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The Pregnant Woman's Guide To Sleep

Furthermore and DUXIANA present Life, Awakened - a series of videos and articles promoting deep, regenerative sleep as the foundation for an active, healthy lifestyle.


Pregnancy comes with all kinds of curveballs. Some are trivial and easy to push to the back of the mind, like weird cravings and swollen feet, while others are so intrusive that they’re impossible to ignore. (There’s a human growing in there, after all.) Certain side effects make it difficult to log restorative sleep, which can put both mother and baby at risk.

A study from the University of California at San Francisco found that women who sleep fewer than six hours per night at the end of their terms have significantly longer labors and are 4.5 times more likely to need cesarean sections compared to those who clock seven hours or more. Research also shows that women who have sleep disorders during pregnancy are less likely to make it to term.

But while necessary, sleep can also be elusive during this nine-month period thanks to common side effects like back pain and restless legs, says Jennifer Martin, Ph.D., clinical sleep psychologist and member of the Equinox Health Advisory Board. A study published in Sleep Medicine found that throughout the three trimesters, all women wake up frequently throughout the night, three-quarters of them sleep poorly, and half feel extremely tired during the day.

That’s not to say it’s impossible to get a full night’s rest. Here, a trimester-by-trimester guide to overcoming the obstacles that pregnancy presents.


This is when night-time nausea starts to impair shut-eye. To offset its negative effects, Jacques Moritz, MD, an associate clinical professor of obstetrics and gynecology at Cornell Medicine and a member of the Equinox Health Advisory Board, suggests taking a sleep aid that contains doxylamine, like Unisom, in combination with 25 milligrams of vitamin B6. (He notes that women should always consult their physicians before taking any new vitamins or supplements.)

The uterus also starts pushing on the bladder between six and eight weeks into the pregnancy, causing frequent urination plus the urge to relieve the bladder, even if it’s not necessary. To keep this from interrupting sleep, avoid drinking fluids two hours before bedtime, says William Schweizer, MD, clinical associate professor in the department of obstetrics and gynecology at New York University Langone Health.

A more serious condition that can develop is sleep disordered breathing, or sleep apnea. Martin recommends that any pregnant woman visit her doctor if she experiences symptoms like snoring, which is likely to worsen with pregnancy weight gain. “Trouble breathing well while asleep can have an impact on the growing baby,” she says. Preliminary research on 1.4 million birth records found that babies born to women with sleep apnea are more than three times as likely to be admitted to the intensive care unit.

Anxiety over the baby’s health and development may also play a role in restless nights, Martin adds. “This is a great time to start a relaxing bedtime routine,” she says, to help keep worries at bay.


Hormonal changes can lead to sleep-impairing discomfort. “Heightened levels of relaxin and progesterone cause ligaments to become more stretchy, leading to back pain in the second trimester,” Schweizer says.

To ease the aches, lie on your side, wedge a pillow between your knees, and use another to cushion your abdomen, which will reduce pressure on the spine, he says.

Moritz recommends sleeping on your left side for the rest of the pregnancy. It maximizes blood flow to the heart; increases the amount of nutrients that reach the placenta and fetus; and reduces gastrointestinal pangs from acid reflux and heartburn, both common during pregnancy.


The real challenge, Moritz says, is resting well during the last three months of pregnancy, when physical discomfort peaks as the baby nears its birth weight. During this period, nighttime leg cramps are common; Mortiz recommends taking calcium and magnesium supplements to help manage it.

Low iron levels can contribute to restless legs syndrome (RLS), another lower-body sleep disruptor that peaks around this time, Martin says. In fact, 36 percent of women reported experiencing RLS in their third trimester, and half of them had moderate to severe symptoms, according to a study published last year in the Journal of Clinical Sleep Medicine. The American Pregnancy Association suggests that expecting mothers get 18 milligrams of iron per day. Getting it through food sources (such as tofu and beans) or supplements can help relieve the issue.