How To Sleep Comfortably and Safely During Pregnancy

The female body is incredible in the way it continuously adapts to the constant changes of pregnancy. Along with these physical changes and the progression of your pregnancy, you may need to adjust the way you carry out certain everyday tasks such as sleeping. Finding the safest and most comfortable way to sleep can give rise to certain concerns. What is the safest way to sleep whilst you are pregnant and how can you do so comfortably?

The medical community collectively agrees that sleeping on your side whilst pregnant is the safest and probably the most comfortable position. They go on to indicate that sleeping on your stomach is safe during the first trimester. After this it is likely to be too uncomfortable for you and will not be a position you will gravitate to. It is also best to avoid falling asleep whilst lying on your back after your first trimester as this can impact your blood flow resulting in low blood pressure and breathing difficulties. There are also potential risks to your baby.

Making sure that you get enough sleep during pregnancy is important but what should be considered when finding the safest and most comfortable way for you to sleep whilst pregnant?

WHAT MAKES SLEEPING DURING PREGNANCY DIFFICULT?

The constantly shifting hormone levels as well as the new changes in your body often result in difficulty sleeping when you are pregnant. Some of the following can be contributing factors: 

• Nausea and vomiting      
• Increased body temperature   
• Breast tenderness      
• Insomnia    
• Frequent need to urinate      
• Leg cramps or restless leg syndrome 
• Heartburn      
• Lower back pain   
• Trying to find a comfortable position as your bump grows

WHAT ARE SAFE SLEEPING POSITIONS DURING PREGNANCY?

The best way to answer this question is to look at each trimester on its own.   

First trimester:      

• Dr. Sara Twogood, an ob-gyn at the University of California indicates that your sleeping position during the first 12 weeks does not need to change and you can safely continue sleeping the way you did pre-pregnancy.      
• You may, however, notice that certain positions will be more comfortable than others because of bodily changes such as tender and swollen breasts, acid reflux and hot flushes that are already happening. 
• Although there are no restrictions on how you sleep, it is encouraged that you try and get into the habit of sleeping on your side. The earlier you start the habit the easier it will be as your pregnancy progresses.      

• If you have not already started sleeping on your side, it is recommended that you begin to do so.
• Having a firm mattress can help support your back as your tummy continues to grow. Alternatively, you can slip a small cushion or rolled up towel under your tummy to add extra support. 
• This is also a good time to invest in a U or C shaped pregnancy pillow or a wedge pillow. These pillows can be positioned to provide your back with support, comfort your bump and tuck something between your knees to help keep your hips and spine aligned. They also prevent you from rolling over onto your back.     

• It is best to continue sleeping on your side with the pregnancy pillow during the third trimester.      
• Most resources indicate that sleeping on your left side is safest because it promotes blood flow to your heart, kidneys and baby and relieves your uterus of pressure caused by your internal organs.      
• This, however, is not set-in stone as the research surrounding sleeping on your left side does not clearly indicate if there is a difference in safety when compared to sleeping on your right side. 
• Sleeping on your left side does, however, have the added benefit of easing the symptoms of heartburn. Interestingly, sleeping on your right side has the potential of triggering heartburn.

CAN I HURT MY BABY BY SLEEPING ON MY RIGHT SIDE?

Previously it has been indicated that sleeping on your right side could possibly increase your risk of stillbirth, slower foetal growth and place the mother at risk due to high blood pressure. The theory behind this is that the increasing weight of your uterus compresses your aorta (a major artery transporting blood from your heart to the rest of your body) and inferior vena cava (a major vein that runs alongside your spine returning blood from your body to your heart) which would result in reduced blood flow to your baby. 

However, a new study carried out by the University of Utah and published in 2019 indicates that the position you sleep in does not have any negative impact on your baby. The study was conducted on approximately 8700 women and concluded that sleeping on your right side does not put you or your baby at risk of developing serious complications. Important to note is that this study was only conducted on women up until the 30th week of pregnancy. Thus, the results are not valid from 31 weeks and onwards. 

IS IT SAFE TO SLEEP ON MY BACK WHILE PREGNANT?

