Tips and best sleeping positions for when you’re pregnant

Tips and best sleeping positions for when you're pregnant

Pregnancy is a remarkable journey, but it can also be challenging for a woman’s body. As the baby grows, the mother starts to feel discomfort. One of the biggest problems many pregnant women face is having trouble sleeping. 

Insomnia during pregnancy is a common concern, with approximately 42.4% of pregnant females experiencing insomnia in the third trimester of pregnancy. The hormonal changes, physical strain, and anticipation of motherhood contribute to sleep disturbances during pregnancy. From nausea and breast tenderness to leg cramps and vivid dreams, the list of sleep disruptors is extensive. 

Finding a comfortable sleeping position can become even more difficult as the delivery date approaches. Expectant mothers must prioritise sleep, as it plays a vital role in maintaining the health of both mother and baby. This article explores common sleep problems during pregnancy, the best sleeping positions for pregnant women, and tips to ensure restful sleep for pregnant females.

Best sleeping position during pregnancy

Sleeping on the side is widely recommended during pregnancy. Here are the reasons why sleeping on the side is beneficial for both mother and baby:

Blood flow optimisation: The left-side sleeping position is considered ideal for sleeping during pregnancy due to its impact on blood flow. The inferior vena cava (IVC), a large vein in the human body, runs parallel to the spine on the right side. When a pregnant female lies on her left side, the IVC remains unobstructed, allowing optimal blood circulation. This improved circulation facilitates the efficient delivery of oxygen and nutrients to the mother and developing foetus.

Pressure relief: Sleeping on the side can relieve pressure on the mother’s liver and kidneys. It decreases the risk of issues such as swelling in the hands, ankles, and feet.

Reduced back pain and heartburn: Pregnancy often brings discomfort, especially in the lower back. Sleeping on the side, particularly the left side, can help to maintain proper spinal alignment and reduce back pain. Additionally, this position can reduce the frequency and severity of acid reflux and heartburn, which are common during pregnancy due to hormonal changes and the growing uterus.

Sleep positions to avoid during pregnancy

To ensure the well-being of both the mother and the developing foetus, pregnant women should avoid certain postures:

Avoid sleeping on your back

A supine sleep position (sleeping on the back) is generally considered safe during the first trimester. However, it carries significant risks after the 28th week of pregnancy and should be avoided in the third trimester. Sleep on your back can increase the risk of stillbirth and can cause a reduction in ejection fraction and cardiac output.

Increased risk of stillbirth

Sleeping on the back after 28 weeks of pregnancy can potentially double the chances of stillbirth during the later stages of pregnancy. The proposed mechanism behind this increased risk is due to the impact of the mother’s sleeping position on the flow of blood and oxygen to the developing baby. 

When a pregnant woman lies on her back, the weight of the growing uterus can compress major blood vessels, potentially reducing the supply of vital nutrients and oxygen to the foetus. This disturbance in blood flow and oxygen delivery increases the risk of stillbirth.

Maternal haemodynamics and cardiac output

Lying flat on the back during pregnancy can cause a reduction in ejection fraction and cardiac output. The compression of the enlarged uterus on the Inferior vena cava affects blood return to the heart, which can result in a condition known as supine hypotensive syndrome. This can cause foetal heart rate decelerations and even foetal growth restriction.

Other issues sleeping on your back can cause

In addition to the increased risk of stillbirth, sleeping on the back during pregnancy can also contribute to other complications, such as:

  • Backache
  • Low blood pressure
  • Reduced blood flow to the kidneys and liver
  • Exacerbate issues like swelling, headaches, and heartburn

Avoid sleeping on the stomach

Stomach sleeping is fine until pregnancy reaches up to 16 weeks. As the baby bump expands, expectant mothers find it difficult to find a comfortable position when lying on their stomachs. This sleeping posture can negatively affect both the mother’s and the baby’s health and well-being. The weight of the growing uterus and developing foetus places pressure on the mother’s back and abdomen, compromising her breathing and circulation.

How to find a comfortable sleeping position

Pregnancy brings many physical changes that can make it hard for expectant mothers to get good sleep. As the baby grows, the increased weight and shifting of the body’s centre of gravity can cause discomfort and make it difficult to rest. There are several strategies that pregnant females can use to increase their comfort and sleep:

Bending the knees for support

One effective technique is to bend the knees while lying on the side, preferably the left side. The expectant mother should gently draw her knees towards her chest and place a pillow between her knees to provide additional support and maintain proper pelvic alignment. It will take pressure off the lower back and pelvis and reduce pressure on the sciatic nerve. 

Utilising pillows for targeted relief

Pregnant women should use pillows for comfortable sleep. Pillows offer targeted support, relieve pressure points, and enhance overall comfort. Expectant mothers can experiment with different pillow placements, such as under the belly to support the growing baby’s weight, between the legs to maintain hip alignment, and behind the back to prevent rolling onto the back during sleep.

