Pregnancy and Sleep by Caitlin McCurdy-Robinson, PT, DPT
For those of who you are currently pregnant you may start to notice more difficulty sleeping during the second and third trimester. The lack of sleep may be related to intense, vivid dreams, but for most women it is the discomfort associated with a growing baby and changing body. Depending on which trimester you are in you may be limited in sleep positions.
The American Congress of Obstetricians and Gynecologists (ACOG) recommend that you avoid lying on your back after the first trimester for longer than 3 minutes at a time because of blood flow. You have a large vessel in your abdominal cavity, called your inferior vena cava, which provides blood flow to your body and baby via the uterine arteries. When you lay on your back the weight of the baby compresses this blood supply and decreases the amount of blood provided to you and your baby. Generally speaking, if you accidentally roll onto your back in the middle of the night your body will become aware of any blood flow deficits and you will roll to your side. However, when you are awake or exercising you should avoid prolonged time on your back, especially if you start to feel symptoms of nausea, swelling, dizziness, or light headedness.
While pregnant sidelying is the recommended position for sleep, primarily on your left side, to help with the promotion of blood flow to your uterus and body. Side sleeping can be challenging and uncomfortable, especially as ligaments become more lax. With ligamentous laxity, there is more separation around the sacroiliac joint which makes hips feel and appear wider for preparation of childbirth. The other aspect of discomfort is the growing abdomen which will also put strain on ligaments around the uterus and sacrum. The best recommendation is to find a supportive body pillow or pregnancy pillow (such as the snoogle). When the pillow is positioned properly, your knees should be approximately hips width apart and your abdomen supported. Though the added pillows may feel cumbersome, you will be happy to have the added support even if it means repositioning when you roll side to side. If you are still having difficulty with sleeping or positioning, speak to your physical therapist who can assist you with these issues. Enjoy your sleep now, Mamas-to-be!