Written By: Lana Adler
Medically Reviewed by: Dr. Sherrie Neustein
Updated March 9, 2021
For many pregnant women, sleep quality in their first trimester is fairly good compared to sleep in their second and third trimesters. However, it doesn’t always feel that way when morning sickness, backaches, and bathroom trips interrupt sleep earlier in pregnancy than expected. If you have trouble sleeping during your first trimester of pregnancy, you can help yourself sleep better through a conscious effort to develop personal habits that support good sleep.
Why Is It Hard to Sleep During Early Pregnancy?
Changes in sleep during a woman's first trimester of pregnancy are largely driven by rising levels of progesterone (1). An increase in progesterone triggers changes in the uterus and the rest of the body to support the developing fetus. However, this rise also triggers daytime drowsiness, contributes to nighttime snoring, and increases the risk of sleep apnea.
Progesterone and other pregnancy hormones are also behind these common pregnancy sleep disruptors:
- Morning sickness-related symptoms, such as nausea and vomiting
- Back pain
- Increased asthma symptoms (2)
- Sleep disorders (3), such as obstructive sleep apnea and restless leg syndrome
- Acid reflux
- Increased bathroom trips
- Tender breasts
Another reason women may struggle to sleep during early pregnancy is anxiety. It’s natural to worry about your health, the baby’s health, financial changes surrounding a new baby, and all the other unknowns of childbirth and parenting.
Do I Need More Sleep Than Usual During Pregnancy?
The average adult needs seven to nine hours of sleep every day (4), and your sleep recommendations remain the same while pregnant. However, during the first trimester, progesterone floods the body, causing fatigue and drowsiness. Consider taking a nap during the day or sleeping more at night to see if it reduces your daytime fatigue. Don’t be surprised if you feel tired earlier (5) in the evening than you did pre-pregnancy, since a rise in progesterone can likely increase the production of melatonin (6), a key sleep-inducing hormone.
Changes taking place in the body also make it harder for virtually all pregnant women to receive several consecutive hours of sleep without unwanted awakenings (7). For some women, a better mattress or a mattress topper can help promote sleep by supporting a rapidly changing body, providing comfort, and preventing pain-related waking. However, when you’re struggling to sleep early in pregnancy, track your total hours of sleep rather than consecutive hours of sleep. You may have to take naps to achieve a total sleep time within the recommended sleep range. However, you should not stress about sleeping less, as that stress can then also impact your sleep as well.
What is the Best Sleep Position During the 1st Trimester?
In the first trimester, sleep position doesn’t play as important of a role as it does later in pregnancy because your uterus hasn’t yet grown large enough to push on your other organs and blood vessels. Sleeping on your back might become uncomfortable as your uterus grows. A growing uterus can also press on the vena cava, reducing blood return to the heart and causing low blood pressure (8).
Stomach sleeping is almost impossible by the third trimester, but it might not be a problem during the first trimester. Many pregnant women find that side sleeping feels the most comfortable and reduces snoring. Many physicians recommend sleeping on the left side over the right because it lets blood flow more freely. However, a 2019 study (9) found that back and right-side sleeping do not increase poor pregnancy outcomes or increase birth complications.
The position a pregnant woman chooses to sleep in should be chosen based on comfort and physician’s recommendations. Since back and stomach sleeping may become uncomfortable during the second trimester, some pregnant women might want to become accustomed to side sleeping during the first trimester.
Tips for Better 1st Trimester Sleep
Making relevant behavioral and lifestyle changes will increase your chances of receiving a full eight hours of rest each night throughout your first trimester. Most changes are simple and worth it because adequate sleep (10) lowers the risk of preterm delivery, long labors (11), cesarean sections, low birth weight, high blood pressure, and delivery complications.
Stay Hydrated, but Drink Early
Good hydration during pregnancy might help prevent nighttime sleep disruptions (12). When you’re pregnant, hydration also benefits the body by:
- Decreasing constipation (therefore, reducing hemorrhoids)
- Relieving swelling
- Maintaining energy levels
- Reducing the risk of urinary tract infections
Based on your size and your doctor’s recommendations, you’ll probably need 8 to 12, 8-ounce glasses of water per day. Try to drink most of your fluids early in the day. Otherwise, trips to the bathroom can disrupt your sleep all night long.
Avoid drinks or foods with caffeine and other stimulants that might keep you awake or make you go to the bathroom more often. Hydrating earlier in the day becomes increasingly important as you enter the second and third trimesters, when the uterus and fetus put pressure on the bladder.
Eat Nutritious Food and Take Prenatal Vitamins
Your eating habits during pregnancy can impact your nighttime sleep quality. Acid reflux could keep you awake at night, while morning sickness could wake you early in the morning. Keep a small amount of food in the stomach to ward off morning sickness. Small, frequent meals composed of fruits, vegetables, lean protein, and whole grains can help you feel better throughout the day and night. Avoid eating heavy, fatty meals, or eating meals close to bedtime (13) to prevent acid reflux and make sure to discuss your reflux symptoms with your doctor.
Start taking prenatal vitamins before you get pregnant or as soon as you find out you’re pregnant. Your doctor may prescribe them, but you can use over-the-counter prenatal vitamins before your first doctor’s visit. Prenatal vitamins include higher volumes of folate and iron that are important for the developing fetus. They can also help prevent and reduce (14) the symptoms of restless leg syndrome, a sleep disorder that becomes more likely as your pregnancy progresses.
Keep Your Bedroom Dark and Cool
Blood volume increases throughout pregnancy, and then blood vessels expand and move closer to the skin, making it easy to feel overheated. Your body temperature (15) usually drops slightly at the onset of sleep and fluctuates slightly throughout the night. If you feel overheated, that might affect your sleep cycle or even wake you up. Keep the bedroom cool. For most people, 60 to 68° Fahrenheit offers a comfortable range.
Eliminate as many sources of light in your bedroom as possible. Light, especially blue spectrum light (16), suppresses the secretion of melatonin, delaying the sleep cycle. Even small light sources, such as power indicator lights on a television or phone charger, can affect melatonin and sleep.
Sleep with Support Pillows
Changes in hormone levels can affect muscle flexibility, loosen ligaments, and decrease strength. These factors along with others make low back pain (17) common among pregnant women. Sleeping with a pillow between the knees or a pregnancy pillow in front of or behind you might help you sleep more comfortably and reduce back pain.
Develop or Continue Good Sleep Habits
The first trimester of pregnancy is a good time to focus on overall sleep habits, including:
- Going to bed and waking up at the same time every day
- Developing a relaxing bedtime routine
- Exercising regularly
- Limiting exposure to blue light within two hours of bedtime
- Eating an early dinner
A Final Note on How to Sleep Better in Early Pregnancy
Pregnancy is a unique and special time as you prepare to meet your baby. Be gentle with yourself and your body as you change and grow into the parent you’ll soon be. Sleep is a vital part of your overall health at this time, helping reduce the anxiety of delivery and parenthood. A healthy approach to sleep will also give you and your baby the best chance at a safe, healthy delivery.
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