Get Better Sleep During Pregnancy: 1st Trimester

Sleeping is crucial to health and well-being, yet many of the rapid physical changes during pregnancy can make it harder to get a good night’s sleep. Around 25% of pregnant people have sleep issues during their first trimester, often related to frequent trips to the bathroom, nausea, and back pain. 

Several strategies are available to help people sleep better during early pregnancy. Talking to a health care professional is also important, as they can assess sleep problems and recommend appropriate tips and treatment.

Adequate sleep during your first trimester, which lasts from the 1st through the 12th week, is essential to a healthy pregnancy. Sleep is important for your mood, ability to handle stress, and to protect your health. And poor sleep in the first trimester has been linked to an increased risk of complications. 

It is common to feel tired during the first trimester. Fatigue during this time is generally related to the changes taking place in the body. Questions about fatigue and sleep during the first trimester and throughout pregnancy should be discussed with a health care provider.

A number of physical changes that occur during the first trimester may affect the length and quality of your sleep. 

Breathing Changes

Changes in your body that occur during pregnancy can affect nighttime breathing. Your blood volume begins to increase in the first trimester, which may contribute to fluid retention in the neck and swelling in the throat when you’re lying down. 

These changes can lead to nighttime breathing problems, such as obstructive sleep apnea (OSA). While OSA is more common in later pregnancy, people in their first trimester still may have a heightened risk. Snoring may also be more likely during pregnancy.

If you or a bed partner notice that you begin snoring, gasping, or choking during sleep in early pregnancy, be sure to mention these symptoms to your doctor. OSA increases the risk of complications for pregnant people and their babies. Treatments like continuous positive airway pressure (CPAP) may be helpful. 

Additionally, nasal congestion often increases during pregnancy. Close to a third of pregnant people experience increased nasal congestion during pregnancy, which can negatively affect their sleep and cause them to breathe through their mouth during the night. Methods of safely alleviating nasal congestion include: 

• Saline nasal spray
• Nasal irrigation via bulb syringes or other methods
• Nasal dilator strips
• Elevating the head of the bed during sleep 

Pregnant people should talk with their doctor before using any over-the-counter medications to help treat nasal congestion. A doctor can discuss whether these medications are safe and effective to use. 

Frequent Urination

In the first trimester, your body amps up the production of the hormone human chorionic gonadotropin or hCG. Higher levels of hCG increase blood flow to the pelvis to support the pregnancy, but may also cause you to urinate more frequently. 

While getting plenty of fluids during the first trimester benefits you and your developing fetus, reducing the amount you drink a few hours before going to bed may help you get out of bed less often during the night. 

Restless Legs Syndrome

Restless legs syndrome (RSL) is a sleep disorder characterized by an irresistible urge to shift the feet and legs when inactive. During pregnancy, about 20% of people develop RLS. The risk of RLS peaks later in pregnancy, but symptoms may begin during the first trimester.

Most people will experience complete recovery from RLS symptoms after pregnancy. A doctor can help determine the best way to manage RLS during pregnancy, which may involve medications and lifestyle changes.

Heartburn

Pregnancy hormones cause your digestive system to slow down and relax the muscle that separates your esophagus from your stomach. And a growing fetus can put pressure on the stomach, pushing food in the wrong direction. Both can contribute to heartburn. 

Heartburn frequently flares up during the evening, which can interfere with sleep. You may sleep better if you avoid heartburn triggers, including: 

• Fried, spicy, or greasy foods
• Citrus fruits and juices 
• Carbonated drinks
• Chocolate
• Peppermint
• Dairy products
• Tomatoes 

Dietary changes alone may not resolve all pregnancy-related heartburn. Talk with your doctor to learn about medications that may help alleviate your symptoms. 

Nausea

The first trimester is usually the worst for nausea and vomiting, although some people have it throughout their pregnancy. Also called morning sickness, pregnancy-related nausea can occur at any time of day or night. Nausea can cause people to wake during the night, leading to sleepiness the next day. 

Some pregnant people find that taking certain steps can help reduce nausea. 

• Avoid an empty stomach: Try eating toast, crackers, and other small, bland snacks. Small snacks at bedtime and during nighttime awakenings may be helpful. 
• Ginger: Research has shown a small anti-nausea benefit to consuming ginger during pregnancy. Ginger products like ginger tea, ginger ale, or ginger candy may help to decrease nausea. 
• Avoid triggers: Different people have different nausea triggers. Common triggers include strong odors, spicy or fatty foods, flickering lights, riding in a car, noise, heat, and humidity. 

Managing nausea and vomiting during pregnancy is especially important because hydration and nourishment are vital for a pregnant person and a growing fetus. If symptoms persist or become more intense, be sure to talk to a doctor. A severe form of morning sickness known as hyperemesis gravidarum may require additional treatment. 

Insomnia

About one out of four pregnant people experience insomnia during the first trimester. This is often due to pregnancy symptoms like nausea, backaches, and needing to use the bathroom frequently.

A number of steps can be taken to alleviate insomnia during the first trimester, including:

• Establishing a regular sleep schedule
• Using the bed only for sleep and sexual activity
• Limiting caffeine
• Creating a comfortable, cool, dark bedroom environment 

It is normal for people to feel stress during major life changes. Pregnant people may feel stressed because of the physical changes that happen during pregnancy or changes in their family, career, and finances. Stress and anxiety have the potential to interfere with sleep. There are a number of ways that may help people cope with stress:

• Learn meditation 
• Try breathing exercises, yoga, or progressive relaxation 
• Engage in gentle exercise, if approved by a doctor 
• Unwind with fun activities

If insomnia persists despite taking steps to improve comfort and sleep hygiene, talk to a health care professional about coping strategies and treatments to make it easier to sleep.

Additional tips may help you rest a little easier during the first few months of pregnancy. Be sure to talk to your doctor about the safety of any measure you are considering to improve sleep, even taking over-the-counter or “natural” products.

Use Pillows

Your body begins to feel different during early pregnancy, with many people experiencing sore breasts and other aches and pains. Extra pillows can help you feel more comfortable during sleep. Some people like to relieve pressures with a special pregnancy pillow, which is designed to support your back and stomach.

Start Sleeping on Your Left Side

During the first trimester, it’s okay to sleep in whatever position you find most comfortable, but experts recommend starting to sleep on your left side with your legs bent when you reach the second trimester, at 13 weeks of pregnancy. Near the end of the first trimester, it may be helpful to start getting used to sleeping on your side.

Keep Cool

Your body temperature may be slightly higher than normal during the first trimester. Keeping cool can help you sleep better, so keep your bedroom temperature around 65 to 68 degrees Fahrenheit. You can also wear cool, loose-fitting clothing. 

Get Some Gentle Exercise

If your doctor approves, exercise can provide many benefits during pregnancy. Exercising at least a few hours before bed is best for promoting healthy sleep. Talk to your doctor about the best exercises for you while pregnant. 

Be Mindful of Exposures

The first trimester is the time when the fetus is most vulnerable to birth defects from chemical and environmental exposures. Therefore, it is important to speak to your doctor about any measures you consider for improving sleep, including herbs and supplements such as melatonin. 

Don’t assume that something is safe because it doesn’t require a prescription, is a vitamin or dietary supplement, or is advertised as “natural.”

Sleep is important for a healthy pregnancy. Your doctor can talk with you about how to sleep better during pregnancy.

It is also important to speak with your doctor if you have recurring sleep issues during pregnancy or sleeplessness begins to interfere with your daily life. They can evaluate your symptoms and suggest a safe approach to getting better sleep.