Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team — February 2026.
Sleep often changes during pregnancy. Early on, you may feel exhausted. Later, you may feel uncomfortable, restless, or wide awake in the middle of the night. These shifts are common, and happen for many reasons:
- Progesterone, a hormone that supports pregnancy, can make you sleepy during the day. It can also lead to more nighttime wakeups and vivid dreams.
- Your growing uterus shifts your center of gravity. This can strain your back and hips, especially later in pregnancy.
- Physical changes, such as heartburn, shortness of breath, leg cramps, or more frequent trips to the bathroom can interrupt rest, too.
- During the second half of pregnancy, your baby may decide that 2 a.m. is the perfect time for some exercise!
While disrupted sleep is common, there are ways you can safely improve your comfort.
Choosing a safe sleep position
In the first trimester, you can sleep in any position that feels comfortable. The uterus is still small and protected within the pelvis.
After about 20 weeks, it is safest to sleep on your side. Lying flat on your back can press on the inferior vena cava. This is the large vein that carries blood from your lower body back to your heart. Pressure on this vein may reduce blood flow to the uterus and placenta.
While both sides are safe to sleep on, some healthcare providers suggest the left side because of how major blood vessels are positioned.
The most important thing is to avoid spending the whole night sleeping flat on your back in the second half of pregnancy. If you do wake up on your back, roll onto your side and settle back in.
Making side sleeping more comfortable
Pillows are your friends! They can reduce strain and help you rest well. Here’s how it’s done:
- Placing a pillow between your knees can keep your hips aligned.
- Using a small pillow under your abdomen may reduce pulling.
- Putting a pillow behind your back can help prevent rolling.
- Supporting your upper arm may ease shoulder tension.
- Adding a full-length pregnancy pillow can help provide more support.
If you have back or pelvic pain, keeping your spine in a neutral position can help. Gentle stretching before bed may reduce muscle tightness. If pain becomes persistent or severe, talk to your provider about available options, such as physical therapy or acupuncture.
Managing common sleep disruptions
Heartburn is common, especially in the second and third trimesters. That’s because pregnancy hormones relax the muscle between your stomach and esophagus, the tube that carries food. The growing uterus also increases pressure on your stomach. Together, these changes can cause reflux. You can try:
- Avoiding large meals within 2 to 3 hours of bedtime
- Limiting foods that you know will trigger discomfort
These can help, but if heartburn doesn’t improve, talk with your provider about medicine for heartburn in pregnancy.
Leg cramps and restless legs syndrome can also interrupt sleep. The top symptom of restless legs syndrome is an urgent need to move your legs, usually in the evening when you’re lying down on sitting. If this affects your rest, talk with your provider about managing this condition.
You or your partner may also notice more snoring, caused by fluid shifts and weight changes that narrow your airway. In some cases, pregnancy increases the risk of obstructive sleep apnea, a condition in which breathing pauses during sleep. Let your provider know if you have loud snoring, gasping at night, morning headaches, or significant daytime sleepiness. Treatment can support both your and your baby’s health.
Can sleep aids help?
While some sleep aids are safe, always check with your provider before taking sleep medications, melatonin, or herbal supplements. Your care team can help you understand what is safe for you.
In the meantime, you can try to help your body wind down by:
- Keeping to a consistent bedtime and wake time
- Making your bedroom cool, dark, and quiet
- Limiting your screen time before bed
- Practicing light stretching, deep breathing, or guided relaxation
When to reach out
Interrupted sleep is common during pregnancy, but you still deserve support if the symptoms are overwhelming. Reach out to your provider if you have severe insomnia, ongoing heartburn, signs of sleep apnea, or mood changes that affect your rest.
Progyny is here for you, too. Please contact your Progyny Care Advocate for support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.