You knew sleepless nights would be part of the new-mom deal, but you didn't expect them to begin before your baby was born. Depending on how pregnant you are, everything from "morning" sickness to scary dreams to restless leg can take their toll on your nightly shut-eye. Fortunately, you don't have to slog through your final months of pregnancy in exhaustion. Our trimester-by-trimester guide will teach you how to sleep while pregnant.
First Trimester Sleep Problems
"Most women don't know what's in store for them [in terms of sleep] during pregnancy," says Kathryn A. Lee, R.N., Ph.D., a professor of nursing at the University of California, San Francisco, who researches the topic. "Women who've had kids know how low-energy they're going to feel during pregnancy and plan for that by sleeping more." Here are some sleep problems you'll likely face in the first trimester and how to solve them.
Disturbed Sleep Patterns
The Cause: Lethargy and overwhelming fatigue are common due to the dramatic rise in progesterone; necessary for maintaining pregnancy, the hormone is also a soporific. Another culprit: the metabolic changes your body is going through. "A lot of calories are going into the gestation process," explains Lee. "The growing fetus is taking every bit of your energy."
The Fix: Update your sleep schedule. Plan your snooze time just like you do your meals or your day at the office, and nap as often as possible. "It's best to nap between 2 p.m. and 4 p.m.; otherwise you'll have trouble falling asleep at night," advises Teresa Ann Hoffman, M.D., an OB-GYN at Mercy Medical Center in Baltimore. "And take one or even two 30-minute catnaps rather than one long, two-hour sleep." Nap on the floor of your office or in your car if you need to. Another tip? Exercise early. Planning physical activity in the morning, afternoon and early evening will promote sounder sleep. Late-evening workouts, however, tend to encourage insomnia.
Increased Bathroom Visits
The Cause: Your high progesterone level, along with a growing uterus that's pushing against the bladder, means more frequent urination.
The Fix: Cut down on fluids after 6 p.m. This will help curtail nocturnal bathroom runs. "If you drink caffeinated beverages, do so only in the morning," says Dr. Hoffman. The good news: Your need to pee constantly will temporarily subside in your second trimester.
The Cause: "Morning" sickness can and often does strike during the evening and wee hours of the night.
The Fix: Stock Saltines on your nightstand: Crackers will quell midnight queasiness—and you won't have to trudge to the kitchen to get them.
The Cause: Breasts become painful early on, thanks to skyrocketing estrogen and levels of hCG (human chorionic gonadotropin, the hormone produced by the placenta during pregnancy). While these hormones prep your breasts for milk production, they also make them much more sensitive. "And as the breasts grow, women who were tummy sleepers may find that this is now impossible because any pressure on the breasts is painful," says Barbara Dehn, R.N., author of Your Personal Guide to Pregnancy. "You may have to learn how to sleep in other positions, which can also lead to getting fewer winks."
The Fix: A hot shower just before bed can ease you into dreamland, and acetaminophen (e.g., Tylenol), which is safe during pregnancy, can alleviate soreness, says Kellie Flood-Shaffer, M.D., associate professor of obstetrics and gynecology at Texas Tech Health Sciences Center, in Lubbock, Texas. If it's difficult to sleep on your stomach and you can't get comfortable on your back, reposition your pillows: Sleeping on your side and using a body pillow might do the trick.
A Throbbing Headache
The Cause: Once again, blame your fluctuating hormones, namely your skyrocketing progesterone in the first and second trimesters. It causes your blood vessels to dilate, leading to headaches, which in turn may lead to sleep loss, Dr. Flood-Shaffer says.
The Fix: Acetaminophen is a safe fix, Dr. Flood-Shaffer advises. You can also apply a cool towel to your forehead. This will help the blood vessels contract while relaxing muscles and relieving the headache. And get rest when you can, if not at night, then by taking a catnap during the day; this will give your body a much-needed break from any fatigue-induced headaches, she explains.
Second Trimester Sleep Problems
"Women in their second trimester tend to sleep better," says sleep researcher Meena Khan, M.D., a professor at the Ohio State University Medical School in Columbus. (Your body undergoes its most dramatic metabolic changes in the first trimester.) Still, you might not be sleeping like a baby yet because of these common issues, so learn how to fix them.
The Cause: Queasiness usually subsides, but acid reflux rises. "The growing uterus places pressure on the stomach, forcing acid up into the esophagus," explains Dr. Hoffman. Meanwhile, your hormones are skyrocketing, which can loosen the muscles between your stomach and esophagus, allowing acid to leak. Lying down in bed aggravates the burn.
The Fix: Stay upright for four hours before sleeping. The digestive process takes a lot longer during pregnancy, and sitting up will help keep stomach acids where they belong. "Lying down and watching TV after dinner is not a good idea," Dr. Hoffman says. You may want to start eating bigger breakfasts and lighter dinners if heartburn is keeping you awake. Consider breaking up your usual three meals into six smaller ones throughout the day. You should also avoid spicy, fried, and acidic foods, including tomatoes, citrus fruits and juices, and coffee. If you take all these precautions and still experience heartburn when sleeping during pregnancy, you might want to seek some relief from an over-the-counter product. "At this point in pregnancy, you can use Tagamet, Prilosec, antacids, or Mylanta to ease discomfort," Dr. Flood-Shaffer says. But to be on the safe side, contact your OB-GYN to get her go-ahead.
