Home / Pregnancy and Sleep / Sleeping During Your Third Trimester

Sleeping During Your Third Trimester

Danielle Pacheco

Written by

Danielle Pacheco, Staff Writer

Ealena Callender

Medically Reviewed by

Ealena Callender, OBGYN

Fact Checked Icon
Fact Checked

Our team of writers, editors, and medical experts rigorously evaluates each article to ensure the information is accurate and exclusively cites reputable sources. Learn More

Recency Statement Icon

We regularly assess how the content in this article aligns with current scientific literature and expert recommendations in order to provide the most up-to-date research.

The third trimester of pregnancy brings a host of sleep-related changes as the weight gain and pressure of the growing fetus start to have a direct impact on muscles, joints, and blood flow.

If you can’t sleep and you’re pregnant in your third trimester, keep reading for advice on how to improve your sleep quality. We’ll take a closer look at the factors that influence third trimester sleep, including conditions like sleep apnea and restless legs syndrome, and discuss the best third trimester pregnancy sleeping positions.

How Does Sleep Change in the Third Trimester?

For most women, the third trimester is the most difficult, bringing back pain, heartburn, and sleep apnea, among other things. Not only is it more difficult to get quality sleep, but you’ll also experience daytime fatigue as a result of your changing body.

Back Pain and General Discomfort

It’s estimated that 2 in 3 women suffer from lower back pain and sore muscles during pregnancy, which in turn causes sleep disturbances. Women with higher levels of depression or anxiety typically describe their back pain as more severe.

Depression, Anxiety, and Insomnia

Insomnia strikes an estimated 3 in 4 women during late pregnancy. Principal drivers of insomnia in pregnant women include anxiety, depression, disturbed dreams, nighttime awakening, fetal kicking and other movements, and pain and discomfort from the baby bump. Frequent bathroom breaks due to overactive kidneys and the weight of the uterus against the bladder can also disrupt sleep.

Snoring and Sleep Apnea

A significant number of women develop snoring and sleep apnea during pregnancy. Although often benign, this may also be a warning sign of a more severe condition. Research shows that snoring is correlated with high blood pressure and preeclampsia, while sleep apnea may increase the risk of maternal morbidity. Sleep apnea also appears to be correlated with gestational diabetes.

Leg Cramps and Restless Legs Syndrome

Research shows that as many as 1 in 3 women have restless legs syndrome in the third trimester, characterized by uncomfortable sensations that provoke an irresistible urge to move the legs. Restless legs syndrome appears more when the body is at rest and can make it virtually impossible to get to sleep. The third trimester also brings nighttime leg cramps for many women.


As the digestive system slows down in late pregnancy, many mothers-to-be develop heartburn. This uncomfortable condition involves acid rising back up through the esophagus, causing a burning sensation in the chest.


Why Sleep Is Important During Your Third Trimester

Poor sleep during the third trimester is associated with a host of problems, the most serious being preeclampsia and preterm birth. Pregnant women who experience insomnia or habitual snoring appear to be more likely to give birth to a baby that is too large or too small for gestational age, and research shows that women who experience sleep problems in late pregnancy have longer labors and are more likely to need a cesarean section.

In terms of risks to the mother, poor sleep also appears to be linked to a higher risk of gestational diabetes mellitus. In turn, better sleep is associated with more successful breastfeeding and a lower chance of depression during pregnancy and postpartum.

How to Sleep Better During Your Third Trimester

Through a combination of sleep hygiene, vitamin and mineral supplements, and safer sleeping positions, pregnant women can improve the quality and quantity of their sleep. Remember to always check with your healthcare provider before changing your routine or starting a new medication, and inform them immediately if you have symptoms that could indicate a serious condition.

What Is the Best Third Trimester Pregnancy Sleeping Position?

Doctors agree that the best sleeping position in the third trimester is on the left side, with your legs slightly tucked up towards your chin. This position improves blood flow to the uterus, and helps deliver nutrients and oxygen to the fetus. The improved circulation and kidney function also reduces swelling, hemorrhoids, and varicose veins in your legs. Women with severe swelling may try propping the legs up higher than the belly.

By contrast, sleeping on your right side during the third trimester puts the weight of the uterus on your liver, and sleeping on your back can block the inferior vena cava and cut off blood flow. As you’ll soon find out, sleeping on your stomach is virtually impossible because of the baby’s size. Don’t worry if you briefly flip into these positions, but try not to spend too long in them.

