It may be a bit of a cliché, but the fact is that pregnancy and sleep don’t always go hand-in-hand. And, although you know it’s par for the course, the lack of sleep and the reasons for it can really take their toll both physically and mentally. There’s the vexed question of which sleep position is safest for you and your baby. Then, what do you do when your preferred position seems to be against all the advice?!

So let’s take a look at sleep and pregnancy and see if we can’t manage to get a bit more satisfying slumber.

The First Trimester

Many new Mums aren’t expecting it, but the first trimester is often a time when sleep requirements significantly increase. This is the stage of pregnancy when the fetus is growing and developing at an amazing pace and the metabolic demands on the mother increase accordingly. Progesterone is also at its highest levels at this time, and, although it is vital for maintaining a healthy pregnancy, it tends to have a soporific effect and increase daytime sleepiness. Interestingly, progesterone can actually be disruptive to sleep in the night-time and contribute to nocturnal insomnia. The best solution is to accept the need for the occasional daytime nap and even try to work it into your schedule.  Don’t worry – studies show than the majority of Mums do take extra ‘nanna naps’ in the first trimester so you’re not alone!

Other night-time sleep stealers at this stage can be the increased need to urinate because of added pressure on the bladder and the ever present nausea and heartburn which some women experience. On top of this, there is the potential difficulty in finding a comfy position in which to doze – one that accommodates those tender breasts and enlarging uterus.


  • Consider decreasing the amount of fluid you consume during the evening and before bed, and concentrate on adequate fluids in the early part of the day.
  • Start to train yourself to sleep on your side rather than your back or stomach.
  • Take steps to bring reflux and morning sickness under control if they are impacting on your rest.

The Second Trimester

The good news is that the second trimester is often a big improvement on the first. Energy levels tend to rise and with any luck the morning sickness will abate. So make the most of the good times and optimise your sleep. Establish a good sleep routine and prioritise rest in your day. Maintain (or get back into!) some regular pregnancy appropriate exercise, but avoid anything too vigorous immediately before bed. Finally, if you haven’t already, take steps to achieve comfortable side sleeping.

Sleep stealers in the second trimester can include snoring and sleep apnoea, leg cramps and restless legs syndrome.  


  • Be proactive and know how to manage these issues if they arise.
  • Grab the good sleep while you can.

The Third Trimester

The third trimester is almost universally a poor time for sleep.  The situation tends to only get worse as the weeks roll by. The sheer physicality of late pregnancy makes sleep very difficult – between the massively enlarged uterus, the gloriously expanded breasts, the intrusive yet wonderful fetal movements and the often aching back and pelvic girdle, finding a comfy spot to snooze can be impossible. When you do find the elusive perfect position, undoubtedly you’ll need to get out of bed to wee or be forced to roll over because some part of your anatomy has gone numb. And then there is the reflux, the leg cramps and the Braxton-Hicks contractions!

Getting good rest in the third trimester can be nigh on impossible, so it’s essential to plan for success and make sleep, however broken it might be, a priority. Consider reducing work hours and slowing down the pace of your day.


  • Optimise your sleep position for comfort.
  • Avoid large meals or excessive fluid intake in the evenings before bed to limit reflux and bathroom calls through the night.
  • Take day time naps.
  • Know that all things must pass and soon your baby will be here (and you may end up looking back fondly at all the sleep you did get in the last stages of your pregnancy!)

So what is the perfect sleep position in pregnancy?

After about 16 weeks your back is definitely not the best. Lying on your back allows your expanding uterus to put extra pressure on the large blood vessels that run through the back of your abdomen and carry blood from your feet and legs back to your heart. Pressure on these vessels can slow circulation to your body causing dizziness and light-headedness, and potentially impact on blood flow to the uterus and your baby.

Many women also find sleeping on their backs can lead to shortness of breath, worsened reflux and even abdominal upset from excessive pressure on the intestines.

Whilst lots of women enjoying sleeping on their stomachs in normal circumstances, your expanding uterus and enlarging breasts will usually make this impossible as pregnancy progresses.

So side it is – and which side really doesn’t matter. From the point of view of avoiding compression of the abdominal blood vessels, even placing a pillow or rolled up towel under one hip is sufficient to displace the uterus to one side and avoid problems. From the perspective of being more comfortable and providing support for your belly and back, prop a pillow under your belly or between your knees and consider using another under your body or behind your back to help keep you on your side. And, just for the record, there is no evidence that sleeping on the right or the left is better or safer – either is fine so just go for the most comfortable.

If you do wake to find yourself lying flat on your back – don’t panic! Just roll to your side and go back to sleep. Letting your body find its most comfortable position and getting as much sleep as possible is more important than waking yourself up every 10 minutes to stay on your side. You’ll be glad you got the extra rest once your baby starts waking you for those midnight (and 1am, and 2am, and…) feeds.

Goodnight! Sleep tight!