As your pregnancy progresses in the second trimester, the weight of your uterus and the effect of gravity increases the amount of pressure on your inferior vena cava (a major vein that runs alongside your spine returning blood from your body to your heart). This can cause difficulties with breathing and low blood pressure leading you to feel dizzy or lightheaded. Similarly, the aorta (a major artery transporting blood from your heart to the rest of your body) may also be compressed and can cause shortness of breath and a racing heart.

As the uterus continues to grow, it also exerts extra pressure on your pelvis and back. This can lead to backache which can be aggravated by sleeping on your back. 

Despite the warnings about sleeping on your back while you are pregnant, you do not need to panic or become concerned should you wake up during the night and find yourself lying on your back. Sleeping on your back for 1-2 hours will not cause you or your baby significant harm. You will also likely wake up because you may start feeling dizzy or lightheaded. Making use of a pregnancy cushion or wedge is useful in preventing you from rolling onto your back. 

CAN LYING ON YOUR STOMACH CAUSE MISCARRIAGE?

There are many reasons that a miscarriage can occur and often the exact cause is unknown. Linking sleeping on your stomach to having a miscarriage is difficult to prove. However, research shows that it is safe to sleep on your tummy during the first trimester as your baby is tucked behind your pubic bone and protected from any pressure. The wall of your uterus has also thickened which assists in protecting your baby.

Whilst sleeping on your tummy in the second trimester does not present with any specific risks to your baby, it is likely to be very uncomfortable as your bump continues to grow. If you normally sleep on your tummy and are struggling to adjust to sleeping on your side, you can use a donut shaped pillow to support your bump which may help you sleep more comfortably. A downside of sleeping on your tummy during this period is that there is an increase of pressure on your internal organs and this can aggravate heartburn.

The risks of sleeping on your tummy in the third trimester are higher as an immense amount of pressure will be put on your internal organs and inferior vena cava. As with sleeping on your back, this negatively impacts the blood flow to you and your baby. It is unlikely that you will accidentally find yourself in this position as your ever growing tummy will be in the way and it will be far from comfortable. Sleeping on your side still provides the safest way to sleep whilst you are pregnant.

WHAT SLEEP AIDS ARE SAFE DURING PREGNANCY?

The aches and pains that are sometimes associated with pregnancy can make sleeping challenging. To assist with this, try some of the following:      

• Having a warm bath can assist in relaxing your body before bed and allow you to unwind and soak your sore muscles. 
• Make use of your C or U pillow to support your back and stomach. You can also use normal pillows to prop your tummy and place behind your back.     
• Place a pillow or use your C or U cushion between your legs as this will help align your hips and pelvis and alleviate some of the discomfort.     
• Doing some light stretching before getting into bed can help minimise leg cramps. Do not overexert yourself whilst stretching or place yourself in a position which is uncomfortable or causes you pain.

• Making use of good sleeping habits can also assist in getting a good night's rest:    
• Keep screen time before bed to a minimum as the blue light emitted by devices hampers sleep by making your brain think it is still daytime.      
• Try your best to keep your sleep schedule similar each day. 
• Keep your bedroom as dark and quiet as possible.
• Avoid drinking caffeine or too much liquid close to bedtime. 
• Eat smaller and more frequent meals as this can assist in minimising heartburn. Lying on your left side and slightly elevated is also recommended as your oesophagus is higher than your stomach.    

Resources

https://www.sleep.org/best-pregnancy-sleep-position/

https://kidshealth.org/en/parents/sleep-during-pregnancy.html

https://www.thebump.com/a/safe-sleeping-positions-while-pregnant 

https://www.healthline.com/health/pregnancy/sleeping-positions-inpregnancy#The-takeaway 

https://www.sleepfoundation.org/pregnancy/sleeping-during-2nd-trimester

https://www.parents.com/pregnancy/my-body/can-i-still-sleep-on-my-back-while-im-pregnant/ 

https://parenting.firstcry.com/articles/sleeping-on-stomach-during-pregnancy-is-it-dangerous/