Sleep Better During Pregnancy: Tips for More Restful Nights
Pregnancy is an incredible journey but let's be honest, getting comfortable enough to sleep can be a challenge. Between frequent bathroom trips, heartburn, aches and pains, restless legs, muscle cramps and not being able to lay on your back, quality sleep can feel impossible.
The good news? While you might not be able to eliminate every nighttime wake-up, there are several things you can try that can make a huge difference!
1. Find Your Best Sleeping Position
As your baby grows (especially after about 20 weeks), your uterus becomes much heavier. When you lie flat on your back, that weight can press on a large vein that helps return blood from your lower body back to your heart.
This pressure may:
Make you feel dizzy or lightheaded.
Cause nausea or shortness of breath.
Reduce blood flow enough to make you feel uncomfortable.
Decrease blood flow to the placenta in some situations.
If you wake up on your back, DO NOT PANIC! Trust me, your body will tell you when it is time to change positions. Many people naturally wake up or reposition before these symptoms even appear. All you need to do if you wake up on your back is simply roll back onto your side and go back to sleep.
One of the most common pregnancy myths is that you must sleep on your left side. While the left side has traditionally been recommended, the good news is that either side is perfectly okay. The best position for your to sleep in is the one that makes you sleep!
2. Use Pillows to Support Your Body
Pillows are going to be your best friend during pregnancy! They can make a huge difference in helping you stay comfortable and get a better night's sleep.
The good news is that you don't need an expensive pregnancy pillow to sleep well. Regular pillows placed in the right spots can provide just as much support.
If you're considering purchasing a pregnancy pillow or if traditional pillows didn’t help enough, the YANA Pregnancy Pillow is one that many of my patients have loved and consistently recommend.
Start simple with pillows you already have and see how your body feels. If you're still struggling to get comfortable, then it may be worth investing in a pregnancy pillow that provides full-body support.
Between Your Knees
Placing a pillow between your knees helps keep your hips, pelvis, and spine in better alignment, which can reduce stress on your low back, SI joints, and pelvis.
One important tip: the pillow should be thick enough to keep your top knee in line with your hip. If the pillow is too thin or too soft, your knee will drop toward the mattress, allowing your pelvis to rotate and potentially increasing discomfort. If you find yourself waking up sore, your pillow may simply not be providing enough support.
Under Your Belly
As your belly grows, its weight can create a pulling sensation through your abdomen and low back. Placing a small pillow, folded towel, or blanket underneath your belly can help support the extra weight, reduce strain, and make side sleeping much more comfortable.
Behind Your Back
If you tend to roll onto your back while sleeping, placing a pillow behind you can provide gentle support and help keep you comfortably on your side.
A pillow behind your back can also be especially helpful if you have hip pain. Instead of lying directly on the outside of your hip all night, you can lean back slightly into the pillow. This takes a little pressure off the hip while still keeping you in a safe side-lying position, often making it much easier to get comfortable.
Hug a Pillow
Don't forget about your upper body! Hugging a pillow supports the weight of your top arm and helps keep your shoulders in a more relaxed position. This can reduce tension through your neck, shoulders, and upper back while also making side sleeping feel more natural and supported.
3. Stretch Before Bed
Just 5–10 minutes of gentle movement before bed can help calm your nervous system and reduce nighttime aches and pains.
A simple bedtime routine may include:
Figure-4 stretch (can be done leaning back on your hands or the couch vs. flat on your back)
Calf stretch if you're prone to leg cramps
The goal is relaxation not increasing flexibility so move slowly and within a tolerable range.
4. Magnesium Before Bed
Many pregnant individuals find magnesium helpful for promoting relaxation, easing muscle tension, and reducing restless legs.
A magnesium spray, lotion or cream applied to the calves, feet, hips, or shoulders before bed can become part of a calming nighttime routine. While research on topical magnesium is still limited, many people report symptom relief.
If you're considering an oral magnesium supplement, discuss it with your obstetric provider first to ensure it's appropriate for you.
5. Create a Wind-Down Routine
Your body thrives on routine, and your nervous system loves consistency. Creating a calming bedtime ritual can help signal to your brain that it's time to slow down and prepare for sleep.
You don't need an elaborate routine, even 15–30 minutes of intentional relaxation can make a difference.
Dimming the lights 30–60 minutes before bed.
Limiting screen time when possible.
Reading a book.
Listening to calming music or a podcast.
Practicing gentle breathing or meditation.
