Pregnancy exhausted me like nothing else—even the fatigue after a sleepless night with a newborn doesn’t compare. Whether it’s heartburn, hormonal changes, restless legs or just plain old discomfort, there are so many reasons sleep during pregnancy is difficult. “Pregnancy asks a tremendous amount of the body physically, emotionally and hormonally, and sleep is one of the primary ways the body restores itself,” says Erica Manto Paulson, a certified doula and childbirth educator. To help you get that incredibly important restorative rest during pregnancy, I interviewed Manto Paulson and an OBGYN. Among their top tips: use a pregnancy pillow to help you get comfortable and create a calming bedtime routine. Ahead, find their other advice and learn more about why it can be so difficult to sleep well during pregnancy.
Why Is It So Hard To Sleep During Pregnancy?
From physical discomfort to anxiety, there are so many reasons sleep during pregnancy can be hard to come by. “Many women assume poor sleep only becomes an issue at the end of pregnancy when they’re physically uncomfortable,” says Manto Paulson. “But sleep challenges can be common throughout all three trimesters.”
Hormone Changes
“Early in pregnancy, hormonal shifts can contribute to fatigue while also disrupting normal sleep patterns,” says OBGYN Dr. Maral Malekzadeh. Progesterone rises during pregnancy, which can make you more tired during the day while simultaneously making it more difficult to get solid sleep at night. The high levels of estrogen during pregnancy can also affect sleep—for example, estrogen can cause swelling in your nasal passages, which can contribute to obstructive sleep apnea.
Physical Discomfort
“As the body changes, women may experience back pain, hip pain, pelvic discomfort, frequent urination, heartburn, congestion, leg cramps or difficulty finding a comfortable sleeping position,” says Manto Paulson. Add on the fact that most women can only sleep on their side by the end of pregnancy, and nighttime aches and pains are common.
Stress And Anxiety
Paradoxically, the more you struggle to sleep, the more you worry about getting enough sleep, thus more elusive sleep becomes. Pregnancy is such a huge transition, and it’s very common to feel stress and worry. “Many women are carrying a tremendous amount of responsibility, decision-making, planning and worry,” says Manto Paulson. “They are preparing for birth, thinking about parenthood, managing work and family obligations, and processing a major life transition. Even when their body is tired, their nervous system may still be in a state of alertness that makes it difficult to fully rest.”
How To Get Quality Sleep During Pregnancy
“One of the most important things I want women to understand is that sleep is not a luxury during pregnancy. It is a critical component of maternal health,” says Malekzadeh. As such, finding ways to get comfortable so you can sleep is essential. Here are some tips and tried and true techniques to sleep better during pregnancy.
Create A Bedtime Routine
Once your baby is born, you’ll get all sorts of advice about creating a bedtime routine for them, but the same advice can actually help you sleep even before they’re born. “One of the biggest shifts I encourage is moving away from the idea that sleep begins when your head hits the pillow. Sleep actually starts hours before bedtime,” says Manto Paulson. “Creating a calming evening routine can help signal safety to the nervous system.” Your bedtime routine might include:
- Dimming lights
- Reducing screen exposure
- Taking a warm (not hot) bath or shower
- Practicing gentle stretching
- Breathwork
- Meditation or yoga
- Creating a slower pace before bed
- Reading a book
- Avoiding caffeine and large meals before bed
Try A Pregnancy Pillow
A pregnancy pillow is one of the main tools that many women find helpful when they’re trying to sleep during pregnancy. As your pregnancy progresses, experts recommend sleeping on your side, and a pregnancy pillow can help make that more comfortable. “Physically, supporting the body with pillows can make a significant difference,” says Manto Paulson. “Many women benefit from placing pillows between their knees, behind their back, under their belly or using a pregnancy pillow for full-body support.”
We tested 16 options so you can find the best pregnancy pillow for you. Our top pick is the Queen Rose U-Shaped Pregnancy Pillow. “Pregnancy pillows are often one of the most impactful tools because they help accommodate the body’s changing shape and reduce strain on the hips, pelvis and lower back,” says Manto Paulson. Malekzadeh recommends wedge pillows as well for women who experience reflux or heartburn.
