Sleep during pregnancy is one of the most powerful tools you have for your health and your baby’s health, yet it is often one of the first things to slip. Your body is working harder than ever, and a long list of pregnancy changes can get in the way of a good night’s rest. The good news is that you have more control over your sleep than you might think. In this episode, you will find out how sleep actually works and what the research says about poor sleep in pregnancy. You will also walk away with simple, evidence-based tools to help you sleep better tonight, and habits that will serve you well on your adventure into parenthood.

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Why Sleep During Pregnancy Matters

Sleep is not just about feeling rested in the morning. A growing body of research shows that sleep supports nearly every system in your body. This includes learning, memory, mental health, appetite regulation, immune function, metabolism, gut health, and even your cardiovascular health. While you sleep, your body and brain can repair and rebuild. During pregnancy, those demands are higher than at any other point in your life.

Researchers have looked closely at what happens when sleep suffers during pregnancy. The largest analysis on this topic is a systematic review and meta-analysis of 120 studies that included more than 58 million pregnant women. It looked at poor sleep quality, sleeping too little or too much, insomnia, restless legs, and breathing problems during sleep. These sleep disturbances were associated with higher rates of preeclampsia, high blood pressure, gestational diabetes, cesarean birth, preterm birth, larger babies, and stillbirth.

Individual studies echo these findings. For example, research links sleep problems before and during pregnancy with preterm birth, as well as with sleep problems and temperament in children. Evidence also shows that disrupted sleep during pregnancy is linked to increased inflammatory markers. Other research connects poor sleep quality and short sleep with a higher risk of gestational diabetes.

Sleep may also play a role in labor. In one study of 131 women, women in their ninth month of pregnancy who slept less than six hours a night had longer labors and were 4.5 times more likely to have a cesarean birth.

Your sleep also affects your mental health. A study in China found that poor sleep quality in the second trimester was associated with stress and symptoms of depression. A meta-analysis of 16 studies with more than 12,000 women found that sleep disorders during pregnancy were linked to a higher risk of postpartum depression. When the researchers broke this down, poor sleep quality was associated with postpartum depression, but insomnia on its own was not. Some researchers have also proposed that poor sleep could affect the early relationship between mother and baby through fatigue, mood, and hormonal changes. That idea is still a hypothesis and is not proven, but it highlights how connected sleep is to the rest of your life.

If you are still trying to conceive, sleep matters for you and your partner. Evidence suggests that sleep helps regulate the hormones involved in fertility. For partners, one study linked short sleep in men with lower odds of conceiving each cycle, and another found that men with the most sleep disturbances had about a 25% lower total sperm count.

It is important to understand what this research can and cannot tell us. Most of these are observational studies, which means they show an association, not proof that poor sleep causes these outcomes. Many of the same factors that disrupt sleep, like high blood pressure or a higher BMI, can also affect pregnancy outcomes. If your sleep is not great right now, please do not panic. A few rough nights, or even a rough stretch, do not mean something bad will happen. The point of this research is to show how important sleep is during pregnancy, and that the effort you put into your sleep is worth it.

How Pregnancy Changes Your Sleep

Your sleep will likely look different in each trimester. Surveys show that sleep increases in the first trimester, to an average of 7.4 to 8.2 hours. By the third trimester, sleep decreases to an average of 6.6 to 7.8 hours.

Fatigue is most common in the first trimester. This is largely due to a surge in progesterone, a hormone that has a natural sedating effect. At the same time, your blood volume increases, your blood pressure drops, and your metabolism ramps up. All of those changes take energy and lead to fatigue which explains why sleep increases in the first trimester. In the second trimester, many women feel a welcome boost in energy. Then, fatigue often returns in the third trimester as your body carries more weight and sleep becomes more challenging.

Disrupted sleep is extremely common. In a study of 2,427 pregnant women, every single participant reported waking up frequently during the night. In addition, 38% reported not getting enough sleep, and 76% reported poor sleep quality. The point being, if you are struggling, you are not alone.

How Sleep Works

Understanding what drives sleep makes it much easier to understand why the tips we cover in this episode work. Two main systems control when you feel sleepy and when you feel alert.

The first is sleep pressure. From the moment you wake up, a chemical called adenosine gradually builds up in your brain. As more adenosine binds to receptors in your brain, you feel sleepier. Sleep clears it away, which is why you feel refreshed after a good night of sleep.

The second system is your circadian rhythm, which is your internal 24-hour clock. In the morning, your adrenal glands release cortisol. We often think of cortisol as a stress hormone, but it also plays an important role in helping you wake up and feel alert. Later in the evening, as it gets dark, your pineal gland releases melatonin, which signals to your body that it is time to sleep. Light is the most powerful signal your internal clock uses to stay on schedule.

