Pregnancy Sleep: Best Positions & Beating Insomnia

Sleep problems affect the majority of pregnant people at some point. Early on, progesterone makes you sleepy by day but can fragment night sleep, and you're up to wee more often. Later, a big bump, heartburn, leg cramps, restless legs, breathlessness and anxiety all conspire against a solid night. None of this means you're doing anything wrong — pregnancy is genuinely hard on sleep.

First trimester

Sleep however is comfortable — your bump is small and there's no position to avoid yet. It's a good time to start getting used to side-sleeping so it feels natural later.

Second + third trimester

• Sleep on your side from 28 weeks. Either side is fine; the left is often recommended to optimise blood flow to the baby.
• Put a pillow between your knees to align your hips, and one under your bump for support.
• Use a wedge or extra pillow behind your back so you don't roll fully flat.
• If you wake up on your back, don't panic — simply turn onto your side. It's the position you fall asleep in that matters most.
• For heartburn, prop your upper body up with extra pillows.

• Keep a consistent bedtime and wake time, even at weekends.
• Build a wind-down routine: dim lights, a warm (not hot) bath, reading or gentle stretches.
• Get daylight and gentle activity during the day — both strengthen your sleep drive.
• Limit screens before bed and keep the bedroom cool, dark and quiet.
• Avoid caffeine from the afternoon and don't drink large amounts of fluid right before bed (cut back in the evening, not all day).
• If you can't sleep after ~20-30 minutes, get up and do something calm in low light, then return to bed when sleepy — don't lie there clock-watching.
• Nap early and briefly (20-30 minutes) if you need to, so it doesn't steal night sleep.

Heartburn

Very common late on. Avoid large or spicy meals close to bedtime, prop yourself up, and ask your pharmacist about pregnancy-safe antacids if needed.

Needing to wee

Reduce fluids in the last hour or two before bed (but stay well hydrated across the day), and lean forward when you wee to empty your bladder fully.

Restless legs + cramps

Restless legs syndrome (an irresistible urge to move the legs) is common in pregnancy and sometimes linked to low iron or folate — worth a mention to your midwife. For night cramps, gently stretch the calf (toes toward you), stay hydrated, and keep moving during the day.

• Loud snoring, gasping or pauses in breathing, or extreme daytime sleepiness — possible sleep apnoea, which is worth assessing.
• Restless legs that are severe — your iron/folate levels may need checking.
• Insomnia driven by anxiety or low mood that isn't improving — perinatal mental-health support helps.
• Any red-flag symptom (severe headache, reduced movements, swelling) is always more important than sleep advice — act on those first.