How Hormones Affect Sleep in Pregnancy
Mar 24, 2025
Rita Singha
Pregnancy Health
Pregnancy hormones can disrupt your sleep, but understanding their effects can help. Here's what you need to know:
Progesterone: Makes you sleepy during the day but causes fragmented sleep at night.
Estrogen: Triggers night sweats and restless sleep by affecting temperature regulation.
Cortisol: Stress hormone that spikes during pregnancy, leading to a cycle of poor sleep and higher stress.
Melatonin: Supports sleep and helps your baby develop a sleep-wake cycle, but screen time and bright lights can interfere with its production.
Each trimester brings unique challenges:
1st Trimester: Fatigue and sleepless nights due to hormonal surges.
2nd Trimester: Nasal congestion and restless legs.
3rd Trimester: Frequent bathroom trips, Braxton Hicks contractions, and difficulty finding a comfortable position.
Quick Tips for Better Sleep:
Stick to a regular sleep schedule.
Keep your bedroom cool (60-67°F).
Avoid screens before bed to boost melatonin.
Try prenatal yoga, meditation, and relaxation techniques.
Sleep on your left side with supportive pillows.
If sleep issues persist, consult your doctor - rest is essential for you and your baby.
How Does Pregnancy Affect Sleep Hormones? - Sleep Wellness Workshop
Main Hormones That Disrupt Sleep During Pregnancy
During pregnancy, your body produces a mix of hormones that play a big role in how you feel - and how you sleep. Four key hormones, in particular, can throw your sleep patterns out of balance. Let’s take a closer look at how each one affects your rest.
Progesterone: The Double-Edged Sword for Sleep
Progesterone levels rise sharply during the first trimester to help relax the uterine muscles and support your immune system. While this hormone has natural sleep-inducing properties, it also tends to disrupt your sleep at night.
"The high levels of human chorionic gonadotropin and progesterone that are required to maintain pregnancy are also soporific and thermogenic, promoting daytime sleepiness and early sleep onset." - Christine H.J. Won, MD, MS
This explains why you might feel drowsy during the day yet experience fragmented sleep at night. Falling asleep may come easily, but staying asleep? That’s another story. The result? Waking up tired, even after spending plenty of time in bed.
Estrogen: The Culprit Behind Night Sweats and Restless Nights
Estrogen levels climb throughout pregnancy to support your baby’s growth and the development of the placenta. But this hormone also has a knack for messing with your sleep.
One major effect of estrogen is on your body’s temperature regulation. It can cause hot flashes and night sweats, waking you up multiple times during the night. On top of that, estrogen increases REM sleep, which might sound good in theory but can leave you feeling less refreshed overall. It also disrupts the natural temperature patterns your body relies on for deep, restorative sleep.
To counteract these effects, keep your bedroom cool - aim for a temperature between 60-67°F (15.5-19.4°C). Use breathable bedding, fans, or air conditioning, and consider blackout curtains to create a calm, comfortable sleep space.
Cortisol: Stress Hormone on Overdrive
Cortisol, your body’s stress hormone, naturally rises during pregnancy to support essential functions. But when cortisol levels spike, your sleep often takes a hit. Research has shown that poor sleep quality in pregnancy is linked to higher evening cortisol levels, often driven by anxiety symptoms.
Here’s where it gets tricky: poor sleep raises cortisol, and high cortisol makes it harder to sleep - a frustrating cycle. Studies reveal that 48% of pregnant women report poor sleep quality by 24 weeks, and 40% by 36 weeks. Even more concerning, elevated cortisol late in pregnancy has been associated with shorter pregnancy durations, potentially influencing delivery timing.
Melatonin: A Sleep Ally for You and Your Baby
Melatonin, your body’s natural sleep hormone, plays a key role during pregnancy. Melatonin levels increase as pregnancy progresses, peaking during labor, and then drop quickly after birth. Beyond helping you sleep, melatonin also supports your baby’s development.
