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How to sleep better in pregnancy

From your growing bump to heartburn and (what feels like) a constantly full bladder, it can be harder to get an undisturbed night’s sleep in pregnancy. Try our tips for a better night’s slumber.

Planning maternity leave, getting everything ready for your baby and navigating the last few months at work when your energy levels are plummeting… no wonder you need a rest when you’re pregnant. Ironically though, just as you need it most, sleep can become increasingly elusive.

Why can't I sleep in pregnancy?

It’s normal to feel tired in pregnancy (NHS, 2021a) so try not to get frustrated with yourself, as getting frustrated can cause more sleeplessness. Your baby is growing, and your expanding bump is understandably making it hard for you to get comfortable at night.

Changes in your hormones also add to tiredness in the first trimester. Experiencing heartburn, nausea and needing to wee more often are all normal symptoms (NHS, 2021a).

Also, you might have worries about what it’ll be like when your baby arrives, adding to those sleepless nights.

Why am I waking up at night?

Bladder problems can be twofold in pregnancy. Early on, you might still find you need to pee more often due to changes in your hormones during pregnancy (NHS 2021b).

Just as this is settling down in later pregnancy, your growing uterus puts pressure on your bladder – meaning more toilet trips again. However avoiding drinking completely before bed can lead to leg cramps, so be thoughtful but drink to make yourself comfortable.

Nearer the end of your pregnancy, as your baby’s head engages, your bladder might feel full even when you’ve just been to the loo. Try going to the loo before bed, leaning forward and exhaling to empty your bladder completely, then make yourself as comfortable as possible. At least the end is in sight – and if nothing else, it’ll prepare you for night awakenings to come…

Feeling hot in pregnancy

It’s normal for you to feel warmer than usual during pregnancy. This is due to hormonal changes and an increase in blood supply to the skin (NHS, 2021b).

You're also likely to sweat more. It can help if you wear loose clothing made of natural fibres to bed, as these are more absorbent and breathable than synthetic fibres. In warmer months, perhaps have a cool shower before bed, and try to keep your room cool with an open window or electric fan.

Restless legs syndrome

It’s estimated that between 10 and 25 per cent of women report symptoms of Restless Legs Syndrome (RLS) during pregnancy (RLS-UK, no date). This is when you feel an overwhelming urge to move your legs. Symptoms are more noticeable in the third trimester and might make it difficult for you to relax and fall asleep.

Thankfully, symptoms are often temporary. Some women find it useful to stretch their legs, or have a massage or warm bath before bed to relieve the symptoms.

The worry factor

Fears about the birth or what life will be like with a newborn have an annoying habit of whirling around your head at 2am.

Some women also have strange dreams or nightmares about the baby, labour or birth. This is completely normal in pregnancy (NHS, 2021a). Talking about them with your partner or midwife can help. Remember, just because you dream something, it doesn't mean it's going to happen.

In fact, it shows that your mind is preparing you for the enormous task of being a parent, and becoming more focussed on your baby. Relaxation and breathing techniques may be helpful in reducing any anxiety you might be feeling (Ozkan and Rathfisch, 2018).

Attending an antenatal class like an NCT course and visiting the birthing centre or hospital you’re going to have your baby in can help you learn about what to expect. If you’re planning a home birth, talk to your midwife about what’s likely to happen and what you might need.

Occasionally, sleeplessness – when accompanied by other symptoms – can be a sign of depression (NHS, 2021a). If you have any of the other symptoms of depression, such as feeling hopeless and losing interest in the things you used to enjoy, speak to your doctor or midwife. There is treatment that can help (NHS, 2021c).

Top tips for getting a better night's sleep in pregnancy

1. Fresh air and exercise

Getting lots of fresh air and doing moderate exercise for as long as you feel comfortable might help you feel sleepier at night. There are other benefits, too.

One study found that 35-90 minutes of aerobic exercise 3-4 times a week during pregnancy is associated with a higher chance of vaginal birth and a lower chance of gestational diabetes and high blood pressure (Di Mascio et al, 2016).

