According to research shared by the Huffington Post, hormonal changes can often be the culprit in lost sleep for women. Women have a more difficult time getting enough sleep at certain points in their menstrual cycles each month. Pregnant women also frequently lose sleep or suffer from insomnia as hormone levels surge during their pregnancy. Menopause can also bring about hot flashes and restlessness at night that prevent women from getting adequate or restful sleep. This is the second in a series of blogs that focus on the various conditions that affect women’s sleep, and what they can do to help ensure they get a better night’s rest.

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Sleep Challenges by Trimester

Pregnancy is a time of great joy and excitement, but unfortunately for some women, it can also be a time of severe sleep deprivation. According to the National Sleep Foundations 1998 sleep poll, Women and Sleep, 78 percent of women reported more disturbed sleep during pregnancy than at any other time. Changing hormone levels and common physical discomforts associated with pregnancy highly contribute to sleep and fatigue problems. Each trimester of pregnancy has its own set of unique sleep challenges, with the worst being in the first and third. Most women of the study reported that they felt “extremely fatigued during pregnancy,” especially in the first and third trimesters. The second trimester is often seen as a reprieve, and most women get their best sleep during pregnancy at this time. However, it isn’t always without its problems.


First Trimester

In the first trimester, especially, rising progesterone levels can explain excessive daytime sleepiness. The change in hormones and blood flow to accommodate the growing of another life increases the amount of fluids in a woman’s body- which could increase their need to urinate. An increased need to go to the bathroom often wakes women in the first trimester. Due to hormonal changes, bad dreams, hot flashes, and headaches are common in all stages of pregnancy which can make sleeping well difficult. Sleep is also disrupted as a result of the physical and emotional stress associated with a pregnancy. Some women experience “morning sickness,” which should really be called “anytime sickness,” and this too can interrupt healthy sleep patterns.

Second Trimester

During the second trimester, nighttime urination is less of an issue as the growing fetus moves above the bladder reducing the pressure placed upon it. “Morning sickness” usually subsides at this point too, greatly improving sleep. Sleep may still be disrupted by emotional stress related to pregnancy, and some women may experience some hip and back pain making getting comfortable at night difficult. It is also during the second trimester that fetal movement becomes noticeable to the mother, and for some, an active baby may keep them awake at night. Doctors often suggest that you take advantage of the ability to sleep better during this time and avoid packing on too many extra activities. Rest while you can!

Third Trimester

The most sleep problems during pregnancy are often reported during the third trimester. The need to urinate frequently returns in the third trimester, due to the baby changing position and putting pressure on the bladder once again. At this point in the pregnancy, many women experience leg cramps, sinus congestion, and heartburn as well as discomfort, aches, and pains from a growing belly. Stress over the impending delivery and arrival of the baby also keep expecting mothers awake at night.


12 Tips for Better Sleep in Pregnancy

You may find one or more of the following tips beneficial. Try them out until you find what works best for you. However, if nothing helps, and your sleep disturbances are severe, you should talk with your doctor.

  1. Use extra pillows. Pillows are great to add extra support for both your growing belly and your back. Sleeping with a pillow between your legs supports the lower back and makes sleeping on your side easier. A full-length body pillow goes a long way in terms of comfort during pregnancy. Special “pregnancy” pillows and mattresses may also be used if you want to invest in one of those.
  2. Try drinking a glass of warm milk when you are getting ready for bed to help bring on sleep. Also, a couple of hours before bed a snack of foods high in carbohydrates, like bread or crackers, can promote sleep. High protein snacks will help keep the blood sugar levels up and help prevent headaches, bad dreams, and hot flashes.
  3. Maintain a healthy exercise routine during pregnancy (following your doctor’s recommendations). Exercise during pregnancy promotes physical and mental health and helps you to fall asleep more easily at night, as well as enables you to sleep more deeply. Exercise benefits circulation and helps reduce or prevent nighttime leg cramps. You can also try some leg stretches before bed for leg cramp prevention. However, you should avoid vigorous exercise within four hours of bedtime.
  4. Practice some relaxation techniques. Stretching, yoga, massage, deep breathing and a warm shower or bath before bed can help calm your mind and relax your muscles promoting better sleep.
  5. Avoid heartburn by not eating large quantities of acidic (like tomatoes), fried, or spicy foods. You should also avoid carbonated beverages too close to bed. If you find that heartburn is a problem at night, try sleeping with your head elevated and eat small, frequent meals throughout the day. If changing your diet doesn’t help, check with your doctor to see if you can take antacids like Tums to help keep heartburn from keeping you up at night.
  6. Take advantage of the second trimester. As stated above, the second trimester is often the best for sleep. Get as close to eight hours of sleep a night as possible.
  7. Sleep on your side with your knees and hips bent to help with the pressure on your back and stomach. Place a pillow between your knees, under the belly, and behind your back. In the third trimester, sleep on your left side to allow for the best blood flow to the baby and to your uterus and kidneys. Don’t lay on your back for a long period of time.
  8. Drink a lot of fluids during the day, cut down before bedtime.
  9. Nap if you need to. The National Sleep Foundation poll found that 51 percent of pregnant or recently pregnant women reported at least one weekday nap and 60 percent reported at least one weekend nap.
  10. Dress comfortably for sleep. Avoid pajamas that put pressure on your belly. Skip anything with a tight waistband- keep underwear low-fitting. If you need the support, wear a loose cotton bra to sleep in.
  11. Keep it dark. Use a nightlight in the bathroom and use it instead of turning on the bathroom light in the middle of the night- this will be less arousing and help you get back to sleep more quickly.
  12. Talk to your doctor if you develop medical problems and/or insomnia persists.


Prioritizing sleep and finding effective strategies for managing sleep problems as early as possible in their pregnancy is very important for pregnant women. New sleep disorders may be caused by pregnancy and existing sleep disorders may become worse. If you have tried all you can and are still having difficulties feeling rested and getting a good night’s sleep you should address your concerns with your doctor as soon as possible.

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