Sleeping on your left side is easier said than done for those who are normally stomach or back sleepers. A pillow between the legs, tucked into the small of the back, or propping up your belly may ease the strain and help you feel more comfortable, and a strategic pillow wedged behind you may help you adjust to side sleeping. Some companies even make purpose-built positional therapy devices, pregnancy wedges, and body pillows that are designed with your needs in mind.

Sleeping Products to Help With Third Trimester Sleep

Most sleep medications are contraindicated for pregnant women, but there are still plenty of products that can aid in improving your sleep. A white noise machine, meditation app, or lavender scent may help lull you to sleep, while the best pillow and mattress are essential to make sure you’re properly supported.

Sleep Hygiene Tips for the Third Trimester

Women who suffer from specific pregnancy-related sleep disorders should prioritize dealing with these first. This may mean doing some light stretching before bed or taking mineral supplements to prevent leg cramps and restless leg syndrome. Heartburn can be avoided by sleeping on your left side, eating smaller meals, not eating right before bed, and avoiding certain trigger foods such as spicy or very fatty foods.

As the uterus grows, you may experience shortness of breath, which can be alleviated by propping up the head while you sleep. Rolling over onto your side generally opens the windpipe and eases symptoms of sleep apnea. Those with more severe sleep apnea symptoms may use a sleep apnea machine.

Pregnant women who struggle from anxiety may find it helpful to join a yoga class or parenting class for a supportive group environment. Regular exercise is recommended for pregnant women and is an important part of sleep hygiene, but it’s important not to exercise too late in the day as the body needs time to wind down afterward. Yoga or relaxation exercises, a prenatal massage, and relaxing music are some ways to prepare your body for falling asleep.

General sleep hygiene tips apply to pregnant women as well. Try to set a regular bedtime and create a calm, dark atmosphere with an adequate temperature. Wind down before bedtime with a warm bath or a calming cup of herbal tea, and avoid caffeine, stimulants, and blue screens before bedtime.

While you should stay hydrated throughout the day, it’s a good idea to avoid big meals and excessive fluids in the hours leading up to bedtime. This is especially true for women who suffer from heartburn or find themselves waking up for frequent bathroom breaks. Using a nightlight in the bathroom will help you stay drowsy so you can get back to sleep more easily.

When nothing else works, many pregnant women compensate for lost sleep overnight by taking naps during the day. This is a good option for some, but it may make it more difficult to drift off at night.

Mental Health Tips

Your bed should be a soothing haven that’s reserved for sleep and sex. If you’ve been lying in bed for a while and you can’t fall asleep, get up and do a calming activity such as reading a book or taking a bath. Lying in bed fretting about getting to sleep is counter-productive and may make you associate bedtime with stress.

Interestingly, one study found that women were more likely to experience postpartum depression if they worried about sleep in the third trimester, regardless of the actual quality of their sleep. So, while it’s good to have awareness of the importance of sleep, try not to let it become a major source of stress. Likewise, don’t worry if you feel like you’re sleeping a lot during your pregnancy third trimester. This is likely just a result of the extra energy the fetus requires.

Promising evidence suggests that a combination of cognitive behavioral therapy coupled with sleep hygiene practices may be an effective way to help with sleep problems in the third trimester. Research also suggests that treating depressive symptoms may help improve sleep quality and reduce daytime fatigue. It’s normal to feel anxious and excited about the impending childbirth, so don’t be afraid to discuss these fears with your partner or a trusted confidant.

  • Was this article helpful?
  • YesNo

About Our Editorial Team

Danielle Pacheco

Staff Writer

Danielle writes in-depth articles about sleep solutions and holds a psychology degree from the University of British Columbia.

Ealena Callender



Dr. Callender is a board-certified obstetrician-gynecologist who has been working in women’s health for over a decade.