Sleep Stages and Sleep Cycles

Sleep falls into two main categories. REM, or rapid eye movement sleep, gets its name from the quick eye movements that happen during this stage. Most dreaming happens during REM sleep, and it is important for memory, learning, and emotional processing. Everything else is non-REM sleep.

Sleep scientists group non-REM sleep into three stages, called N1, N2, and N3. The N simply stands for non-REM. N1 is the brief transition from wakefulness into sleep. N2 is a slightly deeper, light sleep, and it is where you spend the largest share of your night. N3 is deep sleep, which is when your body does much of its physical repair and supports your immune system.

A typical cycle moves from N1 to N2 to N3, back up to N2, and then into REM. Each cycle takes roughly 90 minutes, and most people go through four or five cycles a night. However, not every cycle looks the same. Earlier in the night, your cycles contain more deep sleep. Later in the night, they contain more REM sleep. This means that if you cut your night short, you lose a disproportionate share of your REM sleep. Every stage matters, so aim to give yourself enough time in bed to get through all your cycles.

How Much Sleep Do You Need?

The American Academy of Sleep Medicine and the Sleep Research Society recommend that adults sleep seven or more hours per night on a regular basis. Regularly sleeping less than that is associated with health problems, including weight gain, diabetes, high blood pressure, heart disease, and depression. There is no separate official recommendation for pregnancy. That said, your body is doing more work than usual, and many women find they require more sleep.

It is also worth adjusting your expectations. From pregnancy through the first years of your child’s life, your sleep will be disrupted in ways you cannot always control. This phase is temporary. In the meantime, the strategies in this episode can help you get the most out of the sleep you do get. You can apply them now, after your baby arrives, and at any stage of life.

Get Bright Light During the Day

Light is the main signal that sets your internal clock. For most of human history, people woke up with the sunrise and spent much of the day outdoors. After sunset, the only light came from fires. Today, many of us spend our days indoors and our evenings surrounded by bright artificial light. This can confuse your internal clock and interfere with melatonin. A large body of evidence supports getting bright light during the day and reducing it after dark.

The most useful time to get light is in the morning. Try to get outside within the first hour or so after you wake up. You do not need to look at the sun, and a short walk or a few minutes outside can work. On an overcast day, you may need to stay out longer because there is less light. Windows filter out a lot of light, so being outdoors is more effective than sitting by a window.

If you wake up before sunrise, turn on bright lights in your home. If you live somewhere with very little natural light, a light therapy lamp may help. Spending time outside throughout the day may also help. In a study of more than 400,000 adults, more time in daytime outdoor light was associated with fewer insomnia symptoms and an easier time getting up in the morning. When you can, take your breaks outdoors.

Keep Your Evenings Dim

Just as bright light during the day helps your internal clock, bright light at night can work against it. Nearly every light source in your home, from overhead lights to phones, tablets, and televisions, can signal to your brain that it is still daytime. In the evening, use only as much light as you need. Lamps are better than bright overhead lights, and dimmer is better than brighter.

Screens are a double problem because they emit light and keep your brain engaged. Ideally, you put your devices away an hour or so before bed. If you do use them, most phones and computers have a night mode that shifts the screen to warmer colors. On an iPhone or Mac, this is called Night Shift. On Windows, it is called Night Light, and most Android phones also have a Night Light setting. For your computer, there is also a free program called f.lux that works on both Windows and Mac. These settings are less effective than turning off your screen, but they are a step in the right direction.

Some people wear blue light-blocking glasses in the evening. The theory makes sense. However, the research on these glasses for sleep is limited and mixed, so think of them as an optional extra rather than a proven tool. Dimming your lights and putting your phone away will do more than wearing blue light-blocking glasses.

If you need to get up in the middle of the night, try to keep the lights low. A dim nightlight in the hallway or bathroom lets you move around safely without flooding your eyes with bright light. Even better if your nightlight has a red bulb. The cells in your eyes that signal daytime to your brain are most sensitive to blue light and much less sensitive to red. In a small study, melatonin recovered under red light but stayed suppressed under blue light. Keeping any light dim is what matters most, but red is the least disruptive choice.

Keep Your Bedroom Dark

Light during sleep matters too. Research shows that light exposure while you sleep can reduce your sleep quality. In a small study of 20 adults, sleeping with the room lights on for just one night led to less deep and REM sleep, a higher heart rate during sleep, and signs of higher insulin resistance the next morning. Another study found that light during sleep was linked to eye fatigue the next day, including tired, sore eyes and difficulty focusing.

