Why pregnancy disrupts sleep
- Hormones — progesterone is sedating early and contributes to fragmented sleep later; oestrogen affects mood and temperature regulation.
- Physical pressure — bladder, diaphragm, ribs, and the lower back.
- Reflux, which worsens lying flat and is common in the third trimester.
- Restless legs, which has a well-documented association with pregnancy and often relates to iron and folate status — worth raising with your midwife or doctor rather than tolerating.
- Anxiety about birth and parenthood, which is normal and amplifies at night.
What is safe and effective
Position
- Side sleeping, usually left side, becomes standard later in pregnancy.
- A pillow between the knees, one under the belly, and one behind the back.
- A wedge under the upper body if reflux is the problem.
Timing and behaviour
- Reduce fluids in the two hours before bed — while keeping daytime intake high.
- Smaller evening meals, and nothing within two to three hours of lying down if reflux is involved.
- A consistent wake time, even when nights are broken.
- Brief naps earlier in the day rather than long ones late.
Body-based work
Gentle movement is generally safe in uncomplicated pregnancy and is often the most useful thing available for the physical component. The Feldenkrais bedtime routine can be adapted substantially — most of it works on the side or semi-reclined, and the small-range principle suits pregnancy well because it does not involve stretching or strain. Check with your midwife or doctor first, and avoid anything that causes discomfort.
What to avoid
- Alcohol, including as a nightcap.
- Over-the-counter sleep aids and antihistamines unless your clinician has approved them.
- Herbal remedies — "natural" does not mean established safe in pregnancy; check each one.
- Melatonin: discuss with your clinician; data in pregnancy are limited.
Special note on restless legs
If you have crawling, aching, or urge-to-move sensations in the legs that are worse at rest and relieved by movement, mention it specifically. It is common in pregnancy, it is a real and legitimate cause of misery, and it is often related to iron status that can be checked and addressed.
After the birth
New-parent sleep is a different problem — fragmented by design rather than by disorder. Protecting the parent's sleep in shifts, and accepting that consolidation is not available for a while, is the realistic approach. Sleep restriction and stimulus control are not appropriate in the first months.