Pregnancy & Newborn

Sleep During Pregnancy: Positions, Insomnia, and Snoring

If sleep has gotten harder since you became pregnant, you're not imagining it — an estimated 78% of pregnant women experience some insomnia along the way, and you're in very good company.

By the Nooma Editorial Team 16 min read Reviewed July 8, 2026

A pregnant woman asleep on her side with a pillow supporting her bump and another between her knees

Why sleep gets harder — and why it’s worth protecting

More than half of pregnant people report general trouble sleeping, and the numbers back that up in more specific ways too — in one 2017 study that followed 782 pregnant women, 28% were sleeping fewer than seven hours a night by the second trimester. Insomnia has a specific clinical meaning here: trouble falling asleep, trouble staying asleep, or waking earlier than you meant to despite having the chance to sleep more. If that’s happening three or more nights a week, it’s genuinely worth mentioning to your prenatal care provider rather than assuming it’s just part of the deal.

It’s worth protecting your sleep for reasons beyond how tired you feel the next day. Research has connected poor or short sleep during pregnancy to a higher likelihood of gestational diabetes, weaker immune function, preeclampsia, preterm delivery, and depression. Sleep quality and duration later in pregnancy have also been associated with how long labor lasts and the type of delivery a person has. These are population-level associations, not a prediction about any one pregnancy or any one rough night — but they’re a good reason to treat your sleep as something worth real attention, not the thing you sacrifice first.

A long list of things can chip away at sleep during pregnancy: shifting hormones, physical discomfort in your back, pelvis, or round ligaments, heartburn, needing to pee more often, stuffy sinuses, restless legs, and the very real anxiety that comes with anticipating an entirely new role. Sleep and mental health are closely tied together here too — conditions like depression, anxiety, and PTSD are strongly linked with sleep trouble and insomnia during pregnancy, and the relationship tends to run in both directions.

What changes, trimester by trimester

What’s keeping you up at 9 weeks is rarely what’s keeping you up at 33 weeks. Here’s roughly what tends to show up when, and what tends to help.

First trimester: nausea, hormones, and fatigue

In the early weeks, rising levels of hCG and progesterone commonly bring on nausea, vomiting, and a kind of daytime fatigue that can feel almost disorienting — paired, frustratingly, with trouble sleeping at night. Tender breasts, more frequent bathroom trips, and a new wave of anxiety about the pregnancy and the parenting ahead can all pile on top of that.

Ease up on fluids in the hour or two before bed to cut down on nighttime bathroom trips.
Put screens away before bed — blue light can suppress your body’s melatonin production and make it harder to fall asleep.
Keep a light snack, like crackers, on your nightstand for nausea that flares up overnight.
Only get into bed once you actually feel sleepy, rather than forcing an early or fixed bedtime.
Start a calming pre-sleep routine now — meditation, breathing exercises, reading, or gentle stretching — even this early, it’s worth building the habit.

Second trimester: heartburn, a growing belly, and restless legs

For a lot of people, the second trimester brings a bit of an energy rebound — but sleep can still get complicated by heartburn, a belly that’s changing your usual sleep position, and restless leg syndrome. This is usually around when stomach sleeping stops being realistic and side sleeping starts to feel both more comfortable and more necessary.

Avoid eating right before bed and lean toward smaller, more frequent meals through the day — heartburn tends to worsen when you’re lying flat on a full stomach.
If restless legs are keeping you up, some light daytime exercise (even a short walk) and gentle stretching before bed can help ease the sensation.

Third trimester: a bigger belly, aches, and practice contractions

By the third trimester, a larger belly, pelvic pain, back pain, and rib discomfort from your baby’s movement are all common reasons for a rougher night. Later in this stretch, you may also start noticing irregular practice contractions — your body’s way of warming up for labor — and they can become uncomfortable enough on their own to pull you out of sleep. If you ever suspect what you’re feeling has shifted from practice contractions into real labor, contact your obstetric provider promptly rather than waiting to see how the night goes. If it turns out not to be labor, that’s also a good moment to ask your provider about ways to sleep more comfortably through the practice-contraction discomfort itself.

Surround yourself with pillows, or use a maternity pillow, to support your back and belly and help keep you from rolling onto your back overnight.
Stay well hydrated during the day, rather than concentrating your fluids at night — it helps head off nighttime leg cramps.
A pillow between your knees while side sleeping keeps your hips aligned and eases pelvic pressure.
Pace your activity through the day — overdoing it can leave your back and pelvis achier by nightfall.

