8 Solutions to Your Pregnancy Sleep Problems

By Robert Rosenberg, DO

Pregnancy is both joyous and stressful, and many expectant mothers are ill-prepared for the negative effect pregnancy has on their sleep.
Here are my suggestions for solutions to eight common problems that have kept some of my pregnant patients up at night:

1. Increased Urinary Frequency

During the first or third trimester, many pregnant women simply need to pee more often, which is due to a combination of factors, including increased production of progesterone and the uterus compressing the bladder.
Solution: Avoid fluids two hours before bedtime and try to empty your bladder completely before going to sleep.

2. Nausea

Nausea — morning sickness — is a very common first-trimester occurence. Although people call it morning sickness, it can occur at any time, including bedtime.
Solution: Keep crackers at your bedside so your stomach is never empty — an empty stomach may be more prone to digestive upset. You can also make ginger tea to help soothe nausea.

3. Back Pain

An aching back is quite common at the end of the second trimester and throughout the third trimester. The growing baby and relaxin, a hormone released during pregnancy, combine to weaken ligaments.
Solution:  Put a pregnancy pillow between your legs to support your abdomen, and sleep on your left side. Sleeping on your left side increases blood flow and oxygen to your uterus and your baby. In addition, exercises that increase back strength, such as straight leg raises and pelvic tilts, are safe and beneficial.

4. Restless Legs Syndrome (RLS)

RLS occurs in about 20 percent of pregnant women, usually during the third trimester. It is a major cause of sleep deprivation during pregnancy.
Solution: Make sure you are taking folate and iron supplements. Daily exercise such as walking and stretching may also help. Avoid caffeine, nicotine, and alcohol. In some cases — especially when your have associated swelling — support hose can help. Finally, talk to your obstetrician about any medications you may be taking as some drugs can make RLS worse.

5. Insomnia

In the National Sleep Foundation’s 2014 Sleep in America survey, 79 percent of women reported that they had trouble falling or staying asleep during pregnancy.
Solution: Develop a calming bedtime routine and try to keep a stable sleep schedule. Learn relaxation techniques such as progressive muscle relaxation, abdominal breathing, and guided imagery. Above all, practice good sleep hygiene, which means no caffeine after noon; and no computers, cell phones, or televisions before bed. If your sleep difficulties continue, talk to your healthcare provider. Untreated insomnia, especially during the third trimester, has been associated with postpartum depression.

6. Sleep Apnea 

Sleep apnea is a major cause of pregnancy-induced hypertension, as well as gestational diabetes. If you are among the 40 percent of women who snore during pregnancy, You may be doing more than snoring: Your airway may be collapsing during sleep.
Solution: Speak to your doctor about being evaluated for sleep apnea. If you have it, treatment can also help bring down your blood pressure and improve blood sugar levels.

7. Leg Cramps

An estimated one-third of pregnant women suffer from severe leg cramps that disturb their sleep. This may be due to low calcium and magnesium levels during pregnancy. A growing baby requires a lot of calcium.
Solution: Discuss your magnesium and calcium levels with your healthcare provider. You may need to take calcium supplements, or in some cases vitamin D3. Foods high in magnesium such as almonds, cashews, legumes, and dairy products may be helpful.

8. Nasal Congestion (Pregnancy Rhinitis)

Nasal congestion is a common pregnancy problem, as well as a major cause of discomfort and difficulty sleeping. The congestion is due to a combination of increased mucous (caused by increased levels of estrogen) as well as the higher blood volume associated with pregnancy.
Solution: Elevate the head of your bed or use a pillow to elevate your head. Be sure to avoid caffeine, which can exacerbate the problem. Steam, in the form of a hot shower before bed, as well as saline nasal sprays may provide relief. Avoid spicy foods, which can intensify the problem.