I have never been a good sleeper. So when I got pregnant last fall, I was nervous. I’d heard horror stories about insomnia during the third trimester in particular — that it’s “the worst sleep you’ll ever get in your life,” according to one friend, even compared to having a newborn. (This was backed up by another friend of mine who had twins.) I braced myself.
Things started to get bad around week 12. On New Year’s Eve, I conked out at 10:30 p.m., woke up at 1 a.m., tossed fitfully for what felt like years, and finally made myself a ham-and-cheese sandwich at 4 a.m. When I dragged myself out of bed in the morning, my body felt toxic and heavy, like my veins were pumping lead. I spent the witching hours of January lying on the cold kitchen floor, listening to meditation apps and dreading how exhausted I’d be the next day. Finally, I begged my doctor for help. My trusty old friend Ambien was off-limits, I knew. But was there anything else I could do or take?
She gave me some advice, which I followed with the religious fervor of the truly desperate. To my surprise and relief, it actually worked. I’m now 37 weeks pregnant and still sleeping pretty well, as long as I stick to my finely calibrated routine. It’s a little obsessive, but every bit worth the eightish hours of rest I’ve been getting most nights. Here’s my full, doctor-approved program; no matter what stage of pregnancy you’re at (or even if you’re not pregnant), I hope you find something here that helps you.
1. Exhaust yourself physically.
No pregnant person wants to hear that they should exercise more. But as my doctor put it, “Whatever kind of activity you’re doing, do it as much as you can.” Dr. Taraneh Shirazian, an associate professor of obstetrics and gynecology at NYU Langone Health, was even more emphatic. “Everyone should exercise in pregnancy,” she told me. “It’s important on multiple fronts. Not only does it make you sleep better, but it also helps get higher oxygen delivery to the fetus.”
In the cold, isolated, pre-vaccine days of last winter, making myself exercise required a literal departure from reality: I got my hands on an Oculus headset and hurled myself around my living room using a virtual-reality fitness program called Supernatural. In real life, I was bloated and couldn’t even fit into my sweatpants, but once I put the headset on, I became a dragon-slaying warrior goddess in faraway lands. In the spring, after I got vaccinated and the weather improved, I started taking outdoor fitness classes and walking as much as possible. Every day, I waddle out to get lunch from a place about a mile away from my apartment. It doesn’t always feel great to move, but I’m always glad I did when I get into bed at night.
2. Try gentle sleep aids.
People get squeamish about taking pills while pregnant, and with good reason. “The problem with most drugs and supplements is that they are not studied on pregnant women, especially newer ones like CBD, so it’s hard to know with 100 percent certainty if they are safe,” says Dr. Shirazian. However, some are widely believed to be fine.
My doctor suggested that I take Unisom, an over-the-counter antihistamine that touts itself as “drug free.” She also said I could try low doses of melatonin, a hormone that the body naturally produces as part of your sleep cycle. When I asked her if it was okay to take both regularly, she said yes. So I take a small amount of melatonin (2 milligrams) and two of Unisom’s SleepMelts on most nights, and it makes a huge difference. The only time I ever felt groggy the next day was after I decided to skip the pills, only to lie awake for hours and take an emergency melatonin at 4 a.m.
“In general, antihistamines [like Unisom] are safe in pregnancy,” confirmed Dr. Shirazian. “Millions of pregnant women have taken antihistamines for years, so they have been studied.” They work by lightly suppressing your immune system, which makes you drowsy. (Of course, not all antihistamines are created equal, so don’t swig Benadryl with abandon; pregnant women should always consult their doctors before taking anything.) Melatonin is also considered safe in low doses for pregnant women, Dr. Shirazian added, because it already exists in your body.
I also take magnesium powder dissolved in a cup of water every night, which my doctor recommended to alleviate cramps and constipation (pregnancy is so fun!), but apparently helps you relax, too. The brand I use is called Calm; I’ve noticed (and heard anecdotally) that it’s more effective in powder form than as a pill or a gummy, because taking it in water helps your body absorb it.
3. Have a snack.
Despite eating like a starved wolf throughout my pregnancy, I am almost never hungry when I wake up in the middle of the night. But my doctor said that having something small, ideally with some protein, can be helpful. (For what it’s worth, my dad swears by this too. When I was little and couldn’t sleep, he would give me yogurt or a glass of milk.) These days, my go-to 3 a.m. snack is cottage cheese, and it always works.
4. Get as comfortable as possible.
Not to be Captain Obvious, but sleeping is a lot easier when you’re comfortable. The tricky part is getting there. A position might feel wonderful for five minutes, and then suddenly my left butt cheek is on fire and I MUST roll over immediately, which requires heaving around a six-pound fetus that’s pressing against my internal organs, kicking me in the ribs, and stretching out my ligaments. It’s weird at best, painful at worst, and usually involves a lot of grunting. I also have to get up and pee two to four times a night.
After some trial and error, I have developed what can best be described as an elaborate sleep fortress that involves the following: (1) A C-shaped pregnancy pillow that supports both my belly and my back (mine is made by Pharmedoc, but there are plenty of others in a variety of configurations, including the much-hyped Snoogle); (2) A fan to keep me ten degrees colder than my bed partner, who for some reason does not want to set the air conditioner to 60 degrees; (3) An eye mask to block out light (these ones by Lunya are pricey, but hands-down worth it because they stay put and also cool your face somehow); and (4) A white-noise sound machine (mine is by Hatch, but I’ve used the free White Noise app on my phone too).
I make no apologies for this high-maintenance setup, which monopolizes most of the bed, and Dr. Shirazian has my back. “Finding a comfortable sleep position is one of the best things you can do,” she said. “Make sure you have enough space. Pregnancy pillows and belly bands are good things to try.”
Being able to sleep when you’re tired is a worthy pursuit on its own. But for what it’s worth, it’s also better for your baby. While poor sleep doesn’t directly affect placental health, Dr. Shirazian said that it “can affect lifestyle choices and downstream consequences.” For example, I tend to eat more sugary foods when I’m tired, which (as Dr. Shirazian kindly reminded me) puts me at a higher risk for gestational diabetes. “Mental health is also very important, and if you don’t get enough sleep, it can further exacerbate issues like anxiety and depression,” she added. There’s also a higher risk of losing your balance and injuring yourself (and your fetus) if you’re fatigued. So, do whatever you can to get the rest you need.