Finding your best sleep position

You may have heard that the left side is the side to sleep on during pregnancy. That specific guidance traces largely to an older, small study that linked sleeping in positions other than the left side to worse outcomes for babies. Since then, larger and more rigorous studies have told a more reassuring story: a study published in the journal Obstetrics and Gynecology that followed pregnant women through roughly 29 to 30 weeks, along with a separate NIH-funded study, found no meaningful difference in complication risk between sleeping on the left side, the right side, or the back earlier in pregnancy. That’s softened the old “left side only” rule considerably, at least for that stretch.

The picture is a little less settled specifically for the third trimester, where the research is less conclusive than it is earlier on. Because of that, the precautionary advice — including from ACOG — is to favor side sleeping as your pregnancy progresses, with the left side still commonly recommended out of extra caution, even though it’s no longer treated as a strict rule. That caution is reinforced by one small study out of New Zealand, which reported a possible link between back sleeping and a higher risk of stillbirth late in pregnancy — though it’s worth being precise about what that study actually showed: its own researchers described the evidence behind the finding as low-quality, and it hasn’t been confirmed as a cause-and-effect relationship. It’s one data point folded into an overall precaution, not proof that back sleeping is dangerous.

For context, sleeping at a slight incline rather than completely flat on your back appears to carry little added risk, and most people naturally drift away from flat-on-the-back sleeping on their own as pregnancy advances — a growing belly tends to make that choice for you well before you’d need to think about it. And if you’ve always been a stomach sleeper, there’s no evidence that position is dangerous during pregnancy either; it simply becomes physically awkward, and eventually impossible, as your belly grows. The position generally recommended, especially in the second and third trimesters, is lying on your side with your knees bent and a pillow between them — it relieves pressure on a major vein running along your right side and helps keep your back and pelvis in a more supported, neutral alignment through the night.

Pregnancy pillows: do you need one, and which kind

A pregnancy or body pillow isn’t a medical necessity — plenty of people get through pregnancy without one — but it can make a real difference in comfort by improving how your spine lines up while you sleep, and it’s specifically associated with relief from low back and hip pain. Many people first feel like they need extra support around 20 weeks, when rolling over or settling into a comfortable position starts to take real effort. Whatever shape you choose, the underlying goal is the same: keeping the natural curves of your neck, upper back, and lower back in line with each other, so the muscles around your hips and pelvis can relax instead of working all night to hold you in place.

A regular pillow, or a small pregnancy pillow, between your thighs or knees creates space in your hips and pelvis and tends to work well through the first and second trimesters.
A C-shaped pillow supports your head, neck, and spine more fully and can ease third-trimester discomfort. For back support, place it behind your back, rest your head on the curved end, and tuck the far end between your knees. For front support, hold it against the front of your body while lying on your side, with the end tucked between your knees.
A U-shaped pillow cradles your head at the connected end while supporting both sides of your body at once — position that end behind your head so it wraps around you.
An I-shaped body pillow works lengthwise: lie on the side you want supported and stretch the pillow along it.
A wedge pillow is a smaller shape that tucks behind your back — helpful if you tend to roll onto your back overnight — or under your belly; a wedge placed under the mattress to raise the head of the bed roughly six to eight inches can also ease heartburn without asking you to give up side sleeping.

If you’re prone to rolling onto your back overnight, a wedge behind your back or a C- or U-shaped pillow can physically block the roll and reinforce side sleeping.

Your pregnancy pillow doesn’t have to retire the day your baby arrives. Plenty of people keep using the same pillow after delivery for their own postpartum comfort, and as positioning support while bottle-feeding, breastfeeding, or just holding their baby. What it shouldn’t become is a place for your baby to sleep.

Safe sleep reminder: Always place baby on their back to sleep, on a firm, flat sleep surface in their own crib, bassinet, or play yard, with a fitted sheet only and no loose blankets, pillows, bumpers, stuffed animals, or other soft items.

A body pillow being used to prop you up for feeding is a comfort tool for you, not a safe sleep surface for your baby, and it shouldn’t be part of a bed-sharing setup either. Once your baby is a little older and working on sitting independently, that same pillow can take on a new job — propping them up for supervised sitting practice.

Heartburn and reflux (GERD)

Heartburn is extremely common in pregnancy — as many as 17 to 45% of pregnant people experience gastroesophageal reflux disease, or GERD, at some point. It shows up as a burning feeling in your chest or stomach, burping, bloating, and general discomfort, usually worse after meals and when you’re lying flat, which is exactly what you’re trying to do at bedtime. The good news is that GERD in pregnancy is usually managed well with lifestyle and diet changes, adjustments to how you position yourself, and relaxation techniques — medication is something your doctor might add in some cases, but it’s rarely the first move. Foods that commonly trigger symptoms include alcohol, coffee, chocolate, rich or fatty foods, tomato-based foods, fruit drinks, and carbonated drinks, so trimming those back, especially in the evening, can make a real difference.