Ideally, your bedroom is completely dark. Turn off or cover small lights from alarm clocks, chargers, and electronics. A piece of tape works well for this. If light comes in from outside, blackout curtains can make a big difference. A comfortable sleep mask is another simple and inexpensive option.

Keep Your Bedroom Cool

Another tool you can use is temperature. Your core body temperature naturally drops in the evening, and this drop helps you fall asleep and stay asleep. If you get too warm during the night, you are more likely to wake up. Many sleep experts suggest a bedroom temperature in the mid-60s Fahrenheit, around 65°F (18°C). Everyone is different, and pregnancy can make you run warmer than usual, so adjust based on what feels comfortable.

To keep cool, lower your thermostat at night, use a fan, or open a window. Layers of blankets make it easy to adjust if you get too warm or too cold. Breathable pajamas and bedding can also help.

It sounds counterintuitive, but a warm bath or shower before bed may help you fall asleep faster. Warm water draws blood to your skin. When you get out, that heat escapes, and your core temperature drops. A meta-analysis found that a bath or shower of as little as 10 minutes, taken one to two hours before bed, shortened the time it took to fall asleep. There is some nuance here for pregnancy. You do not need to switch to cold showers out of worry about overheating your baby. However, the studies used water as hot as a hot tub, and during pregnancy you want to avoid raising your core temperature too much. A comfortably warm bath or shower, rather than a hot one, is the way to go. You can learn more about heat exposure during pregnancy in a separate episode.

Wearing socks to bed may work on a similar principle. Warm feet help your body release heat, which is linked with falling asleep faster. One very small study found that bed socks helped people fall asleep sooner, so this is an easy, low-risk thing to try.

Keep Your Bedroom Quiet and Calm

Noise can wake you up or keep you in lighter sleep, even if you do not remember it in the morning. If you live somewhere noisy, a white noise machine or a fan can mask sounds. Earplugs are another option. If your partner snores, this is worth addressing together, since it can affect both of your sleep.

Your bedroom should feel like a sleep sanctuary. The goal is to train your brain to associate your bed with sleep. Reading or a calming routine in bed is fine for most people. However, working, scrolling, or watching TV in bed can keep your brain alert.

Keep a Consistent Sleep Schedule

Your internal clock works best with consistency. Going to bed and waking up at about the same time every day, including weekends, helps keep it on track. You probably use an alarm to wake up. It can also help to set a reminder to start winding down for bed. Many phones have a built-in sleep schedule feature that does this for you.

Everyone has a natural chronotype, which is your body’s preference for when to sleep and wake. Morning larks tend to go to bed and wake up early. Night owls naturally fall asleep and wake up later. This preference is largely genetic, so forcing yourself onto a schedule that fights your natural rhythm can be difficult. When you can, experiment with shifting your sleep window to find what works best for you.

Of course, a consistent schedule is not always realistic with work, other children, or a newborn. As a new parent, flexibility is essential. When you can control your schedule, consistency is ideal. When you cannot, do your best and know that this phase will not last forever.

Build a Bedtime Routine

Every parent will tell you that a bedtime routine helps children fall asleep. The same is true for adults. A routine signals to your brain that it is time to wind down. It can be anything that relaxes you. For example, you might turn off your devices an hour before bed and dim the lights. Then, take a warm shower, put on pajamas, brush your teeth, and read for a few minutes.

What you feed your mind before bed matters too. Intense shows, stressful news, or endless scrolling can keep your brain alert. On the other hand, reading, gentle stretching, journaling, or breathing exercises can help you relax. When you repeat the same steps each night, the routine itself becomes a cue for sleep.

Exercise Regularly

Exercise and sleep support each other. A systematic review found that exercise can improve sleep, and good sleep can help you get more out of your workouts and recover better. For pregnancy specifically, a systematic review and meta-analysis of randomized controlled trials found that women who exercised regularly had significantly better sleep quality.

The American College of Obstetricians and Gynecologists recommends at least 150 minutes of moderate-intensity aerobic activity each week during pregnancy. Moderate activity means moving your large muscles enough to raise your heart rate and start sweating. If exercise is not a habit for you yet, it is never too late to start. Even a daily walk in your neighborhood can benefit you, your baby, and your sleep. You can learn more in the episode on exercise during pregnancy.

You may have heard that you should finish exercising several hours before bed. The research is more reassuring than that advice suggests. A meta-analysis of 23 studies found that evening exercise did not harm sleep in healthy adults. A later review found that intense exercise ending about an hour before bed might delay sleep, while exercise finished two hours before bed may even help. These studies did not include pregnant women. Still, the practical takeaway is that exercising in the evening may be fine, especially if that is the only time your schedule allows you to get in physical activity. If you notice it keeps you up, give yourself a little more time between your workout and bedtime.

