Pick one suggestion here that feels easy to try tonight. If sleep has been hard and it's affecting how you feel during the day, bring it up at your next appointment.
Why sleep gets so hard right now
A lot is happening in your body, and most of it is working against an easy night. The size of your belly makes it harder to find a comfortable position. Pressure on your bladder means more trips to the bathroom. Hormonal shifts affect the quality of sleep you do get. Your body temperature may run warmer than usual. And for many people, there's worry about the upcoming birth and what comes after it.
Research suggests that by late pregnancy, around 60% of pregnant people experience insomnia, defined as difficulty falling or staying asleep.
What can actually help
None of these suggestions will fix everything. But some people find one or two make a real difference.
Sleeping on your left side is often more comfortable in late pregnancy and is generally recommended by care providers. Nutrients and oxygen flow slightly more easily when you sleep on your left side. Side sleeping (right or left) is safe throughout pregnancy. While sleeping on your back is not recommended later in pregnancy due to the weight of the uterus, if you do wake up on your back, don’t panic — simply reposition and go back to sleep. Pillows can help, either one between your knees and/or one under your belly.
This is exhausting
We understand that advice like this can feel like pouring a cup of water on a house fire, especially when you’re exhausted. Sleep challenges in pregnancy can be really hard, and there isn’t a simple fix.
We don’t want to minimize that experience by offering tips, but the hope is that even small adjustments might bring a bit of relief.
Sleep and your mental health
Sleep difficulty during pregnancy affects your mental health as well as your comfort. Consistently poor sleep is a recognized risk factor for perinatal mood and anxiety disorders (PMADs). That is the clinical term for conditions like depression and anxiety that can develop during pregnancy or after birth. This doesn’t mean struggling to sleep means something is wrong. It means that sleep matters for your mental health.
If you have a personal or family history of depression, anxiety or bipolar disorder, and specifically if you have experienced a psychotic episode, protecting your sleep is especially important. Mention this to your care provider if you haven’t already.
A note on sleep tracking
Apps and wearables that track your sleep can feel helpful. However, some people find that paying close attention to sleep data actually makes things harder. It increases focus on whether you’re sleeping "enough," which can make it more difficult to relax. If tracking is adding to your stress, it’s fine to stop. If you’ve been asked to track your sleep by your health provider, of course, continue to do so, but you can always have a conversation about different ways in which you can/should track your sleep.
One small thing
You don’t need a whole new routine, just one thing to try.
References
This article was developed using sourced educational content from Canadian Perinatal Mental Health Trainings (CPMHT), and informed by the collective knowledge and expertise of CPMHT professionals and Karen Clarke, BA, MSW, RSW, Doula (Open Book Doula, Counselling and Consulting Services), as well as the following cited research and clinical practice guidelines:
Canadian Network for Mood and Anxiety Treatments (CANMAT). Seeds of Hope: Nurturing Mental Health and Managing Perinatal Mood, Anxiety, and Related Disorders. 2024.
Canadian Network for Mood and Anxiety Treatments (CANMAT). Clinician Pocket Guide: Management of Perinatal Mood, Anxiety, and Related Disorders. 2024.
Sleep Foundation. "Pregnancy Insomnia: Causes and Treatment." 2022. https://www.sleepfoundation.org/pregnancy/pregnancy-insomnia.
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