For most people, GERD symptoms fade soon after delivery, and serious complications from pregnancy-related GERD are rare. There’s one combination worth knowing about, though, since it can look like ordinary heartburn at first glance — see “When to reach out” below.

Restless leg syndrome

Restless leg syndrome, often shortened to RLS, affects roughly 26 to 30% of pregnant people at some point, and it tends to show up most in the third trimester. It feels like an urge to move your legs, usually paired with an uncomfortable sensation, that’s worse when you’re resting and worse in the evening — and it eases, at least temporarily, once you move or stretch. A number of things can raise your chances of developing it during pregnancy: hormonal shifts, genetics, being an older parent, sleep deprivation, depression, carrying multiples, and stress or anxiety. Low iron stores, low folate, and not getting enough vitamin D have each been linked to a higher chance of developing RLS during pregnancy too.

Ask your provider whether adding iron-rich foods, or an iron supplement, might help — worth asking about rather than guessing on your own.
Acupuncture and other relaxation techniques are sometimes used alongside this.
A warm, not hot, bath before bed and some gentle stretching through your back and legs can also take the edge off.

RLS doesn’t necessarily disappear the moment your baby arrives — in one small study, about 34.8% of women still had symptoms three months after giving birth. Researchers say more work is needed to understand how long postpartum RLS typically lasts, but if it’s still bothering you at your postpartum visit, it’s a reasonable thing to bring up.

Snoring during pregnancy

Snoring tends to creep up as pregnancy goes on. It usually starts developing in the second trimester and tends to peak in the third, and by then, as many as one in three pregnant people snore — largely from swelling in the upper airway combined with typical pregnancy weight gain. Rising estrogen and progesterone can cause nasal congestion and swelling in the tissue of your nose, mouth, and throat, narrowing your airway just enough to create that vibrating sound at night. Even a relatively modest amount of weight gain has been connected to snoring in research — one study found that gaining around 10% of starting body weight was linked to roughly a six-fold increase in the odds of snoring or other sleep-disordered breathing. Snoring also tends to be worse when you’re lying on your back, which is one more reason side sleeping — knees bent, pillow between your knees — is the position generally favored later in pregnancy.

Side sleeping, especially on the left, tends to reduce snoring compared with lying on your back.
A mandibular advancement device — a dental appliance fitted by a dentist — can reduce snoring for some people.
Nasal dilator strips may help, particularly if congestion is part of what’s driving the snoring.
An anti-snore pillow, or a positional or automatic bed designed to discourage back-sleeping, can help if you tend to roll over overnight.

If you were already a snorer before pregnancy and it carried straight into the early weeks, that’s more likely something that predates the pregnancy itself — possibly worth mentioning to a doctor on its own — rather than a new pregnancy effect, since the airway changes pregnancy causes are usually minimal that early on. Snoring that’s genuinely new, starting for the first time later in pregnancy, has been linked in research to a higher chance of gestational hypertension and preeclampsia than snoring that predates the pregnancy. More broadly, frequent snoring — whether or not it’s ever been formally diagnosed as sleep apnea — has shown up in multiple studies alongside gestational hypertension and preeclampsia, plausibly because fragmented sleep and lower blood oxygen overnight can raise stress hormones, drive inflammation, and reduce antioxidant activity in ways that push blood pressure up.

Snoring by itself isn’t considered a sign of diabetes, but some research also connects frequent snoring to a higher chance of developing gestational diabetes later in pregnancy, through similar pathways affecting insulin sensitivity. If you’ve read that snoring is tied to premature birth, that connection in the research seems to be explained by these same co-occurring conditions — high blood pressure, preeclampsia, gestational diabetes — rather than snoring being a direct cause on its own. New snoring alongside new high blood pressure, specifically, raises the likelihood of an underlying, undiagnosed sleep apnea worth checking for.

For most people, pregnancy-related snoring eases up after delivery as the airway swelling and congestion that caused it resolve — a process that can take up to about eight weeks. If it’s still going strong after that, especially if you had any blood pressure concerns during pregnancy, it’s worth a conversation with your primary care doctor, who may suggest a sleep study to check for sleep apnea.