+34  Sources
  • 1.
    Sedov, I. D., Cameron, E. E., Madigan, S., & Tomfohr-Madsen, L. M. (2018). Sleep quality during pregnancy: A meta-analysis. Sleep medicine reviews, 38, 168–176.
  • 2.
    Mindell, J. A., Cook, R. A., & Nikolovski, J. (2015). Sleep patterns and sleep disturbances across pregnancy. Sleep medicine, 16(4), 483–488.
  • 3.
    Virgara, R., Maher, C., & Van Kessel, G. (2018). The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC pregnancy and childbirth, 18(1), 288.
  • 4.
    Virgara, R., Maher, C., & Van Kessel, G. (2018). The comorbidity of low back pelvic pain and risk of depression and anxiety in pregnancy in primiparous women. BMC pregnancy and childbirth, 18(1), 288.
  • 5.
    Román-Gálvez, R. M., Amezcua-Prieto, C., Salcedo-Bellido, I., Martínez-Galiano, J. M., Khan, K. S., & Bueno-Cavanillas, A. (2018). Factors associated with insomnia in pregnancy: A prospective Cohort Study. European journal of obstetrics, gynecology, and reproductive biology, 221, 70–75.
  • 6.
    Reichner C. A. (2015). Insomnia and sleep deficiency in pregnancy. Obstetric medicine, 8(4), 168–171.
  • 7.
    Ruiz-Robledillo, N., Canário, C., Dias, C. C., Moya-Albiol, L., & Figueiredo, B. (2015). Sleep during the third trimester of pregnancy: the role of depression and anxiety. Psychology, health & medicine, 20(8), 927–932.
  • 8.
    Lara-Carrasco, J., Simard, V., Saint-Onge, K., Lamoureux-Tremblay, V., & Nielsen, T. (2014). Disturbed dreaming during the third trimester of pregnancy. Sleep medicine, 15(6), 694–700.
  • 9.
    Neau, J. P., Texier, B., & Ingrand, P. (2009). Sleep and vigilance disorders in pregnancy. European neurology, 62(1), 23–29.
  • 10.
    Hutchison, B. L., Stone, P. R., McCowan, L. M., Stewart, A. W., Thompson, J. M., & Mitchell, E. A. (2012). A postal survey of maternal sleep in late pregnancy. BMC pregnancy and childbirth, 12, 144.
  • 11.
    Medical Encyclopedia: A.D.A.M Medical Encyclopedia. (2018, September 25). Common symptoms during pregnancy. Retrieved August 22, 2020.
  • 12.
    Tsai, S. Y., Lee, P. L., & Lee, C. N. (2018). Snoring and Blood Pressure in Third-Trimester Normotensive Pregnant Women. Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, 50(5), 522–529.
  • 13.
    Facco, F. L., Parker, C. B., Reddy, U. M., Silver, R. M., Koch, M. A., Louis, J. M., Basner, R. C., Chung, J. H., Nhan-Chang, C. L., Pien, G. W., Redline, S., Grobman, W. A., Wing, D. A., Simhan, H. N., Haas, D. M., Mercer, B. M., Parry, S., Mobley, D., Hunter, S., Saade, G. R., … Zee, P. C. (2017). Association Between Sleep-Disordered Breathing and Hypertensive Disorders of Pregnancy and Gestational Diabetes Mellitus. Obstetrics and gynecology, 129(1), 31–41.
  • 14.
    Louis, J. M., Mogos, M. F., Salemi, J. L., Redline, S., & Salihu, H. M. (2014). Obstructive sleep apnea and severe maternal-infant morbidity/mortality in the United States, 1998-2009. Sleep, 37(5), 843–849.
  • 15.
    Reutrakul, S., Zaidi, N., Wroblewski, K., Kay, H. H., Ismail, M., Ehrmann, D. A., & Van Cauter, E. (2013). Interactions between pregnancy, obstructive sleep apnea, and gestational diabetes mellitus. The Journal of clinical endocrinology and metabolism, 98(10), 4195–4202.
  • 16.
    Dunietz, G. L., Lisabeth, L. D., Shedden, K., Shamim-Uzzaman, Q. A., Bullough, A. S., Chames, M. C., Bowden, M. F., & O'Brien, L. M. (2017). Restless Legs Syndrome and Sleep-Wake Disturbances in Pregnancy. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 13(7), 863–870.
  • 17.
    Hall, H., Lauche, R., Adams, J., Steel, A., Broom, A., & Sibbritt, D. (2016). Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women. Women and birth : journal of the Australian College of Midwives, 29(1), 35–40.
  • 18.
    Felder, J. N., Baer, R. J., Rand, L., Jelliffe-Pawlowski, L. L., & Prather, A. A. (2017). Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth. Obstetrics and gynecology, 130(3), 573–581.
