Pregnancy Sleep

Sleep can feel surprisingly complicated during pregnancy. You may be exhausted but unable to settle, wake repeatedly during the night, struggle to find a comfortable position or find that your usual sleep pattern has completely changed.

Sleep problems and tiredness are common in pregnancy, and there are many possible reasons for them. Physical discomfort, needing the toilet, heartburn, changing hormones and worries about pregnancy can all affect rest. There is also specific guidance about sleeping position later in pregnancy that is worth knowing.

You do not need to achieve perfect sleep. A few practical adjustments may make nights more comfortable, and your midwife or GP can help if poor sleep is persistent or affecting everyday life.

Why can sleep change during pregnancy?

Pregnancy can affect both how tired you feel and how easily you sleep.

The NHS notes that feeling tired or exhausted is common during pregnancy, particularly in the first 12 weeks, when hormonal changes can contribute to tiredness, nausea and emotional changes.

Later in pregnancy, sleep may become more difficult for different reasons. A growing bump can make it harder to find a comfortable position, and you may need to use the toilet more frequently. Physical symptoms such as heartburn, backache or leg cramps can also interrupt sleep.

Some people also have vivid dreams or nightmares about pregnancy, the baby, labour or birth. The NHS notes that strange dreams can happen during pregnancy and do not mean that what you dreamed will happen.

Pregnancy can bring plenty to think about, too. If your mind becomes busy as soon as your head reaches the pillow, you are certainly not the only person to experience that.

What is the safest sleeping position during pregnancy?

The advice changes later in pregnancy.

The NHS advises that after 28 weeks, the safest position to go to sleep is on your side, either the left or right side. This advice applies when you first go to bed, when you return to sleep after waking during the night and when you have a daytime nap.

Research has linked going to sleep on your back after 28 weeks with an increased risk of stillbirth. NHS England includes side sleeping after 28 weeks in its Saving Babies’ Lives guidance.

You do not need to choose the left side specifically. Tommy’s states that good research does not show that sleeping on the left side is safer than sleeping on the right.

Choose whichever side feels more comfortable.

What if you wake up on your back?

Waking up on your back does not mean you have done something wrong.

The NHS advises simply turning onto your side before going back to sleep. The important point is the position in which you settle to sleep, rather than trying to control every movement you make while asleep.

If you frequently roll onto your back, pillows may help you settle more comfortably on your side. Tommy’s suggests placing pillows behind you, while the NHS suggests supporting your bump with pillows and putting a pillow between your knees.

Pregnancy pillows can be useful if you like them, but they are not essential. Tommy’s notes that ordinary pillows can also be used.

Can you sleep on your stomach during pregnancy?

Sleeping on your stomach is generally possible in early pregnancy if it remains comfortable.

Tommy’s explains that sleeping on your stomach in early pregnancy is fine. As your bump grows, the position is likely to become uncomfortable naturally.

If you wake on your stomach later in pregnancy, Tommy’s advises turning onto your side rather than becoming worried about the position you woke in.

Comfort often becomes the deciding factor long before you need to think much about it.

Why am I waking up so often?

There may not be one single reason.

You might wake because you need the toilet, cannot get comfortable, feel too warm or are dealing with pregnancy symptoms. Your baby moving, vivid dreams or simply having more on your mind may also disturb your sleep.

Later pregnancy can make changing position in bed more awkward, particularly if you have pelvic or back discomfort.

If you have pelvic girdle pain, Tommy’s suggests that a pillow under your bump and between your legs may make side sleeping more comfortable. Your midwife can also help you access appropriate support if pelvic pain is making sleep difficult.

Frequent waking can be frustrating, but trying to identify what is actually disturbing you can make it easier to find practical changes that suit you.

What can help you sleep better during pregnancy?

There is no single routine that guarantees good pregnancy sleep, but simple habits may help.

The NHS suggests relaxation before bedtime if you are struggling with insomnia. Relaxation and breathing techniques may also be helpful if anxiety is keeping you awake.

Being active during the day may help you feel more ready for sleep. The NHS recommends staying active during pregnancy where appropriate, while also advising against strenuous exercise close to bedtime if it interferes with sleep.

Your bedroom environment matters too. A room that feels cool, dark and comfortable may be easier to sleep in, particularly because some people feel warmer than usual during pregnancy.

Pillows can also become surprisingly useful. Try them behind your back, between your knees or underneath your bump to see what feels comfortable rather than assuming there is one correct arrangement.

What about naps?

Sometimes a nap is exactly what your body is asking for.

If you are very tired, especially earlier in pregnancy, resting during the day can help you cope with fatigue. However, the NHS notes that sleeping later in the afternoon or evening can make it harder to fall asleep at night for some people.

If naps are affecting your night-time sleep, experimenting with their timing may help.

After 28 weeks, the same side-sleeping guidance applies to daytime naps as it does to sleeping at night.

Caffeine and pregnancy sleep

Caffeine can make falling asleep more difficult, particularly when consumed later in the day.

The NHS advises limiting caffeine during pregnancy to no more than 200mg a day from all sources. Caffeine can be found in coffee, tea, green tea, cola, energy drinks and chocolate, with amounts varying between products.

If you are already staying within pregnancy guidance but sleep is difficult, you may find it useful to notice whether the timing of caffeinated drinks affects you personally.

Do not feel that every poor night’s sleep needs to be solved by changing your diet. Sleep disruption during pregnancy can have several causes.

Rest still matters when sleep is difficult

A difficult night can make the following day feel much longer.

If you can, give yourself permission to adjust your pace rather than expecting exactly the same energy every day. The NHS advises getting plenty of rest when pregnancy tiredness is affecting you.

That might mean going to bed earlier, sitting down more often, accepting practical help or leaving a non-essential task until another day.

Pregnancy tiredness is not a measure of how well you are coping. If exhaustion becomes difficult to manage, however, it deserves a conversation with your maternity team rather than simply being dismissed as part of pregnancy.

When to get professional advice

Speak to your midwife or GP if sleep problems are persistent, you are extremely tired, tiredness is affecting everyday life or you are worried about how you are feeling. Tommy’s advises speaking to your midwife if significant tiredness does not improve, as they may consider whether further assessment is needed.

Also tell your midwife or GP if anxiety, low mood, distressing thoughts or worries are making it difficult to sleep or cope. Support is available during pregnancy, and you do not need to wait until things feel unbearable before asking for help.

Sleep problems should not be used to explain away other pregnancy symptoms. If you experience vaginal bleeding, severe pain, fluid loss or another symptom that worries you, contact your maternity team or seek medical advice according to the guidance you have been given.

If your baby’s movements have slowed, changed or stopped once you normally feel movement, the NHS advises contacting your midwife or maternity unit immediately rather than waiting until the next day.

For an urgent medical problem when you are unsure where to get help, contact NHS 111. Call 999 for a life-threatening emergency.