6 Common Pregnancy Sleep Problems & Solutions

As difficult as it might be, getting a good night’s sleep is essential for a healthy pregnancy. Between finding a comfortable sleeping position and pregnancy symptoms like the frequent need to pee, heartburn, leg cramps, nasal congestion and overall discomfort, it’s no wonder that a full night’s rest can be so elusive. 

Everyone keeps telling you to “get your sleep now” - but that's a whole lot harder with the likes of heartburn and leg cramps. Here are some tips for overcoming the most common pregnancy sleep problems.

General discomfort

General discomfort can happen throughout the entirety of pregnancy, but especially in the second and third trimesters. Discomfort during pregnancy can come from not being able to find a comfortable position to sleep in. Recent study shows 80% of pregnant women said they couldn't find a comfortable sleeping position.

Sleeping on your back isn't advised during pregnancy, the weight of your uterus pressing down on the main vein which carries blood to your lower body back to your heart, interferes with your circulation. It's best to sleep on your side during pregnancy - your left side if possible - this will make things easier for your circulation and is safest for your growing baby. Sleeping on your side also rests in less swelling in your feet, ankles and hands.

If you're used to sleeping on your back or front, it can be difficult to get used to a different sleep position - In that case, pregnancy pillows are the perfect way to finding a comfortable sleeping position. Whatever works for you - you can pile pillows between your knees, under your abdomen and behind your back for extra support and comfort.

Insomnia

Anxiety, hormones and any of the above sleep problems can contribute to insomnia during pregnancy, the inability to fall or stay asleep. It’s super common and super frustrating, and it can make you feel even more tired, irritable, and unable to function during the day.

Have a good wind-down routine before bed and practice good "sleep hygiene" (read more about how in the tips below). But if you’re still having trouble sleeping and it’s affecting your functioning during the day, be sure to ask your doctor for help.

If you simply can’t sleep, a therapist might be able to help. Cognitive behavioral therapy for insomnia (CBT-I) is a type of talk therapy that involves pinpointing inaccurate or unhelpful thinking about sleep and learning habits to improve sleep. 

A 2020 study of 2258 pregnant women with insomnia found that six weekly 20-minute sessions of online CBT-I with a therapist significantly improved most insomnia symptoms. These included how long it takes to fall asleep, sleep quality, interference with daytime functioning and distressing feelings about sleep.

Frequent need to pee

During the first and third tremester you may feel the frequent need to pee — this is completely normal — you’re peeing for two. Your kidneys have to filter up to 50% more blood than usual — which also means more urine. In the third trimester, your growing uterus presses down on your bladder increasing the urge to go.

If you’re finding it’s keeping you up at night, try drinking plenty liquids throughout the day and then cutting back towards bedtime. 

Heartburn

While you can experience heartburn at any time of day, it’s often worse at night when you’re lying down. You can thank pregnancy hormones for this painful sensation, as they relax the muscle that normally keeps stomach acid inside the stomach. You'll also feel a surge in heartburn late in the last trimester, when your baby bump pushes up on your stomach. 

Heartburn-soothing strategies can help. These include:

  • avoiding spicy, greasy and acidic foods
  • eating smaller meals; having dinner at least two hours before bedtime
  • propping your head up with a couple of pillows
  • popping antacids (like Tums and Rolaids)
  • talking to your doctor about proton-pump inhibitors, if nothing else works

Leg cramps

No one’s quite sure what leads to these painful spasms in the calves, but it might be compression of blood vessels in the legs and fatigue as you carry that extra pregnancy weight. Although you’ll sometimes experience leg cramps during the day, they’re typically more common — or at least more noticeable — at night.

A few tips to banish leg cramps during the day include drinking plenty of water, stretching your legs and wearing support maternity wear. When you get a cramp, try straightening your leg, then gently flexing your foot and ankle toward your nose. 

If the pain is severe and persistent, definitely check in with your doctor. Although it’s rare, it’s possible cramps may actually be a sign of a blood clot in the leg.

Nasal congestion

Higher estrogen and progesterone levels increase blood volume everywhere — including to the membranes in your nose. This causes them to swell and produce more mucus than ever, leading to a perpetually stuffy nose as well as postnasal drip later on in your pregnancy that might cause you to cough at night.

Saline nasal sprays and nose strips are safe and can ease nighttime stuffiness. If those don’t work, check with your doctor about other options, including some decongestants or steroid nasal sprays that may be OK after the first trimester.

Try strategies for snoring, including propping your head with pillows, sleeping with a nasal strip on and using a cool mist humidifier.

Solutions to your pregnancy sleep problems

These healthy pregnancy sleep tips can apply to many sleep-stealers, so try them to see if they help you:

  • Avoid caffeine in all its forms — including chocolate — in the afternoon and evening.
  • Stay away from sugar at night, which will give you an energy boost when you least want one and leave your blood sugar levels unstable.
  • Get your eight glasses of water (or other fluids) every day, but taper off at night. Drink if you're thirsty, but don't down a giant glass of water or cup of tea right before bedtime.
  • Work out daily, but only up until the early evening. Regular exercise during pregnancy is great for you and your baby and helps tire you out to improve sleep. Just remember that it could actually energize you and sabotage sleep if it comes too close to bedtime.
  • Eat dinner early on in the evening, since a heavy meal right before bed can keep you from sleeping.
  • Have a light snack before hitting the hay to stave off overnight hunger pangs. Healthy pregnancy snacks include protein and a complex carb, like a whole-grain muffin washed down with a glass of warm milk (almond milk if heartburn’s a problem).
  • Vent your stress to your partner, a friend or your journal to help clear your mind of worries that might keep you up at night.
  • Stay away from screens for at least one hour before bedtime, since the light they give off can mess with levels of melatonin, the hormone that regulates sleep. 
  • Follow a bedtime routine, which can feel comforting and put you in the mood for sleep.
  • Take a warm bath just before bed. It will soothe and relax you, and can help summon the sandman sooner.
  • Try relaxation exercises — visualization, deep breathing, meditation, yoga or even chanting, possibly may with a sleep or meditation app. Counting sheep can work the same way — the monotony of watching those little guys jump over the fence really can send you off to dreamland (unless you associate them with insomnia).
  • Make love if you're in the mood, or ask your mate for a massage. Both can relax you.
  • Crack a window if you feel hot and stuffy and it's not cold outside. If the weather's not cooperative, keep your room comfortably cool.
  • Pile on the pillows, which can help create a comfortable sleep environment. Pregnancy sleep pillows, in particular, are designed to address your unique needs and help you find the best sleep position.
  • Don't watch the clock. It's a surefire way to make you more stressed. And don’t just lie there, either. Instead, try doing something else to unwind (read, listen to music, meditate) until you feel sleepy.
  • Try not to stress. Worrying about your lack of sleep only makes things worse. Sometimes just letting go is all it takes to nod off.
  • Talk to your doctor. Mention any sleep problems to your practitioner; he might be able to suggest more sleep solutions or even medications that are safe during pregnancy. Never pop any sleep meds, prescription, herbal or over the counter, without talking to a doctor first.
  • Consider therapy. Research suggests that insomnia during pregnancy may be a sign of another mental health condition, including prenatal depression and anxiety. 

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