Sleep problems during pregnancy

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

Why can't I sleep?

In the last three months of pregnancy women may have difficulty sleeping. They might have problems falling asleep, getting comfortable or be troubled by unpleasant dreams and nightmares. Women who were able to sleep a lot in the early stages of pregnancy may find themselves sleeping very little during the final stage mainly because of the many physical changes taking place.

Various physical and mental conditions can disturb sleep.

Leg cramps.

Awareness of their heartbeats and shortness of breath.

Needing to pass urine more often.

A very active baby who seems to be an expert at landing kicks in the mother's bladder or some other tender spot.

Difficulties turning over in bed as the womb gets bigger.

Backache, especially pains in the lower back.

More dreams than usual.

Nightmares that are easier to remember.

Feeling nervous about the forthcoming delivery.

Worries about the baby.

Worrying about whether it's normal to be worried.

These are all common conditions during any pregnancy.

How can I get a good night's sleep?

If you have cramps in your legs, pressing the feet hard against the wall or standing up on the cramped leg will help ease the discomfort. Lack of calcium can make cramps worse, so it's important to get enough calcium through milk products, for example.

A pounding heartbeat or shortness of breath is due to an increase in the volume of blood in the body. If you are anaemic, the heart must do more work in order to transport enough oxygen around the body. Ask your doctor or midwife if an iron supplement might help.

The best resting position when pregnant is to lie on your side with your knees bent. This makes the heart's job easier because it stops the weight of the baby applying pressure to your large veins, which carry the blood back to the heart. It is also much better for your lower back to lie on your side.

If you have pain in your lower back, experiment with extra pillows to see how you can make yourself more comfortable when lying down. For example, try one pillow under your abdomen, one between your legs, a firm one behind your back and an extra pillow under your head.

Wanting to pass urine at night is common during pregnancy because the growing baby puts constant pressure on the bladder. It is probably unavoidable, but trying not to drink too much late in the evenings might help a little. Avoid drinks containing caffeine such as tea, coffee, most fizzy drinks since these stimulate your kidneys to produce more urine and are also mild mental stimulants.

It might also help to lie on your side instead of on your back. If it hurts when you urinate, you might have cystitis, so take a sample of your urine to your doctor or midwife.

The bigger your baby becomes, the more difficult it will be for you to turn over in bed. If this is a real problem, you could consider buying a turning sheet. This is a two-ply sheet with two glossy sides, which makes it easier to turn over because they help reduce friction.

Dreams and nightmares can be disturbing and many women suddenly remember much more of their dreams when they are pregnant. Being in a different state such as pregnancy creates a lot of new material for the subconscious. Talking to someone else about your dreams can help you make more sense of them and can make them less frightening.

If you are afraid of the delivery and the pain it may cause, it is advisable to join antenatal classes. Here you will be told what is going to happen to you and which exercises will be helpful during the delivery. It is also an opportunity to ask questions.

Talk with your doctor or midwife if you are afraid. Almost all women worry now and then whether their child is normal and fear that something could be wrong.

What can I do when I can't sleep?

Remember that sleeping pills are not recommended for pregnant women. If you simply can't sleep, this is not dangerous provided it does not exhaust you.

Instead of just lying there getting yourself in a state, it is much more satisfying and relaxing to get up and do something.

Read a book, listen to music, knit, sew, surf the Internet, write letters, watch TV, have a bath, do some light housework or give yourself a manicure. After doing something pleasant, it is much easier to fall asleep.

Many people benefit from relaxation exercises or from listening to music.

If you feel tired during the day, see if you can take a little nap.

Go to your doctor or midwife and discuss your problem. They can help you find a solution to your problem.

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