Sleep patterns change throughout pregnancy, largely as a result of the enormous physical changes that take place as the fetus grows, but also partly due to hormonal changes that occur.

Sleep during the first trimester

The first trimester is the period from conception to 3 months. During this time, the high levels of progesterone in the body have a sleep-inducing and sedating effect on the brain. Progesterone also increases the need to urinate due to the effect it has on the smooth muscle in the bladder. Women often experience more sleep difficulty during the night due to an increased need to go to the bathroom. Many women experience daytime sleepiness and fatigue during this time. Nausea and vomiting is not just limited to “morning sickness” but can also occur in the evening. There is a greater tendency to sleep longer than prior to pregnancy, but there is less slow wave sleep during this time.

Sleep during the second trimester

The second trimester of pregnancy is the period from the fourth to the sixth month. Progesterone levels continue to rise during this period but more slowly. Many women experience a great improvement in their sleep quality and quantity during this period and report more daytime energy. The growing fetus moves above the bladder and the need to urinate decreases. However, many women start to snore at this stage, probably because of the effects of estrogen on blood vessels, resulting in nasal congestion. During this time, there is an increased risk of developing sleep apnea and also high blood pressure, so you must be carefully monitored by your doctor. There is less slow wave sleep than prior to pregnancy and more time is spent awake during the night.

Sleep during the third trimester

The third trimester is the period from the seventh to the ninth month. Progesterone levels are at their peak during this time. Women report the most sleep difficulties during this stage of pregnancy. Sleep disturbances are very common and are caused by a wide variety of factors, including leg cramps, heartburn, nasal congestion, and an increased need to urinate. The baby’s movements can also disturb sleep. In the last few weeks of pregnancy, many women find achieving a comfortable sleeping position difficult. This can lead to increased daytime fatigue and sleepiness. Breast tenderness, shortness of breath, and irregular uterine contractions can also affect sleep adversely. Overall, more time is spent awake and there is less slow wave sleep.

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