Sleeping Comfortably In The Third Trimester

The third trimester breaks most of the sleeping positions you have used your whole life. Front is long gone, flat on your back stops being comfortable, and side sleeping puts all your weight through one hip. Nobody adapts to that instantly.

Why side sleeping gets recommended

From the middle of pregnancy onward, most clinicians suggest settling to sleep on your side rather than flat on your back, because lying flat lets the weight of the uterus press on the large vein returning blood to the heart. If you wake up on your back, do not panic. Just roll back onto your side and go back to sleep.

The support that makes side sleeping work

The discomfort usually is not the side itself, it is that your top leg drags your pelvis forward and twists your lower back. Three points of support fix most of it:

• Between the knees. Enough thickness to keep your top knee level with your hip rather than dropping toward the mattress. This is the one that stops the hip and lower back ache.
• Under the bump. A small amount of support takes the drag off the round ligaments, which is what causes those sharp pulls when you turn over.
• Behind the back. Something to lean against stops you rolling flat and gives you somewhere to rest without holding a position.

A full length pillow does all three at once, which is why they get popular in the last few months. Stacked regular pillows do the same job if they stay put, though most people find they migrate by about 2am.

Heartburn and the rest of it

Raising the head of the bed by a few inches helps reflux more than extra pillows under your head, which tend to bend you at the waist and make it worse. Books or blocks under the bed legs at the head end work well. Leaving a couple of hours between the last meal and lying down helps too.

For restless legs and cramps, a warm bath and stretching the calves before bed are worth trying, and worth mentioning at your next appointment because low iron is one of the things that can drive it.

Getting comfortable enough to sleep hot

Most people run warm in the third trimester. Breathable cotton bedding, a lighter duvet than feels right, and a cooler room usually beat trying to sleep under the same setup you used in winter.

When to raise it

Talk to your midwife or doctor about sudden or severe swelling, headaches that will not shift, itching that is worse at night, or any change in your baby's usual pattern of movement. Sleep advice is for ordinary discomfort, not for symptoms like those.