The Cause: Though worse in your third trimester, disquieting cramps (usually in the calf) that can startle you awake and keep you up in the wee hours begin now.
The fix: Limit or avoid carbonated drinks. "A calcium imbalance can lead to leg cramps," Dr. Lee says. The phosphorous in bubbly beverages (including soda water) decreases the amount of calcium you're able to metabolize, so stay away from them. In addition, make sure you're getting enough calcium; good food sources include dairy products; dark-green, leafy vegetables; and canned salmon with bones. If you do get a painful leg cramp, flex your foot (extend your heel and point your toes toward your head; do not point your toes).
You Can't Settle In
The Cause: You're too big to sleep on your stomach, but you're told to avoid sleeping on your back. When you lie on your back, the weight of the uterus can compress the inferior vena cava, the vein that transports blood from your lower body to your heart. To compensate, your body works harder to pump blood to your heart; as a result, your blood pressure increases and the blood flow to the uterus slows down. This isn't good for you or the baby, which is why doctors recommend sleeping on your left side. What's the benefit? When you sleep this way, your uterus pushes forward (and thus alleviates pressure on your heart), ensuring that your baby will get plenty of blood and oxygen through the night.
The Fix: You don't have to sleep entirely on your side; with the help of a pillow, you can trick yourself into thinking you're sleeping in your favorite old position. While on your back, place a pillow underneath your right hip, Dr. Flood-Shaffer suggests, so your uterus will be tilted but your upper chest and back will be flat. This ensures proper blood flow and will help you doze off.
The Cause: "As the pregnancy progresses, some women get more anxious," says Dr. Hoffman. Stressing about the baby's growth, your parenting abilities, finances—or anything else—can produce some disturbing dreams, which will almost certainly interfere with your good night's rest. Forgetting the baby somewhere is a classic one.
The Fix: Make relaxation a priority. Easier said than done, but a quieter mind will ensure a better night's sleep. Experts suggest meditation, prenatal yoga, or other relaxation techniques; soaking in warm baths; eating tryptophan-rich foods such as turkey, milk and bananas (this amino acid turns into mood-soothing serotonin in the brain); enrolling in a parenting class now so that you feel better able to care for a newborn; and seeing a counselor if you're losing sleep due to anxiety-riddled dreams.
Third Trimester Sleep Problems
By the end of pregnancy, a large percentage of expectant women report waking up at least three times per night. Two-thirds are awakened five or more times. But it's vital to make sleep a priority now: Research has shown that pregnant women who average less than six hours of sleep a night have significantly longer labors and are 4.5 times more likely to have Cesarean sections than those who get seven hours or more nightly. Here are some common issues and solutions for women wondering how to sleep when pregnant during the third trimester.
The cause: A Yale University study found that nearly 60 percent of pregnant women say that lower back pain causes sleep disruptions.
The Fix: Baby Your Back: Prone to sleeping on your right side during pregnancy? You may want to change your routine, since sleeping on your left side will take stress off your lower back, help prevent snoring, and increase circulation to your baby. Put pillows between your knees, behind your back, and under your belly—or use a pregnancy pillow. Stretch and do abdominal exercises frequently.
The Cause: Just like in the first trimester, the urge to go at night increases, as your uterus grows larger and the baby drops lower in your pelvis.
The Fix: Cut back on liquids in the evening. And don't drink for two hours before you go to bed. Whenever you urinate, lift your belly to allow your bladder to empty completely.
Snoring and Disordered Breathing
The Cause: Vascular congestion in the nasal passages and abdominal weight gain can partially close your airways, leading to snoring. In 6 percent of women, snoring can progress to obstructive sleep apnea, a condition in which breathing stops for at least 10 seconds. This is more common in women who were overweight or obese pre-pregnancy and can be very serious: Sleep-disordered breathing is linked with an increased risk for preeclampsia and low-birth weight babies.
The Fix: See a certified sleep specialist: If snoring and apnea become severe, you'll need to have your airflow monitored. A CPAP (continuous positive airway pressure) machine may be prescribed to keep your airways open and ensure that you and your baby are getting enough oxygen. "It will also help you sleep through the night," adds Dr. Khan. Find a specialist at absm.org.
Restless Leg Syndrome (RLS)
The Cause: About 20 percent of pregnant women experience the truly weird sensation of what feels like ants crawling inside their legs. Studies have shown that women who have lower levels of iron and folate are at higher risk for sleepless nights due to RLS.
The Fix: Have a pre-bedtime light leg massage and warm bath. Evening walks also help foil RLS. During the day, you can eat more fortified grains and leafy greens: "Eating foods rich in iron and folate can reduce the severity of restless leg syndrome," says sleep researcher Meena Khan. Avoid caffeine, too, because it inhibits absorption of iron and folate.
The Cause: A major change is coming, and your brain may be one never-ending to-do list.
The Fix: The more you take care of, the more in control and calm you'll feel, so harness your nesting instincts. Keep track of all you need to get done, delegate what you can, and chip away at the rest, tackling a bit each day.