Having a hard time getting sleep during pregnancy? Understand why you're feeling fatigued and strategies for minimizing discomfort and sleep disturbances. By Mayo Clinic Staff

Pregnancy can take a toll on your body. But as much as you need sleep during pregnancy, it doesn't always come easily. Understand how pregnancy affects sleep and what you can do to rest comfortably.

During early pregnancy, levels of the hormone progesterone soar and your metabolism is running high. This can make you feel exhausted. At the same time, lower blood pressure and increased blood production might team up to sap your energy. If you have another child or children to care for, you might experience even more fatigue.

While fatigue typically lessens after the first trimester, you'll likely feel tired again toward the end of your pregnancy as your baby increases in size.

The key to relieving fatigue is rest. However, many pregnancy symptoms can disturb your sleep, including:

  • Nausea and vomiting
  • Frequent urination
  • Anxiety
  • Back pain
  • Fetal movement
  • Abdominal discomfort
  • Leg cramps
  • Shortness of breath
  • Heartburn

Changes in your respiratory system during pregnancy can also worsen certain conditions, such as sleep apnea.

To minimize discomfort during sleep:

  • Favor your left side. Research suggests that lying on your left side can help improve blood flow to your baby and to your body. Also, try to keep one or both knees bent. Don't worry, however, if you wake up in a different position.
  • Use pillows. To prevent discomfort, consider using pregnancy or support pillows between your bent knees, under your abdomen and behind your back.
  • Elevate your head. Elevating the head of your bed can prevent or decrease heartburn or snoring.

You can take steps to manage sleep disturbances during pregnancy. For example:

  • Maintain a sleep routine. Regularly go to bed and wake up at the same time. If you need more sleep, try napping early in the day.
  • Watch your fluids. Drink plenty of fluids during the day. To prevent frequent urination at night, cut down on how much you drink late in the day.
  • Eat healthy foods. Strive for a balanced diet rich in vitamins. A healthy diet can help you improve your energy levels and keep your pregnancy weight gain on target. To prevent heartburn, eat small, frequent meals and avoid fried foods, carbonated drinks, citrus fruits or juices, and spicy foods.
  • Keep active. Regular physical activity during pregnancy might help prevent excess weight gain and leg cramps, as well as help reduce stress and boost energy. Although exercise is safe for most pregnant women, make sure you have your health care provider's OK before beginning an exercise program.
  • Stretch. Stretching your calf muscles before bed may help prevent leg cramps during pregnancy.
  • Practice relaxation techniques. Breathing techniques, in particular, can help reduce tension.
  • Use nasal saline sprays or mechanical nasal dilators. These can relieve the nasal congestion that often occurs during pregnancy. Also, avoid smoking and exposure to secondhand smoke.
  • Set the mood. A dark, quiet and comfortably cool environment can help encourage sleep.
  • Relieve pain safely. If minor pain caused by muscle stretching or your increased weight during the late stages of pregnancy is keeping you up, occasional use of acetaminophen (Tylenol, others) might help.

If you continue to have trouble sleeping during pregnancy or you're concerned about your fatigue, talk to your health care provider.

Mar. 27, 2013