How Sleep Changes During Pregnancy

We are delighted to publish the blog written by Stacey L. Nash. Stacey is a Seattle area writer for whose insomnia led her to research all aspects of sleep. With a degree in communications from the University of Puget Sound, she helps put sleep into the forefront of the health and wellness conversation. When not researching and writing about sleep, she spends time with her husband and four children on their heavily-wooded, twelve-acre piece of heaven.  


How Sleep Changes During Pregnancy

The physical and emotional changes of pregnancy make it a special but trying time for many women, especially when it comes to sleep.

Frequent waking, leg cramps, and heartburn are only a few issues that complicate this most necessary of biological functions.

Your body is continually changing from week to week, which means the sleep issues of the first trimester may not be the same ones in the third trimester.

The First Trimester Sleep Issues

The first trimester, weeks one through thirteen, comes with sleep problems before you even know you’re pregnant.

They’re largely due to changes in the levels of the hormone progesterone.

Progesterone helps in the development of the placenta and uterine lining.

It also causes a general sense of relaxation that leads to sleepiness and fatigue.

Part of its job is to relax the muscles of the uterus so that your abdomen can expand.

However, this process, in combination with other hormones like relaxin, also causes the muscles of the bladder to relax, which leads to more frequent urination.

It’s not unusual to wake up several times during the night for a trip to the bathroom even though you’re not showing.

Unfortunately, more waking up means less sleep.

Snoozing Through the Second Trimester

The second trimester runs from weeks fourteen through twenty-seven.

The amount of progesterone flowing through your body continues to increase, but at a slower rate than during the first trimester.

For many women, this is the most comfortable time of pregnancy.

Stabilized progesterone levels and a change in fetus location often puts less pressure on the bladder, leading to fewer bathroom trips.

However, that doesn’t mean that sleep issues disappear.

A Swedish study found that nearly 23 percent of pregnant women snore, and the second trimester is usually when that begins.

Snoring can be disruptive to you, your partner, and often adds to nighttime waking.

Additionally, by the end of the second trimester, a growing uterus can return the pressure on the bladder as well as adding it to the spine and hips.

While some women breeze through the second trimester without any sleep issues, for some, this discomfort leads to tossing and turning.

Leaving Sleep Behind in the Third Trimester

The sheer size of the uterus puts more pressure on all parts of the body, including the bladder during weeks 28 through 40.

Nighttime bathroom trips will go up to first-trimester levels or even more.

Heartburn and leg cramps are also more common in the third trimester.

Nasal congestion can increase the snoring that started in the second trimester.

Women with high-risk pregnancies may be on bed rest with medical alert systems at their side.

The act of being in bed all day can make it more difficult to sleep at night.

Between a growing fetus that’s running out of the room, shortness of breath, and Braxton Hicks contractions, you may wonder if you’ll ever get a good night’s rest again.

Create Sleep Success

While sleep may be a challenge throughout pregnancy, there are ways to help.

 – Smart hydration:

Hydration is essential for a healthy pregnancy. During the day, make sure to drink plenty of water. However, to reduce your nighttime bathroom trips, try to stop drinking two to three hours before bed.

 – Extra pillows:

The physical changes of pregnancy may necessitate support between the knees, behind the back, or underneath the abdomen. A few extra pillows or a body pillow can give you the support you need where you need it.

 – Sleep upright:

An upright sleep position can help relieve heartburn. You can use some of your extra pillows to make sure you’re not lying flat on your back or side.


Adequate sleep is always important, but during pregnancy when your body is supporting another life, it’s absolutely vital.

There will be challenges, and you’ll have to address your unique sleep issues one at time.

But as you plan and make the effort, you’ll get the rest both you and your baby need.