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How to sleep well during pregnancy: a trimester-by-trimester guide

Pregnancy changes the whole body — and sleep is one of the first things to feel it. Each trimester brings different challenges, and the strategy for sleeping well needs to adapt. This guide divides the 9 months into practical phases, covering what happens, what to expect, and how to get good rest in each.

Before buying: to find the right pillow for this stage, see our complete guide to the ideal pillow 2026. And to re-evaluate your mattress (important in pregnancy), see the complete guide to the ideal mattress 2026.

First trimester: tiredness like you have never felt before

In the first 12 weeks, progesterone rises to unprecedented levels. It is the hormone that maintains the pregnancy — and it is also responsible for the constant daily sleepiness that many women describe as "I have never been so sleepy."

In parallel:

  • The body expends more energy (formation of the placenta and fetal development)
  • Morning sickness (and not always just morning) can interrupt sleep
  • Nocturnal urination starts early — the uterus already presses on the bladder even before the belly appears

T1 strategy: sleep when your body asks for it, without guilt. Short naps (20-30 minutes) during the day are not only allowed but recommended. Avoid caffeine after 2 pm — sensitivity increases in pregnancy.

Second trimester: the good window

Between weeks 13 and 27, for most pregnant women, sleep improves considerably. Nausea usually subsides. Energy returns. The belly is still manageable.

It is the best time to establish a solid routine that will last until childbirth:

  • Fixed bedtime and wake-up time
  • 30-minute screen-free pre-sleep ritual
  • Cool room (17-19°C is ideal)
  • Hydration concentrated early in the day, reduce in the 2 hours before bed

It is also an ideal time to invest in the right pillows if you have not already.

Third trimester: the complicated one

From 28 weeks, the belly becomes an obstacle on several levels. This is when 80% of pregnant women report having the worst sleep of their lives.

Essential rule: position

From 24 weeks, avoid sleeping on your back. The weight of the uterus compresses the inferior vena cava, reducing venous return to the heart and potentially affecting blood flow to the placenta.

Always sleep on your side. Ideally on the left side — it improves placental circulation and venous return.

Pillows: your best ally

This is the phase where having the right pillow makes a real difference. Recommendations by use:

  • Ergonomic side pillow (such as the Kaiteki Dreamura) for the head and neck — keeps the spine aligned when sleeping on your side
  • Pillow between the knees — relieves pressure on the hips and lower back (a natural fibre pillow, such as the Natura Bambu, works well)
  • Support pillow under the belly (from 30 weeks) — prevents the weight from pulling on the lumbar spine
  • U-shaped or C-shaped body pillow — from 32 weeks, it is worth considering a specific pregnancy pillow if you want to simplify things

Other T3 challenges

  • More frequent nocturnal urination: reduce liquids in the 2-3 hours before bed (not during the day)
  • Reflux: elevate the head of the bed 10-15cm; avoid eating 3 hours before bed
  • Restless legs: quite common; try magnesium (consult your doctor first) and gentle stretches before bed
  • Pre-labour anxiety: normal to increase in the last 4-6 weeks; meditating 10 minutes before bed helps

Frequently asked questions

From which week should I stop sleeping on my back?

From 24 weeks. The weight of the uterus compresses the inferior vena cava, reducing venous return to the heart and potentially affecting blood flow to the placenta. From then on, always sleep on your side, ideally the left side.

Which pillows help most with sleeping well during pregnancy?

In the third trimester, four types make a difference: an ergonomic side pillow for the head and neck, a pillow between the knees to relieve the hips and lower back, a support pillow under the belly from 30 weeks, and, from 32 weeks, a U- or C-shaped body pillow to simplify all of this into one piece.

In which trimester does sleep usually get worse?

In the third trimester, from 28 weeks — 80% of pregnant women report having the worst sleep of their pregnancy at this stage, between the size of the belly, more frequent nocturnal urination, reflux, and restless legs.

Why am I so sleepy in the first trimester?

Progesterone rises to unprecedented levels in the first 12 weeks — it is the hormone that maintains the pregnancy and is also responsible for the constant daily sleepiness many women feel at this stage.

When should I talk to my doctor about sleep during pregnancy?

Whenever there is persistent insomnia affecting daily life, severe restless legs preventing sleep, new or worsened snoring, symptoms of prenatal depression or anxiety, or high blood pressure — this last sign should be reported to your obstetrician immediately.

When to consult your doctor

Sleep changes in pregnancy, but there are signs that deserve professional attention:

  • Persistent insomnia that affects your daily life
  • Severe restless legs that prevent falling asleep
  • New or worsened snoring (may indicate pregnancy sleep apnoea)
  • Symptoms of prenatal depression or anxiety
  • High blood pressure — alert your obstetrician immediately (may indicate pre-eclampsia)

Your obstetrician or family doctor is the first point of contact for any of these. Do not ignore them.

See also

Explore: Kaiteki Pillow · Pillow Collection

Disclaimer: this article is for informational purposes only and does not replace medical consultation. Any significant changes in sleep during pregnancy should be discussed with your obstetrician.

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