Invest In A Good Mattress
If you’re due for a new mattress (most last about 7 to 10 years), now is a great time to invest in a good one that helps you get more sleep now and when your baby is born. Look for one that is supportive and offers pressure relief.
I consulted with our sleep and mattress team on staff, and they recommend the Layla Hybrid Mattress, which has both a soft and a firm side, making it a versatile mattress if your sleep needs change after your baby is born. Another standout option is the Nolah Evolution, which we named the best mattress for side sleepers. If you run hot during pregnancy, a cooling mattress is a great option, too.
If getting a whole new mattress isn’t in the cards, or side-sleeping is something that you won’t be doing after delivery, a mattress topper is another way to modify your bed with for less money and commitment.
Change Your Mindset
Some rest is better than no rest. Manto Paulson explains that rest can include slowing down, receiving support and regulating your nervous system. Enlist a supportive prenatal team, which could include some combination of a doula, a therapist, friends and family. If you have the means, you can also give yourself more rest by hiring someone to clean your house, opting for grocery delivery or hiring a babysitter for older kids.
“Sometimes the most supportive question isn’t, ‘How can I sleep better?’ but instead, ‘How can I create more opportunities for rest and recovery in this season overall?’” says Manto Paulson.
Create An Environment That’s Conducive To Sleep
The same things that can help your baby sleep once they’re here may help you sleep, too. Consider soft white noise, blackout curtains and cozy sheets. If you tend to run hot, a portable air conditioner or a bed cooling system can help you get more comfortable, too.
Wear Comfortable Pajamas
Malekzadeh recommends breathable sleepwear. Among the best maternity clothes, we recommend Petite Plume and Lake pajamas—both are designed to accommodate your baby bump and are nursing-friendly. When Hailey Bieber shared her pregnancy and postpartum essentials, she recommended the Bumpsuit The Cloud High Waisted Pant.
Stretch And Exercise
If you’re cleared to exercise, movement and light stretching can be a great way to ensure quality sleep. One study in the journal Behavioral Sleep Medicine found that moderate exercise during pregnancy may help combat sleep disturbances. Gentle stretching can also help relieve aches and pains associated with pregnancy.
Rule Out Medical Concerns
While it’s common to struggle to sleep comfortably during pregnancy, it doesn’t necessarily mean what you’re experiencing is normal. “Women should not hesitate to discuss persistent sleep difficulties with their healthcare provider,” says Malekzadeh. “Significant insomnia, excessive daytime fatigue, loud snoring or breathing disturbances during sleep warrant further evaluation.”
Pregnancy can commonly cause anemia as well as other vitamin and mineral deficiencies, including vitamin D, magnesium, iron, vitamin B and calcium—all of which can affect sleep. Other medical conditions that tend to creep in during pregnancy can impact sleep too, such as hypothyroidism, hyperthyroidism, obstructive sleep apnea, preeclampsia and gestational diabetes. “In some cases, pregnancy can also worsen or unmask sleep disorders such as restless leg syndrome or sleep apnea,” says Malekzadeh.
Why Trust Forbes Vetted
At Forbes Vetted, our baby and kids gear team is committed to not only helping you find the best products for your family but to also help you and your family live your best lives. We interview experts and research products to help parents and caregivers make informed choices.
- Author Alicia Betz is a mom to three, including twins, and has interviewed a variety of pregnancy experts over the years. She has nearly a decade of experience reporting on parenting topics.
- Editor Margaret Badore is also a mom to three. She’s the senior baby and kids gear editor and has over 15 years of experience as an editor and reporter covering health and science.
- We consulted with McKenzie Dillon, the sleep and mattress editor here at Forbes Vetted to learn more about what products can help pregnant women sleep better.
- We regularly cover pregnancy topics, including the best pregnancy books, the best pregnancy compression socks and the best pregnancy-safe protein powders.
Our Experts
- Erica Manto Paulson, a certified doula, childbirth educator and founder of Nurture, a business that provides prenatal and postpartum massage, hypnobirthing classes, doulas and more
- Dr. Maral Malekzadeh, a board-certified gynecologist and co-owner of The Well Westlake