Sleep deprivation during pregnancy

Everywhere you turn, you hear the exact same thing: “Sleep now, while you can”. However, for most of us, there is always something in pregnancy that makes this advice impossible to follow. Find out what’s going on inside your body and what you can do to make peace with your pillow.

So what’s keeping you up?

Back and muscle pain

During pregnancy, the ligaments in your body become looser so that your uterus can expand and eventually allow baby to fit through your pelvis during delivery. Consequentially, this causes achy joints. Once you add the weight of the baby to the mix, your back, especially the joints between your spine and pelvis called the SI joints, are begging for a break. 

Frequent stretching can often relieve some of this pain; simply round your back around your bump with your chin and knees tucked in, hold for a few seconds then release. 

Finish by placing your hands on your lower back and arch slowly. During the night, you want to make sure there isn’t any added strain on the joint that aches. Body pillows that support your bump and your upper leg to align your hips can often take the pressure off your lower back. If the pain still isn’t gone, Tylenol, as opposed to Advil, is safe to take.

Heartburn

Your enlarged uterus places pressure on your stomach and increases the time it takes for your stomach to empty. Also, like your ligaments, the valve between your stomach and esophagus becomes more lax, allowing food and acid to travel up into your esophagus. Try not to eat at least two hours before bed. Avoid caffeine (including chocolate), spicy foods and greasy/fatty foods as much as possible and sleep with two pillows instead of one. 

Frequent Urination

What you may have noticed is that you started peeing more frequently even when your baby was the size of a blueberry. Clearly at this stage, it’s not the weight of the blueberry on your bladder causing you to pee every hour. Even in early pregnancy the blood flow to your kidneys increases, resulting in frequent urination. As baby grows, so may your urge to urinate at night. Try decreasing the amount of drinks that act as a diuretic such as coffee and tea. Also, lean forward when you pee to assure you have completely voided at each bathroom visit. 

Shortness of Breath

As your baby grows, your diaphragm has less room to expand to take in breath. Also, your blood becomes more dilute, putting you at risk for anemia which can also cause shortness of breath. 

At night, you may become short of breath when lying flat on your back or even on your right side. 

This is because a large vein called the IVC runs up the right side of your abdomen to your heart. Lying on your back or right side can sometimes obstruct this vesicle leading to diminished blood flow back to your heart, causing shortness of breath. Try lying on your left side with your back extended. Always tell your physician if you experience shortness of breath as this may be a sign of a more serious condition.

Leg Cramps

Leg cramps often occur in second and third trimester. The physiological reason for this is complicated and not well understood, but can involve low calcium and high phosphate levels. The added weight of pregnancy and inadequate potassium intake may also play a part. If you drink a lot of milk, try cutting back. Although milk contains high levels of calcium, it is also rich in phosphate. Try eating potassium rich foods such as baked potatoes, avocados, spinach and bananas. Also, make sure to keep hydrated with plenty of water and stretch your legs out before bed and when you wake up. Do not take any supplements unless recommended by your physician.

In the end, just try to remember that lack of sleep is just the first of many sacrifices that you will make for your sweet baby. Every ache, every burn and every restless night is worth it a million times over just to hear their first cry.

What’s keeping your partner up?

Snoring

A common partner complaint at night is snoring. In pregnancy, your airways become floppier and congestion can increase. This, along with the added weight, can lead to snoring. Sleep on your side instead of your back, avoid alcohol and smoking (which you have hopefully already done), and avoid a large weight gain by eating healthy and exercising. If your partner notices periods where you stop breathing, make sure to alert your physician immediately. This may be a sign of obstructive sleep apnea (OSA), which can be quite dangerous to you and your baby.

Frequent Positional Changes

With everything already mentioned, it is not surprising that you may toss and turn throughout the night when you’re pregnant. For your own comfort, as well as your partner’s, make sure you follow the above advice on back and muscle pain. Also, when rolling from one side to the other, you can try lifting your belly with your hands for a smoother transition.

Originally published in December 2013. Updated in September 2023.