Research indicates that maternal melatonin crosses into the fetus, helping to establish the baby’s circadian rhythms before birth. In other words, your melatonin production is laying the groundwork for your baby’s future sleep patterns.
However, certain habits can interfere with melatonin production. Bright screens, evening light exposure, and irregular eating schedules can suppress melatonin, disrupting your sleep cycle. This disruption, known as chronodisruption, has been linked to negative outcomes, including preterm birth.
To keep melatonin levels steady, try to limit screen time before bed and use blackout curtains to create a dark, restful environment.
Sleep Problems by Trimester
Sleep struggles during pregnancy change as your body adapts over the nine months. Each trimester brings its own hormonal shifts and physical changes, leading to unique sleep challenges. Knowing what to expect can help you prepare and find ways to rest better at each stage.
First Trimester: Fatigue Meets Sleepless Nights
In the first trimester, you might feel completely drained during the day yet find it hard to sleep at night. This is largely thanks to a surge in progesterone, which acts like a natural sedative but also disrupts your sleep patterns. On top of that, your body is working overtime, with increased blood volume and your heart pumping harder to support the growing placenta and baby. It’s no wonder you feel exhausted!
To cope, focus on eating small, healthy meals throughout the day to keep your energy up and manage nausea. Try adjusting your schedule by taking short naps and heading to bed earlier to give your body the extra rest it needs.
Second Trimester: Nasal Congestion and Restless Legs
The second trimester often brings relief from morning sickness, but new sleep issues can crop up. Pregnancy rhinitis - characterized by a stuffy nose, sneezing, and postnasal drip - affects about 1 in 5 pregnant women, typically between weeks 13 and 21. This can make breathing at night difficult, disrupting your sleep.
Restless legs syndrome (RLS) is another common issue, with nearly one-third of pregnant women experiencing an uncontrollable urge to move their legs. While the exact cause isn’t fully understood, hormonal changes and possible deficiencies in iron or folic acid could be to blame.
To ease nasal congestion, try saline sprays, a humidifier, or sleeping with your head slightly elevated. Staying hydrated can also help thin mucus. For RLS, establish a bedtime routine, stretch or massage your legs before sleeping, and consider warm or cold compresses. Avoid caffeine, and consult your doctor to check your iron and folic acid levels if symptoms persist.
Third Trimester: Bathroom Breaks and Braxton Hicks
As your pregnancy progresses, sleep can become even more elusive. By the third trimester, up to 78% of pregnant individuals report sleep difficulties, with insomnia being a common complaint. Hormonal changes and physical discomfort take center stage, making restful nights harder to come by.
Frequent bathroom trips caused by your growing baby pressing on your bladder can wake you up every hour or two. Braxton Hicks contractions, those practice contractions that feel like your belly tightening, can also disrupt your rest. And as your belly grows, finding a comfortable sleeping position becomes a nightly challenge.
"Despite trying these remedies, many women will continue to suffer from pregnancy-related insomnia. In such cases, catching up on sleep throughout the day by napping could really help them get the required rest. It also might be good training for the postpartum period." - Dr. Maya Nambisan, OBGYN
To manage these challenges, try limiting fluids a couple of hours before bed and use relaxation techniques like deep breathing, meditation, or prenatal yoga to calm your mind. Sleeping on your left side can improve blood flow, and strategically placed pillows - under your belly and between your knees - can make you more comfortable. Sticking to a consistent sleep schedule can also help improve the quality of your rest.
Practical Ways to Improve Sleep Despite Hormonal Changes
Pregnancy hormones can wreak havoc on your sleep, but there are practical strategies to help you rest better. With over half of pregnant women experiencing insomnia, making a few adjustments can significantly improve your sleep quality.
Create Better Sleep Habits
Developing consistent sleep habits is a great first step in dealing with hormonal sleep disruptions. The National Institutes of Health suggests pregnant women aim to spend at least 8 hours in bed each night to secure 7 hours of actual sleep.
