be caused by low iron levels. Restless leg syndrome, a condition in which you feel tingling pain up and down your legs that only ceases if you move around, may also crop up at this time.

Third Trimester

In the third trimester of pregnancy, sleep can be disrupted by a number of issues, from your burgeoning belly making it tough to get comfortable, to good old-fashioned anxiety about what’s on the horizon. Here’s what else might be keeping you awake at night:

• Urinary frequency. It’s baaack! In your final 12 weeks, the size and weight of your baby presses on your bladder, increasing the urge to go.
• Joint and back pain. Carrying around your heavy belly puts stress on your lower back and your joints, the latter of which may also be more vulnerable to injury because pregnancy hormones soften the ligaments that connect joints. All this means greater frequency of aches and pains that can make comfortable sleep even more elusive now.
• Both your increased girth and a higher incidence of nasal congestion during pregnancy can make you snore at night. This may bother your bed partner more than you, but it can also cause you to wake more often during the night, disrupting sleep.

If any of the above sleep-disturbing issues become problematic or worrisome—and can’t be alleviated with some commonsense measures—talk to your healthcare provider right away; he or she may have some solutions you haven’t thought of. A final bit of advice: Take naps!