Treatment of sleep problems during pregnancy is complicated by the fact that many medications have the potential to harm the fetus if taken by a pregnant woman. As a result, most treatments related to sleep during pregnancy involve lifestyle changes and coping techniques.

Women who experience sleep problems during pregnancy are encouraged to adhere to a consistent sleep schedule and to sleep in an environment conducive to sleep. Usually, this is a cool, dark, quiet room. Women are urged to get as much extra sleep as possible. This helps keep them rested and prepared for times when it is more difficult to sleep.

Beginning in the first trimester, women are encouraged to sleep on their left side. This position aids the flow of blood and nutrients to both the woman and fetus and helps prevent extra body weight from pressing on the liver and the inferior vena cava (a large vein that moves blood from the legs back to the heart). Lying on the left side may also help the kidneys to filter wastes and fluids during sleep. Generally, women are urged to sleep with their knees and hips bent. Back pain may be reduced by sleeping with a pillow between the knees, under the abdomen or behind the back.

Pregnant women are urged to avoid sleeping on their back. Lying in this position for extended periods of time can contribute to backaches, breathing problems, digestive problems, hemorrhoids, low blood pressure, and decreased circulation of blood and oxygen for both the woman and fetus. By the third trimester, most women find it difficult if not impossible to sleep on their backs. Sleeping on the stomach also should be avoided during pregnancy.

Other tips for improving sleep during pregnancy include:

• Keep a night-light in the bathroom. Keeping the main overhead lights off during nighttime trips to the bathroom may prevent fully awakening during the night.
  
  
• Nap regularly during the daytime when possible.
  
  
• Avoid fluids before bed. Drinking too much prior to sleep can result in awakenings.
  
  
• Avoid all caffeinated drinks during pregnancy.
  
  
• Monitor the foods and beverages consumed. Snacking on bland foods such as crackers may help prevent nausea, which can interfere with sleep. Avoiding spicy, acidic or fried foods – especially at dinner – may also reduce the incidence of heartburn during the night. Avoiding carbonated drinks can help prevent leg cramps, which may also disrupt sleep.
  
  
• Speak with a therapist or counselor about worries or concerns. Mental health experts can help pregnant women learn to deal with any anxiety they may have. The use of relaxation techniques or participating in relaxing activities such as yoga also may be recommended.
  
  
• Use a pregnancy pillow. These special pillows are made to help facilitate sleep during pregnancy.
  
  
• Exercise regularly. Regular activity can help pregnant women sleep better at night. However, it is crucial to consult a physician before exercising during pregnancy.

Women who are overweight or obese are at increased risk for developing sleep apnea during pregnancy. In some cases, these patients may benefit from using continuous positive airway pressure (CPAP), a treatment method that uses a special mask to provide oxygen that helps keep the patient’s airway open during sleep. Women who report snoring accompanied by breathing pauses during pregnancy typically are urged to seek evaluation for the possibility of sleep apnea.