Resting for Two: Why Sleep Matters So Much and Six Tips for Better Sleep
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If pregnancy is keeping you up at night, you’re not alone. Studies show, 66% to 97% of pregnant people have problems getting enough quality sleep (Morales et al. 2025).
Having trouble sleeping is common, but you shouldn’t have to suffer in silence. Too often, people think they have to accept that sleeping poorly is part of pregnancy. Yet, studies have shown that not getting enough quality sleep can lead to health complications for pregnant people and their babies. Recognizing this is a problem we don’t have to live with is the first step. Taking simple actions to address the problem is the next step—and we’re here to help you do just that!
In this blog, we’ll explore common sleep problems and who’s most at risk, explain potential health complications, and then give you six simple strategies for getting better sleep.
Common Risk Factors
Most pregnant people have some trouble sleeping, but certain things can make it more likely. Here are a few factors that increase your risk:
- Age—if you’re older than 35
- Health history—if you have high blood pressure, diabetes, or breathing issue (like asthma)
- Family history—if your parents or siblings have sleep issues, especially insomnia or restless leg syndrome
- Multiple pregnancy—if you’re having twins, triplets, or more
- Previous pregnancies—if you have been pregnant before
- Weight—if you are overweight or obese
- Mental health—if you’re dealing with stress, anxiety, or depression
- Nutrition—if you’re not getting enough of certain vitamins and minerals like iron, magnesium, or zinc
- Lifestyle factors—if you smoke, drink alcohol, or use illegal drugs
Common Sleep Issues
While there are many ways sleep changes when you are pregnant, problems generally fall into three main categories: insomnia, restless leg syndrome (RLS), and sleep-disordered breathing. These issues can start for the first time during pregnancy, or they might get worse if you already had them.
Insomnia is the most common sleep complaint. If you have insomnia, you may have a hard time falling asleep, or you may wake up a lot during the night, or you may wake up too early and then have trouble getting back to sleep. When you don't get enough sleep, your body doesn't have the chance re-energize and repair itself from the work it does during the day.
Restless leg syndrome, or RLS, is another common sleep problem. If you have RLS, your legs may feel uncomfortable and tingly, and you may feel like you must move them to get rid of the discomfort.
Sleep-disordered breathing includes everything from occasional snoring to a condition called obstructive sleep apnea, which happens when the airways narrow or collapse during sleep making it hard to breathe (or even pause breathing temporarily). The risk of obstructive sleep apnea increases during pregnancy because of other physical changes happening to the body, including hormonal changes, swelling, and weight gain. Long-term obstructive sleep apnea can cause heart and lung problems, so if you experience it, discuss treatment options with your healthcare provider.
How Sleep Issues Change in Each Trimester
The changes your body goes through to support your baby’s development at different stages of your pregnancy can affect your sleep in different ways. Trouble sleeping at night and feeling tired during the day are common. And, as your baby grows, the gap between the amount of sleep you need and the amount of sleep you get widens. Knowing what to expect, how to deal with common issues, and when to talk to your healthcare provider can help keep you and your baby healthy.
During the first trimester, hormonal changes can make you feel really tired during the day, even though you might be sleeping more than usual. Hormonal changes can also cause morning sickness, which can actually leave you feeling sick at night, too. At the same time, it is common to have to wake up at night to urinate, as the kidneys are producing more urine and as hormonal changes are changing the way your bladder functions. And, as your uterus gets bigger, it puts pressure your bladder, which can make you need to urinate more frequently, especially at night. Together, all of these changes can make it hard to get the sleep your body needs—especially as your body is spending more energy supporting your baby’s rapid growth during this time.
During second trimester, you may find it easier to rest, as your hormones stabilize, which can help with the drowsiness and morning sickness. But, as your baby keeps growing, getting comfortable enough to get good sleep gets harder. Figuring out how to deal with this challenge at this stage is important, as it can help prepare you for new sleep challenges common in the final months of your pregnancy. It’s important to know that most doctors recommend against sleeping on your back during the second trimester.
During the third trimester, you may experience back pain, the pressure on your bladder gets more intense, and your baby starts moving a lot more—and all of these things can make sleeping harder. RLS and sleep apnea are also most common and severe during this trimester. In addition to these physical issues, you may also start feeling more anxious about labor and delivery, which can also lead to insomnia.
