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Pregnancy and Sleep: How It Changes Through the 3 Trimesters

If you're having trouble sleeping as your bump grows, know you're not alone.

Jessica Rendall Wellness Writer
Jessica is a writer on the Wellness team with a focus on health news. Before CNET, she worked in local journalism covering public health issues, business and music.
Expertise Medical news, pregnancy topics and health hacks that don't cost money Credentials
  • Added coconut oil to cheap coffee before keto made it cool.
Jessica Rendall
5 min read
A pregnant person sleeping with a pregnancy pillow with orange and pink designs
Jose Martinez/Getty Images

If we think of sleep as our nightly pit stop for restoration, rejuvenation and regrowth, it makes sense that you'd need as much of it as possible when you're pregnant and literally growing a whole new being from scratch. 

It's a bit of a paradox, then, that one of the things experts wish everyone knew is that it's (unfortunately) common to experience sleep disturbances, frequent waking and more things that can keep you from sleeping soundly during your pregnancy. And concerns about sleep can often be met with "not so helpful advice," according to Dr. Sarah Oreck, a reproductive psychiatrist at Mavida Health. 

"'Oh, this is in preparation for what's to come -- your sleep is only going to get worse when the baby's here,'" Oreck mused about advice she received from an OB-GYN. "That's not necessarily what I need to hear to feel better about sleep." 

But why is sleep more difficult during pregnancy? Does sleep stay consistently bad or good throughout? It's more than likely your sleep habits will change throughout your pregnancy, as you cross certain pregnancy milestones or if you're the one-person audience every night for fetal gymnastics. But while hormonal fluctuations and body changes do often cause similar sleep-disrupting symptoms, Oreck said it's also important to keep in mind that there's a "huge range" of sleep patterns during pregnancy, and what's true for you may not be true for your friend who's also pregnant. 

That being said, here are some common sleep experiences by trimester, as well as a few things to be aware of as your pregnancy progresses.

Sleep in the first trimester 

During the first trimester, your body is still busy turning itself into a construction site for the building project of pregnancy and childbirth, and it's accompanied by rising levels of progesterone. Coincidentally, high progesterone levels tend to make people more tired or fatigued. And if you happen to be a naturally bad napper, this newfound sleepiness may make it easier to doze off during the daytime, according to Oreck. 

"Often it just fragments sleep, but with the energy that it takes to build a baby, sometimes the fatigue can actually be helpful and allow people who weren't able to nap, to nap, or to get a little bit better sleep," she said. 

According to the Sleep Foundation, these high progesterone levels and rising hormones in the first trimester translate into an earlier bedtime for many people. To top it off, the Foundation reports that, while people are sleepier than normal, they're more restless at night. The anticipation, stress or anxiety around a new baby and life changes that are unfolding, as well as the physical demands of pregnancy, may all contribute.

Don't be surprised if you experience these common themes of sleep in the first trimester:

  • Earlier-than-usual bedtime 
  • Drowsiness during the day
A pregnant person sleeping on her side, cradling her belly
JGI/Tom Grill/Getty Images

What to look out for 

While postpartum depression and anxiety usually develop after birth, or in the last trimester at the earliest, some people may experience symptoms of depression and anxiety in the first trimester. This may be due to the hormonal changes, or life changes or stressors that a pregnancy and the impending baby create. Because sleep is so connected to mental health, your symptoms of anxiety or depression could make your sleep worse and vice versa, so it's important you get support. 

The first trimester is also a good time to become aware of the symptoms of sleep disorders that can be more common in pregnancy, including sleep apnea.

Read more: What to know about the new pill for postpartum depression 

Sleep in the second trimester 

They don't call it the "golden" trimester for nothing. Many people (though not all) consider the second trimester the easiest, as the nausea and adjustment period of the first trimester starts to fade away, and the increased physical demands and anticipation of birth that brim in the third trimester may not have surfaced yet.

If you're finding yourself having an easier or more restful sleep compared to the first trimester, lean into it. Use your energized mood to plan your baby's room or brainstorm names for the coming little one. (But don't be too caught off guard if you start or continue experiencing wonky pregnancy dreams.) 

Common sleep themes in the second trimester include: 

  • You may have more energy, compared to first and third trimesters    
  • Your bump may be becoming more obvious, which could influence your sleeping position

What to look out for 

Your nose might be stuffy and impact your sleep, if you experience pregnancy rhinitis (nasal congestion during pregnancy). Thanks to your growing bump, you'll need to reconsider your sleeping position -- potentially shifting to your side for optimal blood flow to your baby. To get cozy, revisit the pregnancy pillow selection

Read more: Weird pregnancy dreams? Here's why and what they mean 

Sleep in the third trimester 

The third trimester brings back some first-trimester disturbances like frequent bathroom breaks and tiredness, but also some new ones. This is also when you're most likely to experience fetal movement, which often increases at night and could potentially keep you up. 

"Generally, I think there's a lot of stuff that happens in the third trimester that can throw a wrench in sleep, unfortunately," Oreck said. 

Like in the second trimester, the American College of Obstetricians and Gynecologists recommends side-sleeping as the best option, as lying on your back may reduce blood flow from a major vessel, potentially making you feel dizzy or reducing blood to your fetus. 

Common themes in the third trimester: 

What to look out for 

If you're waking up tired after a long night of lying down, or you have other symptoms of sleep apnea like snoring, gasping or pausing in breathing, see your doctor for help. Some research has linked sleep apnea in pregnancy to a higher risk of early delivery or hypertensive disorders. 

At any point of your pregnancy, you should reach out to your doctor if you're experiencing insomnia or if you're experiencing symptoms of anxiety or depression, Oreck said. Taking magnesium may be recommended for sleep, she said, and it could be especially helpful in the third trimester for people experiencing charley horse cramps. Oreck said to talk to your doctor before you start taking any supplement while pregnant. 

"Taking care of yourself in whatever ways and getting the support that you need is super important," Oreck said. "If the insomnia is really overwhelming, it's really important to talk to your medical providers." 

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.