  • 19.
    Okun, M. L., & O'Brien, L. M. (2018). Concurrent insomnia and habitual snoring are associated with adverse pregnancy outcomes. Sleep medicine, 46, 12–19.
  • 20.
    Liu, H., Li, H., Li, C., Chen, L., Zhang, C., Liu, Z., Wu, Y., & Huang, H. (2019). Associations between Maternal Sleep Quality Throughout Pregnancy and Newborn Birth Weight. Behavioral sleep medicine, 1–13. Advance online publication.
  • 21.
    Lee, K. A., & Gay, C. L. (2004). Sleep in late pregnancy predicts length of labor and type of delivery. American journal of obstetrics and gynecology, 191(6), 2041–2046.
  • 22.
    Cai, S., Tan, S., Gluckman, P. D., Godfrey, K. M., Saw, S. M., Teoh, O. H., Chong, Y. S., Meaney, M. J., Kramer, M. S., Gooley, J. J., & GUSTO study group (2017). Sleep Quality and Nocturnal Sleep Duration in Pregnancy and Risk of Gestational Diabetes Mellitus. Sleep, 40(2), 10.1093/sleep/zsw058.
  • 23.
    Casey, T., Sun, H., Burgess, H. J., Crodian, J., Dowden, S., Cummings, S., Plaut, K., Haas, D., Zhang, L., & Ahmed, A. (2019). Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester. Journal of human lactation : official journal of International Lactation Consultant Association, 35(4), 713–724.
  • 24.
    Tsai, S. Y., Lin, J. W., Wu, W. W., Lee, C. N., & Lee, P. L. (2016). Sleep Disturbances and Symptoms of Depression and Daytime Sleepiness in Pregnant Women. Birth (Berkeley, Calif.), 43(2), 176–183.
  • 25.
    Wu, M., Li, X., Feng, B., Wu, H., Qiu, C., & Zhang, W. (2014). Poor sleep quality of third-trimester pregnancy is a risk factor for postpartum depression. Medical science monitor : international medical journal of experimental and clinical research, 20, 2740–2745.
  • 26.
    Rossi, A., Cornette, J., Johnson, M. R., Karamermer, Y., Springeling, T., Opic, P., Moelker, A., Krestin, G. P., Steegers, E., Roos-Hesselink, J., & van Geuns, R. J. (2011). Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 13(1), 31.
  • 27.
    Warland, J., Dorrian, J., Kember, A. J., Phillips, C., Borazjani, A., Morrison, J. L., & O'Brien, L. M. (2018). Modifying Maternal Sleep Position in Late Pregnancy Through Positional Therapy: A Feasibility Study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 14(8), 1387–1397.
  • 28.
    Effati-Daryani, F., Mohammad-Alizadeh-Charandabi, S., Mirghafourvand, M., Taghizadeh, M., Bekhradi, R., & Zarei, S. (2018). Effect of Lavender cream with or without footbath on sleep quality and fatigue in pregnancy and postpartum: a randomized controlled trial. Women & health, 58(10), 1179–1191.
  • 29.
    Lee, K. A., Zaffke, M. E., & Baratte-Beebe, K. (2001). Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. Journal of women's health & gender-based medicine, 10(4), 335–341.
  • 30.
    Quach, D. T., Le, Y. T., Mai, L. H., Hoang, A. T., & Nguyen, T. T. (2020). Short Meal-to-Bed Time Is a Predominant Risk Factor of Gastroesophageal Reflux Disease in Pregnancy. Journal of clinical gastroenterology, 10.1097/MCG.0000000000001399. Advance online publication.
  • 31.
    Carnelio, S., Morton, A., & McIntyre, H. D. (2017). Sleep disordered breathing in pregnancy: the maternal and fetal implications. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology, 37(2), 170–178.
  • 32.
    The American College of Obstetricians and Gynecologists. (2019, July). Exercise During Pregnancy. Retrieved August 22, 2020.
  • 33.
    Bei, B., Milgrom, J., Ericksen, J., & Trinder, J. (2010). Subjective perception of sleep, but not its objective quality, is associated with immediate postpartum mood disturbances in healthy women. Sleep, 33(4), 531–538.
  • 34.
    Lee, K. A., & Gay, C. L. (2017). Improving Sleep for Hospitalized Antepartum Patients: A Non-Randomized Controlled Pilot Study. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 13(12), 1445–1453.