Sleep problems are very common during pregnancy and can get worse as you’re on the home stretch. It seems very unfair of Mother Nature to let sleep elude you in your third trimester, when you’re at your most tired and so aware of the nighttime feeds ahead of you. Your bump is the largest it’s ever been, making the whole thing feel more real for you and the person you go to bed with, but it is also more uncomfortable to move around and even breathe properly at times. Please don’t worry too much about not sleeping; it won’t harm your baby. Now more than ever you need to be mindful of how much caffeine you're having and when, as it can make a real difference to your sleep.

Why can sleep be more difficult in the third trimester?

There are a number of potential reasons for this. Your bump makes it difficult to find a comfortable position, and the pressure it puts on your bladder wakes you up to go to the bathroom more often. You’ll be finding it harder to turn over properly in bed. The baby isn’t in your sleep cycle and may be moving around when you’re trying to rest. As Dr. Shree explained earlier in this journey, progesterone and other hormone levels peak in this trimester, which can affect your sleep patterns and contribute to restless nights and even insomnia. Pregnancy symptoms like back pain, leg cramps, and heartburn, themselves related to hormones and the size of your bump, also intensify in the final weeks. You may also be feeling anxious about labour and the birth itself, and lying in bed encourages brooding.

Why is it important not to sleep on my back?

At this stage in your pregnancy, you’ve probably been told that going to sleep on your back increases your risk of stillbirth. In the second and third trimesters, lying on your back may compress a major blood vessel that takes blood to your uterus, making you feel dizzy and possibly reducing blood flow to your baby. Sleeping on your side during your second and third trimesters is best. Keep one or both knees bent. Don’t worry too much if you wake up on your back; simply roll back onto your side. For women with symphysis pubis dysfunction or pelvic girdle pain, this can be very hard advice to follow. But however you get comfy on your side, the important thing is that you’re not lying flat on your back, as this is what the research relates to.

How can I sleep better in the third trimester?

Start by developing a good bedtime routine to prepare yourself for sleep.

Try to go to bed at around the same time each night, although, if you are not sleepy, then it can be a good idea to wait until you are - there's a difference between tired and sleepy, and avoid doing anything stimulating beforehand. Try having a bath or listening to a low-effort or boring podcast. If you feel like having sex, then go for it; post-coital sleeps are great. Wake up at the same time as well, even on weekends, as this creates a routine. Both adults and babies thrive on these.

Make your bedroom a sleep (and sex)-only space. Don’t bring work to bed with you, and put your phone away. Make a to-do list for the next day before bedtime if you think you’ll be tempted to get up to tap something into the Notes app. If you’re used to working or scrolling through your phone in the bedroom, the environment will generally be less restful. Keeping the bedroom tech-free could also benefit your intimate relationship.

Make sure your bedroom is at the right temperature (most of us sleep better in slightly colder spaces) and well ventilated. If you’re regularly disturbed by light or noise, use earplugs or a sleep mask.

Use pillows to support your bump and find a comfortable posture. Left-side sleeping enhances blood flow to the uterus and is recommended, but don’t worry too much if you can only get comfortable on your right.

Don’t go to bed until you’re tired. The frustration of tossing and turning can prevent you from drifting off. Although you're bound to feel tired, you still really only need the same amount of sleep you needed pre-pregnancy. Listen to your body. Having a nap in the daytime is crucial if you’re tired, but try to avoid this after 3 p.m. and keep it fairly brief (no more than about 20 minutes), so you can keep your sleep cycle regulated.

Listen to quiet and relaxing music or radio. Anything stimulating can be disruptive. The aim is to distract your mind from day-to-day worries, so sleep will take over.

Try listening to white noise. If you can’t bear the feeling of earplugs, white noise can drown out external sounds.

How can I get comfortable in bed?

Lying down for long periods of time becomes harder on your hips and other pressure points as you get bigger. Try making your bed softer by using a soft mattress topper or simply a spare duvet under your sheet. You may feel more comfortable with extra support. You can try a specially designed pregnancy pillow. In general, having your partner help arrange your duvet and pillows around you until you feel supported should help.

What can I do in the daytime to support restful sleep at night?

Staying active supports your overall wellbeing as well as your sleep, so try gentle exercise. Try not to exercise too close to bedtime, as the endorphin release may disrupt your sleep. Exposure to natural light can also help, so even just getting out for a daily walk will do you good at night.

Antenatal yoga, meditation, and deep breathing exercises can all alleviate stress and promote better sleep. If you’re studying hypnobirthing to use as non-pharmacological labour pain relief, those techniques can help relax you at any time of day or night.

Can I take anything to help me sleep?

It is not recommended to take prescription or herbal pills for sleep during pregnancy. Homoeopathic remedies may be helpful, but always consult with your obstetrician or midwife before taking anything new.

If your sleep is disrupted by chronic pain or the eczema flare-ups that can happen with so much oestrogen in your body, your healthcare team may carefully weigh the risks of prescribing pain relief with codeine or a steroid cream against the harm sleepless nights are doing to your overall well-being.

Your hormones can also cause restless leg syndrome at night. This can also be related to anaemia, so it is vital to report it to your doctor. Pregnant women are also more vulnerable to obstructive sleep apnea, sometimes prompted by hormone-induced nasal swelling. It’s very important to speak up rather than suffer sleep issues in silence and attempt to power through. Taking the best possible care of yourself is taking care of your baby.

Can my partner and I 'bank' sleep before the sleepless nights of new parenthood?

You can’t really stash away extra sleep, as glorious as that seems. In fact, some sleep experts say you’re just “paying off” the sleep debt (caused by a cumulative lack of sleep) you already have when you do lie-in, as well as potentially keeping a good sleep cycle from forming. The prospect of potentially being up all night with a newborn is daunting, but this stage is part of adjusting to life as a new family and won’t last forever. You’ll even look back on it a little wistfully some day, or at least that’s what our mums say.

How can I sleep well in my third trimester?