Stick to a regular sleep schedule by going to bed and waking up at the same time every day - even on weekends. This routine helps regulate your internal clock, making it easier to fall asleep despite hormonal changes. Keep your bedroom environment cool, dark, and quiet. Blackout curtains and a white noise machine can help create the perfect sleep-friendly setting.
Avoid screens for at least an hour before bed, as blue light can interfere with melatonin production. Instead, opt for relaxing activities like reading, listening to soothing music, or practicing gentle stretches.
"It's normal to feel tired in pregnancy (NHS, 2021a) so try not to get frustrated with yourself, as getting frustrated can cause more sleeplessness."
For nighttime bathroom visits, use a dim nightlight to avoid fully waking yourself up. Pair these habits with stress-relieving practices like yoga to further support restful sleep.
Try Prenatal Yoga and Meditation
Prenatal yoga and meditation are excellent tools for managing stress and improving sleep. Studies show that over 55% of yoga practitioners report better sleep and reduced stress after incorporating prenatal yoga. In fact, a 2015 study revealed that women with restless leg syndrome experienced significant symptom relief, better sleep, and improved mood after just eight weeks of yoga.
Start with short meditation sessions of 10–15 minutes and gradually increase as you get more comfortable. Focus on deep, slow breathing to calm your nervous system and encourage relaxation. Yoga Nidra, a guided relaxation practice, is particularly effective for promoting deep rest during pregnancy.
Programs like Rita's Pregnancy 101 offer prenatal yoga and meditation classes tailored for expecting mothers. These sessions combine gentle stretching, strengthening exercises, and breathing techniques to improve sleep and prepare your body for labor. Adding just a few minutes of yoga or meditation to your daily routine can make a noticeable difference.
Change Your Diet and Water Intake
What you eat and drink plays a big role in your sleep quality during pregnancy. Making some simple dietary tweaks can help ease the effects of hormonal changes on your rest.
Include magnesium-rich foods like almonds in your meals, as magnesium deficiencies are linked to sleep problems. Dairy products such as milk and yogurt contain tryptophan, an amino acid that aids melatonin production. Bananas are another great choice, offering both tryptophan and potassium to help prevent muscle cramps that might wake you during the night.
For evening snacks, go for options like berries, which are high in fiber and low in sugar, promoting more restful sleep. Pair magnesium-rich snacks with protein-carbohydrate combinations before bed, and reduce fluid intake two hours before sleeping to minimize trips to the bathroom.
While staying hydrated is crucial during pregnancy, try to drink most of your water earlier in the day. Avoid heavy meals, spicy foods, and caffeine in the afternoon and evening to prevent heartburn and other sleep disruptions.
Sleep in Safe Positions
As your pregnancy progresses, finding a comfortable sleeping position becomes more challenging, but the right position can make a huge difference. Sleeping on your left side is ideal, as it improves blood flow to your uterus, kidneys, and heart while reducing pressure on major blood vessels. This position can also help reduce heartburn.
Use pillows to support your body and ease discomfort. Placing a pillow between your knees can align your hips and relieve lower back strain, while a small pillow under your belly can offer extra support. If heartburn is a problem, elevate your head slightly with additional pillows or by raising the head of your bed.
Avoid lying on your back after the first trimester, as it can restrict blood flow to your baby and may cause dizziness or shortness of breath.
When to Contact Your Doctor
Some sleep disturbances are normal during pregnancy, but certain issues require medical attention. If severe sleeplessness persists despite trying these strategies, reach out to your healthcare provider - it could signal an underlying condition.
Considering melatonin supplements? Always consult your doctor first, as even natural remedies need to be monitored during pregnancy. Watch for signs of sleep apnea, such as loud snoring, gasping, or extreme fatigue during the day, as this condition can develop due to weight gain and hormonal shifts.
Restless leg syndrome is another common issue, affecting 10–25% of pregnant women. If it’s impacting your sleep, ask your doctor to check your iron and folic acid levels, as deficiencies in these nutrients may be the cause.
Don’t hesitate to discuss any sleep concerns with your doctor. Getting enough rest is essential not just for your well-being but also for your baby’s development.