Taking a warm shower or bath.
6. Reduce Nighttime Heartburn
Heartburn and acid reflux are very common during pregnancy, especially as your baby grows and your uterus puts more pressure on your stomach. Symptoms often feel worse at night because lying down makes it easier for stomach contents to move back up toward the esophagus.
A few simple changes can help reduce nighttime discomfort:
Avoiding large meals within 2–3 hours of bedtime.
Limiting spicy, greasy, or acidic foods if they trigger symptoms.
Side sleeping with your upper body slightly elevated using a wedge pillow or adjustable bed.
If heartburn is severe, frequent, or interfering with your sleep, talk with your healthcare provider. There are pregnancy-safe treatment options that can help you feel more comfortable and get the rest you need.
7. Stay Comfortable During Bathroom Trips
Needing to get up to use the bathroom during the night is a normal part of pregnancy. As your baby grows, there is more pressure on your bladder, making those nighttime trips almost unavoidable. While you may not be able to eliminate them completely, a few simple habits can help reduce unnecessary wake-ups.
Stay Hydrated During the Day: It may seem counterintuitive, but don't cut back on your fluids during the day in an attempt to avoid nighttime bathroom trips. Staying well hydrated is important for both you and your baby. Instead, aim to drink most of your fluids during the day and gradually decrease your intake during the last 1–2 hours before bedtime while still meeting your daily hydration needs.
Fully Empty Your Bladder: Many pregnant individuals don't completely empty their bladder before getting into bed, meaning they'll need to wake up again even sooner.
Lean your trunk slightly forward while sitting on the toilet. You can rest your elbows on your knees if it's comfortable.
Take your time, don't rush and don’t push!
Focus on belly breathing and lengthening or relaxing your pelvic floor.
If you feel like there's still urine left, stand up, do a little shimmy then sit back down and try again.
Make Nighttime Trips Easier: Since you'll likely be getting up at least once, make your nighttime routine as easy as possible:
Keep the lights dim to help your body stay in "sleep mode."
Move slowly when getting out of bed to avoid dizziness.
If rolling over is uncomfortable, use the movement strategies described below to protect your pelvis and core.
8. Be Mindful of How You Move in Bed
If rolling over in bed causes pain, don't panic because you're not alone. As your pregnancy progresses, changes in your center of gravity, increased joint mobility, and added pressure on your pelvis can make simple movements surprisingly uncomfortable.
Instead of twisting or rolling "willy-nilly," try this technique to make changing positions much easier.
Scoot Before You Roll: Before rolling over, perform a small bridge by gently lifting your hips off the bed. Then lower your hips a few inches toward the side you're moving away from. This creates enough space so that when you roll, you won't end up too close to the edge of the bed.
Keep Your Knees Together: Bring your knees together before you begin rolling. If it feels comfortable, place a pillow between your knees and gently squeeze it. Keeping your legs together helps reduce stress on your pelvis and pubic symphysis, making the movement more comfortable.
Think "Log Roll": Rather than twisting through your waist, imagine your shoulders, trunk, and hips moving together as one unit, like a log rolling over. Let your knees begin the movement, allowing the momentum of your legs to help guide your hips and shoulders around together. This minimizes twisting through your abdomen and pelvis.
Use Your Arms: As you settle into your new position or get out of bed, use your arms to help push yourself up instead of relying on your abdominal muscles alone. This reduces strain on your core and can make the movement feel much smoother and more comfortable.
9. Don't Fight Every Wake-Up
Pregnancy naturally changes sleep patterns. It's normal to wake several times throughout the night.
Instead of becoming frustrated:
Take a few slow belly breaths.
Avoid checking your phone if possible.
Keep the lights dim.
Return to a comfortable position and allow yourself to relax.
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When Should You See a Pelvic Floor Physical Therapist?
Persistent pain isn't something you simply have to "live with."
A pelvic floor physical therapist can help if you're experiencing:
Hip pain that wakes you at night
Pelvic girdle or pubic bone pain
SI joint pain
Low back pain
Rib pain
Difficulty getting comfortable in bed
Restless muscles due to movement restrictions
Difficulty rolling in bed
Sciatica
Pregnancy-related pelvic floor symptoms
Treatment may include hands-on techniques, individualized stretching and strengthening, sleep positioning recommendations, and movement strategies tailored specifically to your changing body.
Dr. Kellyn Snow
Owner, Doctor of Physical Therapy, CPPS, Pelvic Health Specialist