Investing in a supportive mattress

A high-quality, supportive mattress is crucial for pregnant females. The right mattress can help to ensure proper spinal alignment, minimise discomfort, and reduce the risk of pressure sores. Expectant mothers should look for a mattress with a medium-firm feel, providing the right balance of support and contouring to accommodate the changing body shape. 

Materials like memory foam and latex, which adjust to the body’s curves, are can be helpful for relieving pain. Additionally, as the belly expands in the later stages of pregnancy, strong edge support facilitates easier entry and exit from the bed. 

Elevating the upper body for comfort

Raising the upper body can help to improve common pregnancy-related discomforts, such as heartburn, acid reflux, and shortness of breath. It can be achieved by using extra pillows to prop up the head and shoulders or by investing in an adjustable bed frame that allows for the elevation of the head section.

How to sleep better during pregnancy

Adequate sleep is vital for overall health and well-being, particularly during pregnancy. However, hormonal changes, physical discomfort, and anxiety can disturb sleep patterns for expecting mothers. Here are a few strategies to sleep better during pregnancy:

Breathing Exercises: Pregnancy can lead to shortness of breath. Techniques like the 4-7-8 breathing method (inhalation for 4 seconds, breath holding for 7 seconds, and exhalation for 8 seconds) can regulate breathing patterns and promote relaxation for improved sleep.

Caffeine Management:  Avoiding caffeine is generally recommended for foetal health; it can also negatively impact sleep quality.  Consider eliminating or significantly reducing caffeine intake, particularly in the afternoon and evening. Explore calming herbal teas as an alternative before bed.

Regular Exercise: Engaging in moderate exercise during pregnancy can significantly improve sleep quality. Prenatal yoga or brisk walks can help reduce stress and promote feelings of tiredness, leading to better sleep.

Optimise Sleep Environment: The bedroom should be cool, dark, and free from electronic distractions. The pillow and mattress should be comfortable and support better sleep.

Consistent Sleep Schedule: Establish a consistent sleep schedule, even on weekends. It helps to regulate your body’s natural sleep-wake cycle.

Reading a Book or Journal: Reading creates a calm environment and avoids blue light exposure from electronics, which can disturb sleep patterns. Consider keeping a pregnancy journal to express worries and anxieties before bed; it will help to prepare for better sleep.

Listening to Relaxing Music: Music regulates hormonal levels, including cortisol (the stress hormone). It decreases cortisol levels, which releases stress. When creating a playlist, choose music with 60-100 BPM to mimic normal heart rates and avoid songs with strong emotions.

Mindfulness and Meditation: Meditation techniques combine mental and physical aspects of our health. Yoga and mindfulness meditation involve focusing on the present and allowing yourself to experience emotions and thoughts without judgement. It releases stress and promotes better sleep.

Additionally, certain medical conditions, such as sleep aponea, can worsen during pregnancy and disturb sleep. If you experience excessive daytime sleepiness or difficulty breathing at night, consult your doctor to rule out any underlying sleep disorders.

Why is sleep so important during pregnancy?

Quality sleep is essential for expectant mothers and their developing babies. While adequate rest benefits everyone, it becomes even more important during pregnancy due to unique physiological changes and increased demands on the body. Here are the few benefits of quality sleep in pregnant women:

  • It supports overall health, including immune function, metabolism, and tissue repair.
  • It plays a role in foetal growth and development.
  • It Impacts mood regulation, stress management, and emotional stability.
  • It enhances memory consolidation and decision-making.
  • It helps to maintain hormonal balance and reduces the risk of complications.

What to do if you just can’t sleep?

If you find yourself struggling to sleep during pregnancy, consider the following strategies:

  • Avoid caffeine as it affects both you and the baby.
  • Create a relaxing bedtime routine such as reading a book, taking a warm bath, or practising relaxation techniques.
  • Limit screen time and especially avoid screens before bed.
  • If awake for over 30 minutes, get out of bed and spend some time doing a calming activity.

Pregnancy is a very personal and important journey for every mother and sleep can be hard to come by with all the other stresses of life in the mix. So, it’s important to remember that you’re not alone. If you need more guidance or information on improving your sleep during pregnancy, please read my articles on overcoming insomnia, finding the perfect sleep position, and how insomnia affects women.

As a leading sleep physician and psychiatrist, we offer consultations for those experiencing poor sleep. I have had the pleasure of helping many women deal with poor sleep during their pregnancy. Please contact me if you require further advice on how to fall asleep or are struggling for other reasons. 



The articles in the Sleep Psychiatrist blog have been written by Dr Dipesh Mistry. They are for educational and informational purposes only, and should not be regarded as medical advice. Always seek advice from your sleep physician, personal physician, psychiatrist, or any other suitably qualified healthcare professional in relation to any interventions or treatment for your sleep, mental health or physical health.

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