Your Pregnancy Sleep Questions, Answered

March 12, 2018

Having trouble drifting off with that baby belly looming large? You’re not alone. About 80 percent of expectant moms have sleep challenges, according to the National Sleep Foundation. “You’re more tired than ever, yet you can’t get comfortable,” says Louise O’Brien, Ph.D., associate professor of obstetrics and gynecology at the University of Michigan. Our expert answers to the following questions can help you rest easy.

What’s the safest sleep position while pregnant?

You may have heard that you shouldn’t sleep on your back, especially during the second half of pregnancy. The reason: the inferior vena cava—the big vein that returns blood from the low er part of your body to your heart—may be compressed by your uterus, resulting in symptoms like sweating, nausea and dizziness for you, and a potentially reduced blood flow to your baby. This is true—to a point. Many doctors recommend sleeping on your left side, if you can; it helps blood flow more easily. But here’s a reality check: Most pregnant women spend some time sleeping on their back, says O’Brien. And chances are, it’s nothing to stress about. (While a recent study published in Obstetrics and Gynecology suggested a connection between late pregnancy back sleeping and stillbirth, the risk was mainly in pregnancies where the fetus had additional problems.) A bigger issue for many pregnant women is that back sleeping is uncomfortable. To promote safe and restful sleep, try tucking a pillow between your legs or use one to support your belly as you lie on your left side— or place a pillow behind the small of your back so you’re not sleeping flat. You can also prop a pillow wedge under your right hip so that the weight of your uterus tilts toward the left side.

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May I take something for my stuffy nose?

Unfortunately, doctors generally don’t recommend taking a decongestant when you’re pregnant. This can be a bummer, because the high estrogen levels during pregnancy can swell your nasal membranes, leading to congestion. This condition, known as pregnancy rhinitis, makes it harder to breathe, especially while lying down. Decongestants constrict blood vessels, reducing blood flow to the nasal passages—and to the placenta, says Erika Nichelson, D.O., an ob-gyn with Mercy Medical Center in Maryland. They may also cause your blood pressure to rise.

Instead of meds, try these tricks: “Elevate your head with an extra pillow, put a humidifier in the room and use a saline nasal spray to moisturize nasal passages,” says Judith Owens, M.D., a neurologist and sleep specialist at Boston Children’s Hospital.

How can I manage my nighttime heartburn?

Many expectant women develop heartburn—especially in the second and third trimesters. Blame pregnancy hormones and your growing uterus, which can cause stomach acid to back up into your esophagus. Antacids are typically safe to take once you’re past the first trimester, but check with your ob-gyn first. If over-the-counter meds don’t help, your doctor may recommend a prescription medication.

You can also try eating five or six small meals throughout the day, instead of three larger ones. (Avoid heartburn triggers such as fried foods, chocolate, garlic, onions and acidic fruits.) Elevating your head with an extra pillow at night can also help.

Is it ever safe to take sleep medicine?

Unless your doctor specifically recommends it, you should avoid sleep aids, even natural ones like melatonin. “There aren’t sufficient studies to show that it’s safe to take while pregnant,” says Nichelson. That’s true of prescription sleep meds, too. Instead, try changing up your bedtime routine. Take a warm bath and avoid using devices like e-readers or smartphones shortly before sleep; the light can interfere with your body’s  natural production of melatonin.

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