Conclusion: Getting Better Sleep During Pregnancy
Understanding the impact of hormones on your sleep during pregnancy is a key step toward getting the rest you need. While sleep challenges are common, there are practical ways to manage them and reduce exhaustion. Use these insights to embrace strategies that promote better sleep.
Sleep disturbances affect most pregnant women, often becoming more pronounced as pregnancy progresses. Addressing these disruptions early can help lower potential health risks.
"Good sleep during pregnancy is important for you and your baby." – Sleep Health Foundation
The good news? You can take steps to improve your sleep. Simple changes like sticking to a consistent bedtime routine, incorporating prenatal yoga or meditation, tweaking your diet and hydration habits, and finding safe, comfortable sleep positions can make a world of difference. These techniques allow you to work with your body's changes instead of fighting against them, benefiting both you and your baby.
Sleep is just as important as eating well and staying active during pregnancy. Dr. Christine HJ Won from Yale University School of Medicine puts it perfectly: "The message is clear: good sleep is important for a healthy pregnancy." Prioritizing sleep isn’t selfish - it’s an essential part of caring for yourself and your baby.
Your body is doing the incredible work of growing a new life, and it deserves the rest it needs to keep going strong. With the right strategies and some support, better sleep during pregnancy is absolutely possible. For more expert advice - including guided prenatal yoga, meditation, and practical sleep tips - check out Rita's Pregnancy 101.
FAQs
How does progesterone affect sleep during pregnancy, and what can I do to improve it?
Progesterone, the hormone that ramps up during pregnancy, can throw a wrench in your sleep routine. It often brings along unwelcome companions like frequent trips to the bathroom, heartburn, and general restlessness. But don’t worry - there are a few straightforward ways to help improve your sleep:
Stick to a set sleep schedule: Going to bed and waking up at the same time every day can help keep your body’s internal clock on track.
Wind down with a calming routine: Try relaxing activities before bed, like reading a book, soaking in a warm bath, or practicing gentle yoga or meditation.
Mind your diet and drinks: Steer clear of caffeine and avoid heavy meals close to bedtime to minimize discomfort.
If you're still struggling to get quality rest, consider exploring holistic prenatal support. Programs like Rita's Pregnancy 101 offer tools like guided meditations and trimester-specific tips to help you manage hormonal changes and improve your sleep.
How can I lower cortisol levels to sleep better during pregnancy?
During pregnancy, keeping cortisol levels in check can play a big role in improving sleep quality. Here are some practical ways to help you rest better:
Try relaxation techniques: Gentle yoga, deep breathing, or meditation can ease stress and help you unwind before bed.
Stay moderately active: Activities like walking or prenatal yoga not only improve your mood but also naturally lower cortisol levels.
Create a soothing bedtime routine: A consistent wind-down routine - like reading or listening to calming music - can help signal your body that it's time to sleep.
Eat a balanced diet: Include foods packed with magnesium (leafy greens, nuts, seeds) and omega-3s (salmon, walnuts) to support stress management and better sleep.
By weaving these habits into your daily routine, you can set the stage for more peaceful, restorative sleep during pregnancy. For additional guidance, programs like Rita's Pregnancy 101 offer tailored support with prenatal yoga, meditation, and trimester-specific wellness tips designed just for you.
Can changing my diet help with pregnancy-related sleep problems?
Yes, tweaking your diet can make a big difference in how well you sleep during pregnancy. Try adding magnesium-rich foods like leafy greens, nuts, and whole grains to your meals. Magnesium can help relax your muscles and set the stage for better sleep. In the evening, go for light meals or snacks - options like low-fat yogurt or whole-grain crackers can aid digestion and reduce any discomfort that might keep you up.
On the flip side, steer clear of heavy, spicy, or acidic foods close to bedtime since they can trigger heartburn or indigestion. Cutting back on caffeine and sugar, especially later in the day, is another smart move to improve sleep quality. A well-rounded diet with plenty of fiber, protein, and healthy fats can help you feel more comfortable and rested during pregnancy.