Time Your Caffeine

The American College of Obstetricians and Gynecologists advises keeping caffeine under 200 mg per day during pregnancy, which is about one to two cups of coffee. So many things suddenly feel off-limits when you are pregnant, but caffeine is not one of them. There is a lot of nuance here, and many women enjoy a moderate amount of caffeine throughout pregnancy. After your baby arrives, caffeine also passes into breast milk, and babies clear it much more slowly than adults. You can learn more in the episode on caffeine during pregnancy and breastfeeding.

Caffeine works by blocking adenosine, the chemical that builds sleep pressure. When caffeine sits on those receptors, you feel more alert even though adenosine is still building up. Once your body clears the caffeine, that built-up sleep pressure can hit you all at once.

Caffeine stays in your system longer than many people realize. For most adults, it takes about five to seven hours for your body to clear half of it. For example, if the half-life is five hours, about a quarter of your morning coffee is still in your system ten hours later. Pregnancy slows this process even further, and the effect grows as your pregnancy progresses. This means caffeine lingers longer in the second trimester than the first, and longer still in the third.

A systematic review and meta-analysis of 24 studies found that caffeine reduced total sleep by about 45 minutes and increased the time it took to fall asleep. Based on their analysis, the researchers suggested finishing a regular cup of coffee at least 8.8 hours before bed to avoid losing sleep. These studies were not done in pregnancy. Because pregnancy slows how quickly you clear caffeine, an earlier cutoff is a good idea. Morning is the best time for your coffee or tea.

Alcohol and Sleep

The American College of Obstetricians and Gynecologists advises against any amount of alcohol during pregnancy, and the American Academy of Pediatrics states that no amount or type of alcohol is considered safe at any point in pregnancy. The research behind those recommendations is covered in the episode on alcohol during pregnancy and breastfeeding. Still, it is worth understanding how alcohol affects sleep, because this may be helpful at other stages of your life.

Many people feel that a drink in the evening helps them sleep, but that is not really the case. Alcohol is a sedative, and sedation is different from natural sleep. Alcohol disrupts sleep in two main ways. First, it fragments your sleep, so you wake up more often during the night. Second, it suppresses REM sleep, which is important for learning, memory, and emotional processing.

This matters for your baby too. Newborns spend a large portion of their day in REM sleep, which is critical for brain development. There is evidence that alcohol exposure during pregnancy or while breastfeeding can negatively affect a baby’s sleep, especially REM sleep.

Naps During Pregnancy

Naps are very common during pregnancy. In a study of 2,427 pregnant women, 78% reported taking daytime naps. A nap can help make up for lost sleep, but the length and timing matter.

Humans naturally experience a dip in alertness in the early to mid-afternoon. Sleep scientist Dr. Matt Walker, author of Why We Sleep, explains in a TED talk that this makes early afternoon a natural time to nap. He suggests that if you struggle to sleep at night, you may be better off skipping naps. If you do nap, a short nap earlier in the afternoon is less likely to interfere with your nighttime sleep.

There is also research specific to naps during pregnancy. A study of pregnant women found that the number of daytime naps had little effect on nighttime sleep. However, women who napped for more than 90 minutes had somewhat more disrupted and lower-quality sleep at night. In other words, naps can be a lifesaver during pregnancy. If you are tired and have the chance to rest, take it. Keeping naps under 90 minutes may help protect your nighttime sleep.

Closing Thoughts

Sleep is one of the most valuable investments you can make in your health and your baby’s health. Improving your sleep does not happen overnight, and you may need to experiment to find what works best for you. Start with one or two changes, like getting outside in the morning or setting a caffeine cutoff, and build from there.

It is also important to be kind to yourself. From pregnancy through the early years of parenting, your sleep will be disrupted in ways that are outside your control. Focus on what you can influence and let go of the rest. If specific symptoms like heartburn, leg cramps, or insomnia are keeping you awake, the next episode will cover the research on troubleshooting sleep during pregnancy and as a new parent.

Talking to Your Doctor or Midwife

A survey of 423 pregnant women found that only 39% had discussed their sleep with a health care provider at any point during pregnancy. Even among women with moderate to severe insomnia symptoms, only 57% had brought it up. Sleep problems during pregnancy are common, but that does not mean you have to simply live with them. If you are struggling with your sleep, please bring it up with your doctor or midwife. Ongoing sleep problems are worth addressing, and in some cases, poor sleep can be a sign of an underlying issue that is treatable.

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