Mattress and Sleep During Pregnancy: How to Sleep Better (Guide 2026)

During pregnancy, sleep changes for several reasons at once: the weight of the belly, increased lower back tension, bathroom trips, heartburn, and restless legs. There isn't one trick that solves everything, but there are specific adjustments that make a difference — in your position, mattress, and pillow. I'll go through them one by one.

First of all: I'm Ana Cristina, Dreamura's Sleep Advisor. This guide is for informational purposes only and does not replace your doctor or midwife. If you have a high-risk pregnancy, severe pain, or specific concerns, speak with them first.

Sleeping on your side — and why the left side

From the second trimester onwards, the clinical recommendation is to sleep on your side, preferably on your left side. In this position, the vena cava (which carries blood back to the heart) is less compressed by the uterus, and circulation for both you and the baby improves.

Sleeping on your back for too long, especially in the third trimester, can cause dizziness and reduce this blood return. If you wake up on your back, don't panic — just turn onto your side and go back to sleep. Your body tends to adjust on its own.

Sleeping on your side changes what you need from your mattress and pillow. This is where most discomfort can be resolved.

The right mattress firmness

When you sleep on your side, your shoulder and hip bear the most weight. A mattress that is too firm creates pressure points; one that is too soft allows your hip to sink and misaligns your spine. The balance lies in medium firmness, which yields enough to accommodate your shoulder and hip while keeping your lower back supported.

In the Dreamura range, for this profile I usually suggest two mattresses:

  • Takumi (匠, master craftsman) — pocket springs + memory foam + high-resilience foam, 26 cm, medium firmness. It's our best-seller and works well for couples with different profiles, which helps when one of you starts sleeping differently during pregnancy.
  • Sora (空, sky) — pocket springs + high-resilience foam, no memory foam, medium firmness. Designed for those who mainly sleep on their side and prefer a more ventilated feel.

Pocket springs have another practical advantage: they isolate motion. On nights when you toss and turn more often, your partner will feel it less.

If your current mattress is good but has become a bit too firm for this stage, you don't always need to replace it. A Nemuke mattress topper adds a layer of comfort for your shoulder and hip without changing your base.

The pillow — and the one that goes between your knees

When sleeping on your side, your head needs a higher pillow to keep your neck aligned with your spine — the space between your ear and shoulder is larger than when you sleep on your back. A pillow that is too low will leave your neck drooping, and you'll wake up with tension in your shoulders.

However, the gesture that brings the most relief during pregnancy is another one: a pillow between your knees. It keeps your hips aligned and takes tension off your lower back and pelvis. Many pregnant women resolve half of their lower back discomfort with just this. A second pillow to support your belly in front helps in the third trimester.

For your head, if you sleep on your side, check out our range of pillows — those with a higher and firmer profile are suitable. If you want to understand the right height for you, the pillow guide explains it step by step.

What changes in each trimester

First trimester. Your body hasn't changed much yet, but fatigue and bathroom trips begin. It's a good time to get into the habit of sleeping on your side before your belly demands it.

Second trimester. This is usually the most peaceful time for sleep. Introduce the pillow between your knees and confirm that your mattress firmness supports your lower back. If you wake up with back pain, that's the sign to correct.

Third trimester. The weight of your belly, heartburn, and shortness of breath make getting comfortable more difficult. In addition to the pillow between your knees, support your belly in front and slightly elevate the head of the bed if you have heartburn or reflux. Two or three well-placed pillows are worth more than any single product.

Small habits that help

  • Reduce liquids in the hour before bedtime to lessen bathroom trips — but stay well-hydrated during the day.
  • Room temperature between 16 and 19 °C. During pregnancy, you get warmer, and a cool room helps you fall asleep.
  • If you have restless legs or cramps, speak to your doctor — sometimes it's linked to iron or magnesium and can't be resolved with bedding.
  • Get up slowly, rolling onto your side first. This protects your lower back and prevents dizziness.

“There’s no magic bed for pregnancy. There's medium firmness that supports the lower back, a high pillow for the neck, and one between the knees. Start there. If you're unsure about the mattress, call me before buying — in 10 minutes we can figure out what makes sense for you.”
— Ana Cristina, Sleep Advisor (+351 21 150 95 04)

Frequently asked questions

What is the best sleeping position during pregnancy?
On your side, preferably on your left side, especially from the second trimester onwards. It improves circulation for both you and the baby. If you wake up on your back, simply turn to your side without worry.

What mattress firmness is best during pregnancy?
Medium firmness. It accommodates your shoulder and hip when you sleep on your side and keeps your lower back supported. The Takumi and Sora, from Dreamura, are the ones I usually suggest for this profile.

Do I need to change my mattress because I'm pregnant?
Not always. If your current mattress supports you well, a mattress topper and a pillow between your knees can solve the problem. Only change it if your mattress was already at the end of its life or leaves your lower back unsupported.

Is a pregnancy pillow worth it?
The important thing is the effect, not the shape: a pillow between your knees and another supporting your belly do the job. You can use normal, well-placed pillows or a body pillow, as you prefer.

Can I test the mattress at home?
Yes. All Dreamura mattresses come with a 100-night trial at home, with free returns if it doesn't suit you. They are made in Portugal, with free delivery in 5 working days.

This guide is for informational purposes only and does not replace medical advice. Speak with your doctor or midwife about your situation, especially in cases of high-risk pregnancy.

See also

Related line: mattresses for side sleepers — the recommended position from the second trimester onwards.

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