Pregnancy Sleep Tips: A Trimester-by-Trimester Guide to Better Rest

Pregnancy changes your sleep from the first weeks, and the problems change with each trimester. Early on it's exhaustion and toilet trips. Later it's reflux, a bump you can't get comfortable around, and the advice to sleep on your side. These pregnancy sleep tips are organised by trimester so you can skip to where you are. This guide covers what to expect in each stage, why side sleeping matters from 28 weeks, how to handle reflux and bathroom trips, pillows, your partner's early alarm, and when to talk to your midwife or GP.

The short answer: sleep gets lighter and more broken as pregnancy goes on, so you need more time in bed, not less. In the first trimester, rest when you can and drink your fluids earlier in the day. In the second, build good habits while it's easier. From 28 weeks, go to sleep on your side, either side, for every sleep including naps; if you wake on your back, just roll over. Prop your head up for reflux, put a pillow between your knees, and tell your doctor or midwife about snoring, breathing pauses or restless legs. This guide is general information, not medical advice.

What happens to sleep in pregnancy

The Sleep Health Foundation says that as pregnancy progresses, women have less deep sleep and wake more often during the night, and sleep is less refreshing, which is why expectant mothers should spend more time in bed asleep (source).

Trimester	Common sleep problems	What helps most
First (weeks 1 to 13)	Heavy tiredness, nausea, frequent toilet trips	Earlier bedtime, naps, fluids earlier in the day
Second (weeks 14 to 27)	Often the easiest stretch; leg cramps for some	Build routine, start side sleeping, sort out pillows
Third (weeks 28 to 40)	Toilet trips, reflux, leg movements, bump discomfort, snoring	Side sleeping, head raised, small early dinner, pillow support

First trimester: tiredness and toilet trips

The Sleep Health Foundation notes that many pregnant women feel tired, and this is most common in the first few months.

• Go to bed earlier. Treat tiredness as information. See what time should I go to bed.
• Nap if you can. The Foundation says an afternoon nap of an hour or two will sometimes help.
• Shift your fluids. Drink plenty through the day, taper in the evening, and go to the toilet right before bed. That's the Foundation's advice for cutting night-time trips.

Second trimester: build the habits

Many women find this the most comfortable stretch. Use it.

1. Lock in a wake-up time and keep it within an hour on weekends.
2. Practise sleeping on your side now, before it's required.
3. Sort out your pillows (more below).
4. Mention leg cramps or restless legs. The Sleep Health Foundation notes some women move their legs a lot just as they go to sleep, and that reducing caffeine may help. Restless legs are common in pregnancy and linked to low iron. See restless legs at night.
5. Keep caffeine low and early, within the limits your midwife gives you.

Third trimester: side sleeping, reflux and the bump

Sleep on your side from 28 weeks

This is the one piece of pregnancy sleep advice with safety behind it. Red Nose says that after 28 weeks, sleeping on your back compresses major blood vessels and reduces the supply of blood to your womb and oxygen to your baby, and that sleeping on your side can halve the risk of stillbirth compared to sleeping on your back (source).

The details, from Red Nose and the Safer Baby program (source):

• Left or right, it doesn't matter. Whichever is more comfortable.
• It applies to naps too.
• If you wake on your back, don't panic. Red Nose says it's normal to change position during sleep and many pregnant women wake on their back. Just start on your side when you go back to sleep.
• What counts is the position you fall asleep in.

Reflux and heartburn

Pregnancy, Birth and Baby says you have an 8 in 10 chance of heartburn in pregnancy, because progesterone relaxes the muscle that keeps stomach contents down and the growing uterus pushes upwards (source). Their advice:

• Eat smaller meals more often, and eat slowly.
• Avoid eating for 2 or 3 hours before bed.
• Raise the head of your bed or sleep on at least 2 pillows.
• Watch triggers: big meals, fatty and spicy food, chocolate, citrus juice, caffeine.
• Antacids are described as safe in pregnancy at the recommended dose. Ask your pharmacist which one.

Toilet trips

The baby now sits on your bladder. Fluids earlier, taper in the evening, empty your bladder right before bed.

Snoring and breathing pauses

New snoring in pregnancy is worth mentioning. The Sleep Health Foundation says if snoring is frequent, very loud or interrupts sleep, speak to your doctor or midwife, and if you or your partner have noticed breathing pauses, mention them. See signs of sleep apnoea.

Pillows: what actually helps

You don't need a specific product. You need support in three places. The Safer Baby page suggests a pillow or rolled blanket between your legs, another behind your back, and one under the bump if that feels good.

• Between the knees keeps your hips level and eases back and pelvic pain.
• Under the bump takes the drag off your lower back.
• Behind your back stops you rolling flat.

Your partner's early alarm

By the third trimester you may get to sleep late, be up twice for the toilet, and finally hit deep sleep at 5:30am, exactly when your partner's alarm goes. A loud alarm that wakes you both costs you the best sleep of the night.

• Ask your partner to switch to a silent alarm that only they feel. See wake up without waking your partner.
• Have them dress in another room, with clothes laid out the night before.
• Think ahead. Once the baby arrives, the same silent alarm lets one of you get up for work without waking the other or the baby. See silent alarm without waking baby.

When to see your midwife or GP

Broken sleep is normal in pregnancy. These are worth a call rather than waiting for your next appointment: loud or new snoring, breathing pauses your partner has noticed, legs that won't settle every night, heartburn that is severe or doesn't respond to the steps above, several sleepless nights in a row, or low mood and anxiety keeping you awake. This guide is general information, not medical advice.

Where the Sovune Nudge fits

We make the Sovune Nudge, a silent alarm wristband, so we're not neutral. It's not a medical device and it doesn't help with reflux or side sleeping. Where it fits is protecting the sleep of whoever isn't getting up:

• Silent. Worn by the partner with the early start, it wakes them with a vibration on the wrist, with no sound and no light in the room.
• Each alarm vibrates for a full minute, building through three intensity levels, and only the wearer feels it.
• Three separate alarms, so a backup is set without a second phone alarm.
• Set on the band itself. No app or phone, so the phone can leave the bedroom.
• Under 20 grams and water-resistant for everyday use. It carries straight over to newborn life.

It comes with a 30-day money-back guarantee.

Quick answers

When do I have to start sleeping on my side in pregnancy? From 28 weeks, for every sleep including naps, according to Red Nose. Either side is fine.

What if I wake up on my back when pregnant? Roll back onto your side and go back to sleep. It's normal and expected.

How can I sleep with reflux in pregnancy? Stop eating 2 to 3 hours before bed, eat smaller meals, avoid trigger foods, and raise the head of your bed or sleep on at least two pillows.

Is it normal to be exhausted in the first trimester? Yes. Tiredness is most common in the first few months. Go to bed earlier and nap when you can.

For every type of silent alarm compared, see our complete guide to vibrating alarms in Australia.

See the Sovune Nudge →