Obstructive sleep apnea

Obstructive sleep apnea, or OSA, is a more specific condition than ordinary snoring — it involves snoring, gasping, and brief pauses in breathing that cut into your airflow and blood oxygen and leave your sleep genuinely less restorative, even without you fully waking up for most of it. The same pregnancy-driven nasal congestion and weight gain that fuel ordinary snoring can also bring on new or worsening OSA, and it’s worth taking seriously — research has found higher rates of cesarean delivery among pregnant people at high risk for OSA compared with those without it. Risk factors include being older, carrying extra weight, being African-American, having differences in facial or airway structure, smoking, and having conditions like type 2 diabetes, high blood pressure, irregular heart rhythms, or cardiovascular disease. There’s some evidence that OSA developing during pregnancy improves again afterward, though that’s not guaranteed for everyone.

OSA is thought to be significantly underdiagnosed in pregnancy — one study found that about 90% of women with OSA had no idea they had it. Because it’s so easy to miss, it’s worth knowing the signs (see “When to reach out” below) rather than assuming ordinary pregnancy fatigue explains everything. If OSA seems likely, your doctor will typically start by reviewing your symptoms and examining your nose, throat, and mouth, sometimes followed by a referral to a sleep medicine specialist, and a diagnosis is confirmed with a sleep study, formally called polysomnography.

Everyday habits that support better sleep

A handful of everyday choices can meaningfully protect your sleep throughout pregnancy, on top of anything specific to your trimester. Caffeine is worth capping at around 200 mg a day — roughly one 12-ounce cup of coffee — and it’s best avoided after lunch so it’s fully out of your system by bedtime. Alcohol is advised against entirely during pregnancy, and it’s worth knowing that evening alcohol is discouraged postpartum too, since it works against restful sleep even after your baby arrives. Avoiding tobacco matters for a long list of reasons in pregnancy generally, and specifically here because smoking is a risk factor for both snoring and sleep apnea. Regular daytime exercise, cleared with your provider first, has been linked to fewer backaches, less swelling, a better mood, healthier weight management, and better sleep overall.

Keep a consistent, calming bedtime routine and a fairly fixed sleep and wake schedule, so your body learns what to expect.
Make your bedroom genuinely sleep-friendly: quiet, cool, dark (blackout curtains help), white noise if it’s useful to you, and as clutter-free as you can manage — a room mostly reserved for sleep rather than daytime activity.
Keep a notepad by the bed for worries or tomorrow’s to-do list, so your mind has somewhere to put things down instead of turning them over while you’re trying to fall asleep.
Go to bed when you’re genuinely sleepy, not out of worry or desperation — climbing into bed hoping sleep will just take over can build its own cycle of anxiety and wakefulness.

If sleep hygiene alone isn’t enough, Cognitive Behavioral Therapy for Insomnia (CBT-I) is a non-medication approach that addresses the physical, environmental, emotional, and behavioral pieces of insomnia together. In pregnancy specifically, it’s also been shown to help ease postpartum depression symptoms and may lower the likelihood of depression developing at all — worth asking your provider about if insomnia is a significant struggle. Melatonin supplements are a different story: how melatonin affects fetal development isn’t well established, so it isn’t recommended during pregnancy without talking it through with your doctor first.

How partners can help

If you have a partner, there’s a lot they can do to make pregnancy sleep easier without it falling entirely on you to solve. Helping arrange pillows for positioning, keeping the bedroom calm, decluttered, dim, and quiet, offering a gentle massage for whatever’s sore that day, and helping hold a consistent sleep and wake schedule are all genuinely useful, concrete ways to help — real logistics that add up over a lot of nights, not just moral support.

When to reach out

If contractions start to feel like they might be real labor rather than practice contractions, contact your obstetric provider promptly rather than waiting to see how the night unfolds. If it turns out not to be labor, that’s a good time to ask about ways to sleep more comfortably through practice-contraction discomfort.
Heartburn-like symptoms that show up together with a headache, pain below your ribs, nausea or vomiting, feeling generally unwell, or sudden swelling in your face, hands, or feet — this combination can signal preeclampsia and is worth calling your doctor about right away.
Signs that could point to obstructive sleep apnea: unintentionally dozing off during the day, unusual daytime sleepiness, a headache on waking, a dry mouth or sore throat in the morning, new irritability or forgetfulness, or a partner noticing loud snoring or pauses in your breathing overnight.
Snoring that’s frequent, new, or paired with other symptoms is worth mentioning to your OB provider at a routine visit.
If snoring is still going strong more than about eight weeks after delivery, especially if you had blood pressure concerns during pregnancy, bring it up with your primary care doctor, who may suggest a sleep study.
If you’ve tried the sleep-hygiene basics and poor sleep is still causing real stress, tell your obstetric provider — you don’t have to work through this on your own.

Sources

Written from primary pediatric sources. This is general information, reviewed editorially rather than by a clinician — it isn’t a substitute for your pediatrician’s advice about your child.