Sleeping By the Trimesters: 1st Trimester

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Women in America are getting less sleep according to NSF's annual polls and they report more sleep problems, too. But these problems pale in comparison to the sleep disruptions that occur with pregnancy.

Hayley, a former web site producer, was used to jumping out of bed, grabbing a cup of coffee and heading into the office. Hayley's after-work life was filled with museum trips, concerts and dinner with friends. But as soon as she was pregnant, everything changed. With complaints of vomiting, nausea and exhaustion in the first trimester, she could barely make it through the day without desperately needing a nap. Although the second trimester offered her some relief, she soon realized that she would only feel more fatigued in the third trimester.

Why do women feel so tired throughout pregnancy? If nausea, back pain, fetal movement and constantly running to the ladies' room aren't enough, some women develop restless legs syndrome (RLS), snoring, wild dreams and insomnia. In the National Sleep Foundation 1998 Women and Sleep poll, 78% of women reported more disturbed sleep during pregnancy than at other times.

While mothers do not deny that the pay-off of having a child outweighs the lack of energy or sleep they experience during pregnancy, it helps to understand why this is happening to your body, what you can expect and what you can do to ease the process.

1st Trimester

The first trimester is a mix of excitement and surprises, especially for women who have never been pregnant. Between adjusting to the changes mentally and physically, some women feel great and others feel horrible. Listed below you will find some of the reasons why sleep becomes a challenge in your first trimester. In addition to weathering the effects of the first trimester, Dr. Kathryn Lee of the University of California at San Francisco recommends that first-time mothers plan for sleep the way they plan and schedule the rest of their lives. In a study of first time mothers vs. experienced mothers, the experienced ones got an extra 45 minutes to an hour of sleep each night. That extra sleep can help make pregnancy a more positive experience. Novice moms may feel less energetic and should schedule an allowance for more sleep.

Sleepy or Lacking Energy

Interestingly, the rise of progesterone, one of the hormones essential for the maintenance of pregnancy, may be one of the reasons pregnant women feel drowsier than before they were pregnant. The soporific (sleep-inducing) and thermogenic (heat-producing) effects of high progesterone secretion from the placenta are known to cause fatigue and earlier sleep onset. In the study "Longitudinal Changes in Sleep Architecture During Pregnancy and Postpartum," Dr.

Lee was able to study a group of women before they were pregnant, during their pregnancy and for three months postpartum. During their first trimester, she found an increase in total sleep time but poorer quality sleep due to awakening during the night. She also found a decrease in deep sleep from pre-pregnancy to the first trimester. "The women didn't say, 'I had 10% less delta sleep last night,' but they did complain of feeling fatigued, drowsy, and even depressed. They experienced the sleep loss in a variety of ways," Lee says.

Discomfort with Body Changes

Melissa, a first time mother, told us, "I loved how my body looked as it was changing but my breasts became uncomfortably tender." As the body changes, discomfort can make it harder to fall and stay asleep. Complaints of tender breasts may make sleeping on your stomach a challenge. Dr. Jodi Mindell, professor of psychology at St. Joseph's University and of pediatrics at University of Pennsylvania School of Medicine explained in an article for, "Your first trimester is the perfect time to start training yourself to sleep on your left side to improve the flow of blood and nutrients to your fetus and uterus and to help your kidneys get rid of waste and fluids. The sooner you get used to this position, the better you'll be able to sleep when your belly is bulging."

Urinary Frequency

Progesterone isn't just making pregnant women drowsy; this necessary hormone is also partially responsible for that never-ending quest for a bathroom. Progesterone's inhibitory effects on smooth muscle influences that need to urinate. Later in pregnancy, urinary frequency will be an issue as the uterus compresses the bladder and therefore reduces capacity. Many women will get up more than once during the night to relieve themselves, and this interrupts valuable sleep time.


Although it has long been called "morning sickness," many expecting mothers will clarify that nausea in the first trimester can (and will) happen at any time. Meir H. Kryger, M.D., author of A Woman's Guide to Sleep Disorders explains,

"Morning sickness, which is quite common in the first twelve weeks of pregnancy, can also cause women to awaken with nausea, sometimes before they are ready to wake up."

First Trimester Survival Tips

  • Plan, schedule and prioritize sleep!
  • Sleep while you can. In order to stay out of sleep debt, get extra zzz’s wherever you can.
  • Drink lots of fluids during the day, especially water, but cut down on the amount you drink before bedtime.
  • To avoid nausea try to eat bland snacks throughout the day — like crackers.
  • Sleep on your left side to improve the flow of blood and nutrients to your fetus.
  • Put a nightlight in the bathroom instead of turning on the light to use the bathroom — this will be less arousing and help you return to sleep more quickly.
  • Add daytime naps as necessary.