Potential Health Complications
More and more studies are showing that lack of quality sleep may be linked to complications for both moms and babies. For you, complications include (Kember et al. 2023):
- Anxiety, depression, and stress
- High blood pressure and preeclampsia
Sleep issues may also be linked to having a baby with low birth weight (Kembler et al. 2023 and Morales et al. 2025). And, if you have sleep issues, you may be more likely to need a cesarean section and your baby may need extra care in a neonatal intensive care unit, or NICU (Kembler et al. 2023 and Morales et al. 2025). In severe cases, sleep issues can also increase the risk of a stillbirth (Kembler et al. 2023 and Morales et al. 2025).
Six Tips for Better Sleep
Sleep is vital for everyone, and it is particularly important during pregnancy. When you sleep better, your body—and your baby—benefits. If you’re struggling to get the sleep you need, simple changes to your room and your routine can help.
- Set a sleep schedule—and stick to it.
Make a plan to go to bed and wake up at the same time every day. If you need to nap, be sure to do so early in the day so you can stick to your nightly sleep schedule. And, don’t oversleep. Rest as much as you need to feel refreshed—not more. This will also help you stick to your schedule.
- Get into a routine of getting ready for sleep.
Think about activities you find enjoyable and relaxing—such as journaling, meditating, or reading. Then, set aside time before bedtime for these activities.
- Get your room ready for sleep.
You’re more likely to get good rest if your room dark, quiet, and cool (but not too cold). There are lots of options to optimize your bedroom—from blackout curtains and sleep masks to sound machines and fans. And get the screens—computers, phones, televisions—out of the bedroom. It might be hard at first, but these devices can make it harder for you to fall sleep.
- Nourish your body.
Avoid alcohol, caffeine, nicotine, and heavy meals and spicy foods—especially close to bedtime. Drink plenty of water throughout the day, but cut down in the evening to keep from waking up to urinate. And get regular exercise, just not right before bedtime. These are great tips on their own, and they work even better together, as they can help you maintain a healthy weight.
- Sleep safely and comfortably.
Sleeping on your side, especially you left side, is ideal during pregnancy. This position not only helps with backaches, it’s also safest for you and for your baby. Using extra pillows—particularly between your knees and under your belly—can help you feel comfortable and supported. Try a full-body pillow—it may become your new bedtime best friend.
- Don’t stress about sleep.
When you’re having trouble falling asleep, or falling back asleep after waking in the middle of the night, it’s easy to stress—but that stress is likely to make the situation worse. Here’s what you don’t want to do: don’t toss and turn endlessly; don’t watch the clock. Instead, get up. Leave the room and find something to do to distract yourself from worrying— just make sure it’s something relaxing. Then return to bed again after a short time.
When Self-Care Is Not Enough
If you’ve tried all the tips listed above and are still having trouble sleeping, ask your healthcare provider for help. Depending on your particular need, your healthcare provider may recommend one or more of the following:
- Cognitive behavioral therapy, or CBT, can help treat insomnia and improve sleep habits.
- Medication is available to treat insomnia and restless leg syndrome.
- Medical devices, such as continuous positive airway pressure (CPAP) machines can help with sleep-disordered breathing.
Start Getting Better Sleep Tonight
Remember: Rest is not a luxury. It is a key piece of your pregnancy health puzzle. BobiHealth is here to help you get the sleep you need.
Download the BobiHealth App now and start tracking symptoms like fatigue in real-time and to access more tips and other information to stay healthy throughout your pregnancy journey.
Useful Terms
Here are definitions of a few terms we used in this blog. It may be helpful to read these definitions so you know what they mean if your healthcare provider uses these words with you.
Cognitive behavioral therapy (CBT): Cognitive behavioral therapy is a form of talk therapy that involves identifying and adjusting a person’s behaviors, emotions, and thoughts—essentially teaching skills to replace negative thoughts with healthier thoughts.
Insomnia: Insomnia is a common sleep disorder that can make it hard to fall asleep or stay asleep and it also can cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. Insomnia can drain your energy level and affect your mood.
Obstructive sleep apnea: Obstructive sleep apnea is a common sleep disorder that involves difficulty breathing. This happens when the airways of the throat are blocked, and can leave a person gasping for breath or snoring loudly. In some cases, it can cause your brain to wake you up to breathe, leading to poor sleep quality and daytime fatigue.
Restless leg syndrome (RLS): RLS is a muscle and nerve condition that causes uncomfortable sensations (aching, tingling) and creates an overpowering urge to move your legs. RLS often affects people at night, making it difficult to sleep.