2. Relaxation

Practicing relaxation techniques, such as yoga before bed may help with fewer awakenings and help to lower anxiety.

Jenny Barrett, an NCT antenatal teacher, says:

‘Some pregnant mums find that classes such as Yoga for Pregnancy can really help in getting some gentle exercise and learning some relaxation techniques. You could get your partner to give you a massage to help you relax – this is a good way to practice techniques that you could use during labour.’

3. Cutting the caffeine

Cut down or cut out caffeine, especially later in the day, and remember that caffeine is also present in tea, chocolate, soft drinks, energy drinks, and some medicines, such as cold and flu remedies (NHS, 2020b).

4. No alcohol for me thanks

Alcohol is associated with more disrupted sleep, so you may decide to cut down or cut out alcohol during pregnancy (NHS, 2021d).

5. Healthy eating 

Eat a healthy diet with plenty of fresh fruit and veg, and you might find that herbal teas can help you unwind in the evening. Do some research before you sip though – while ginger and peppermint teas can help to ease morning sickness, green tea contains the same amount of caffeine as regular tea (NHS, 2020d).

6. Sleeping comfortably: a pregnancy pillow might help

Pregnancy pillows, or just an extra regular pillow, are often the favourite sleep aid of expectant mums. They can help support your bump or legs in bed and make you more comfy as your tummy gets bigger. You can also use them to relax on the sofa while you’re reading or watching TV.

You may fall in love with your big maternity pillows so much that you want to carry on using them after your baby is born. And coincidentally, they make great breastfeeding support cushions too! If that doesn't leave much room in the bed for your partner, they might find it easier to sleep in a separate room to get a better night's rest.

7. Helping the heartburn 

Mums-to-be who’ve never suffered from indigestion before can be surprised when they get it badly during pregnancy. It’s caused by the valve between your stomach and the tube leading to it relaxing during pregnancy due to hormonal changes. This means stomach acid can pass into the tube and cause the burning feeling. In later stages of pregnancy, your growing uterus can press on your stomach and make the problem worse (NHS, 2020e).

It can come on when you’re going to bed, or you might even wake up with it in the middle of the night. Some people find avoiding spicy foods or eating too much at one meal can help, especially near bedtime. Eating little and often is the name of the game in the later stages of pregnancy, and try not to eat in a rush.

It can also help to raise the head of your bed by 10 to 15cm, or sleep propped up on lots of pillows (NHS, 2020e). If it won’t go away and stops you sleeping, ask your GP or midwife for advice. Your heartburn may not be completely relieved by medication but your doctor or midwife can prescribe an antacid that is safe during pregnancy (NHS, 2020e).

8. Avoiding the (not) morning sickness

Morning sickness affects nearly 70% of women and is not limited only to the morning (Einarson et al 2013). In fact, morning sickness – or nausea and vomiting in pregnancy (NVP) as it’s known too – can happen at any time of day or night (NHS, 2018).

It can help to eat small quantities of plain food, like toast or rice crackers, before you go to bed, as having an empty stomach can make you feel more sick. Keeping hydrated can help as well. Avoid very greasy or sugary food, as this can be harder to digest and make you feel more sick (that’ll help avoid heartburn too) (NHS, 2018).

9. Try to get help with older children

If you have other children, you could ask your partner to help when older children wake up at night. It can be hard enough to get a good night’s sleep in pregnancy, let alone if you’ve already got a little one who wakes up in the night or climbs into bed with you just as you’ve managed to drift off.

Tell your partner if you’re having difficulty sleeping, and encourage them to help deal with your other children in the night. Or, they could get up with them in the morning to give you a bit of a lie-in.

If older siblings sleep through but need constant attention during the day, try to get some sleep or rest whenever you can. Jenny says:

‘If the older child goes to bed in the evening, you could also go to bed earlier, even if only for a couple of evenings in the week to catch up. If your partner is able to take the older child out for a few hours at the weekend you could get some rest then.’

