Trouble Sleeping In Second Trimester? How to Sleep Better

Pregnancy insomnia is incredibly common.

Some women start to experience insomnia in the first trimester, and then the sleep troubles get progressively worse up until labor.

If you’d like to know why, and how you can improve your sleep, read on.

Why Pregnant Women Often Have Second Trimester Sleep Issues

The second trimester is when your body and hormones really start to change, and this has an effect on sleep for many women.

There are 3 main issues that can lead to sleep trouble at this time:

• Anxiety - As you near labor, stress typically increases as you worry about labor pain, your baby, money, and other things (1, 2).
• Hormonal changes - Higher levels of estrogen and progesterone affect levels of other hormones like cortisol and melatonin in a way that makes sleep worse (9).
• Physical changes - Most women are showing by their second trimester, and having the extra weight in the midsection can cause discomfort and make sleep more difficult.

Second Trimester Related Symptoms That Affect Sleep

On top of those issues above, other physical changes and illnesses are common in pregnant women.

Many of these become more common in the second trimester and get worse in the third trimester (3,4,5):

• Fetal movements
• Heartburn
• Cramps and tingling
• Shortness of breath

Sleep is Important For Both Your Health and Your Baby

While some sleep issues might be expected, this isn’t something you want to “power through” and just accept.

More and more research shows that if your sleep is impacted enough to lead to insomnia, there is an increased risk of (6, 7, 8, 10):

• Depressive symptoms
• Increased pain during labor
• Longer labors
• Higher chance of Caesarean section being needed (up to 5 times as much)
• Preterm birth
• Low birth weight

So take this seriously and try to get help (see below).

How To Sleep Better During Your Second Trimester

There’s no quick fix, and no complete fix for factors like hormonal changes.

However, there are things you can do to improve your sleep to a level that’s safer for you and your baby.

Support Your Abdomen With a Pillow

This is the easiest thing, but very effective.

One you really start to show, put a pillow under your belly and sleep on your side to improve your comfort, and consequently your sleep quality.

While simple, research has found that this reliably reduces backache (11).

Any pillow should do, but there are special pregnancy pillows in the shape of a wedge if you can afford it.

Dial In Your Sleep Hygiene

Sleep hygiene refers to environmental and behavioral factors that affect your sleep that are in your control.

Before you were pregnant, it may not have mattered if your sleep hygiene was bad, but for people having sleep trouble, it’s crucial.

See my complete guide to sleep hygiene for insomnia to learn what good hygiene looks like.

Start Cognitive Behavioral Therapy (CBT)

CBT is a safe treatment method that is the most preferred treatment method by insomnia patients that are pregnant (12). Even if you don’t have insomnia, it can still help.

It’s very effective for reducing stress and anxiety that may be adding to your sleep troubles.

If CBT is new to you, here’s a good summary of what it is from the Mayo Clinic:

Cognitive behavioral therapy (CBT) is a common type of talk therapy (psychotherapy). You work with a mental health counselor (psychotherapist or therapist) in a structured way, attending a limited number of sessions. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.

While there are online CBT courses that you can do by yourself at home, you shouldn’t take chances here.

Go see a professional CBT therapist and make sure it’s done right. You need to see results as soon as possible for your and your baby’s health.

Sleep Medication

As a last resort, there are sleep medications that can help.

While there are some available over the counter, most are prescribed. You should always consult your doctor either way as many sleep medications can have side effects for you or your baby (13).

That’s why it’s a last resort option in most cases if nothing else is helping and you’re suffering terrible sleep.

Acupuncture/Massage/Yoga

Finally, if stress is one of the main causes of your sleep issues, relaxation techniques like acupuncture, massage, yoga, or meditation can help.

And it’s backed by some research too (16):

Acupuncture alleviates insomnia during pregnancy and further research is justified

There are even massages and yoga classes designed specifically for pregnant women.

These are small and simple things that likely won’t fix your sleep issues by themselves, but may help.

Will Your Third Trimester Sleep Be Worse?

I don’t want to scare you, but insomnia in the third trimester typically gets worse, all the way up to labor.

At 39 weeks (i.e. late pregnancy), up to 73.5% of women will have some degree of insomnia (although the majority is mild), with the most common difficulty reported being maintaining sleep (14).

Your body continues to go through hormonal changes, most notably producing more oxytocin (a wake promoting hormone) shortly before labor (15).

This is why it’s so important to fix your sleep issues the best you can right now, so that it won’t be as bad later on. It’s a lot easier to have the energy to improve sleep habits before you become sleep deprived.

References

1. A cognitive model of insomnia
2. Psychological distress in pregnant women in insomnia
3. Sleep disturbance in pregnancy. A subjective survey
4. Sleep disturbances during pregnancy
5. Sleep patterns and sleep disturbances across pregnancy
6. Insomnia and sleep deficiency in pregnancy
7. Sleep quality and depression during pregnancy: a prospective study
8. Sleep in late pregnancy predicts length of labor and type of delivery
9. Women and insomnia
10. Sleep Deprivation during Pregnancy and Maternal and Fetal Outcomes: Is There a Relationship?
11. Evaluation of a Maternity Cushion (Ozzlo Pillow) for Backache and Insomnia in Late Pregnancy
12. Insomnia Treatment Preferences During Pregnancy
13. Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations
14. Is insomnia in late pregnancy a risk factor for postpartum depression/depressive symptomatology?
15. Sleep impairment during pregnancy: possible implications on mother-infant relationship
16. Acupuncture for Insomnia in Pregnancy – a Prospective, Quasi-Randomised, Controlled Study