10. A healthy bedtime routine checklist

It’s a good idea to have a good routine for sleep hygiene. (NICE, 2020). So here is a suggested checklist for a healthy bed time routine to promote a restful night’s sleep:

  • Take up gentle exercise during the day.
  • Avoid caffeine a couple of hours before bed.
  • Avoid heavy meals that could aggravate heartburn.
  • Avoid drinking fluids a couple of hours before bed (but this does increase the chance of leg cramps) (NHS, 2020n).
  • Reduce activity before sleep.
  • Practice relaxation techniques or yoga.
  • Go to the loo to empty your bladder before you get into bed.
  • Wear light clothing from natural fibres to avoid getting too hot.
  • Use a pillow to support your bump or legs and lie on your side.

Safe pregnancy sleep positions

Around the middle of your pregnancy, start to get into the habit of going to sleep on your side. This is because research found that mothers whose baby was stillborn were twice as likely to report falling asleep on their back the night before. This may be to do with the flow of blood and oxygen to the baby (Heazell et al, 2017).

Don't worry if you wake up on your back – the research looked at the position women fell asleep in, as this is the position we keep for longest. If you wake up on your back, just turn over and go to sleep again on your side (NHS, 2021a).

And just remember, it's not forever. One new NCT mum says: ‘Even though my baby often wakes me up in the night now, the sleep I do get in-between feeds is so much better than when I was heavily pregnant and just couldn’t get comfortable.’

This page was last reviewed in March 2021.

Further Information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Beddoe AE, Yang C-P, Kennedy HP, et al. (2009) The effects of mindfulness-based yoga during pregnancy on maternal psychological and physical distress. JOGNN. 38(3):310-9. 

Di Mascio, MD et al. (2016) Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. AJOG 215(5). pp. 561-571. https://doi.org/10.1016/j.ajog.2016.06.014 

Einarson TR, Piwko C, Koren G. (2013) Quantifying the global rates of nausea and vomiting of pregnancy: a meta analysis. J Popul Ther Clin Pharmacol 20(2):e171-83. www.jptcp.com 

Heazell et al (2017) Association between maternal sleep practices and late stillbirth – findings from a stillbirth case‐control study.  BJOG.  125(2) pp254-262.  Available at: https://doi.org/10.1111/1471-0528.14967

Kramer, MS and Mcdonald, SW (2006) Aerobic Exercise for women during pregnancy. Available at: https://www.cochrane.org/CD000180/PREG_aerobic-exercise-for-women-durin…;

NHS (2018) Vomiting and morning sickness. Available at: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness/ 

NHS (2020a) Exercise in Pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/exercise/ 

NHS (2020b) Foods to avoid in pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/

NHS (2020c) Drinking alcohol while pregnant. Available at: https://www.nhs.uk/pregnancy/keeping-well/drinking-alcohol-while-pregna…

NHS (2020d) Foods to avoid in pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/

NHS (2020e) Indigestion and heartburn in pregnancy. Available at: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/indiges…

NHS (2020f) Leg cramps.  https://www.nhs.uk/conditions/leg-cramps/

NHS (2021a) Tiredness and sleep problems. Available at: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/tiredness/

NHS (2021b) Common health problems in pregnancy. Available at: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/common-health-problems/

NHS (2021c) Mental health in pregnancy. Available at: https://www.nhs.uk/pregnancy/keeping-well/mental-health/

NHS (2021d) Insomnia.  https://www.nhs.uk/conditions/insomnia/

NICE (2020) Antenatal and postnatal mental health: clinical management and service guidance. Available at: https://www.nice.org.uk/guidance/cg192/chapter/1-Recommendations

Ozkan S, Rathfisch G (2018) The effect of relaxation exercises on sleep quality in pregnant women in the third trimester: A randomized controlled trial. Available  at: https://www.sciencedirect.com/science/article/abs/pii/S174438811830286X

RLS-UK (nd) RLS in pregnancy. Available at: https://www.rls-uk.org/rls-in-pregnancy/

Smith, C et al. (2019) The effect of complementary medicines and therapies on maternal anxiety and depression in pregnancy: A systematic review and meta-analysis. Journal of affective disorders. 245. pp. 428-439. 

 

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