How to sleep during pregnancy? What are the best sleeping positions during pregnancy ?

In this article you will find a practical guide on the best positions to sleep well during pregnancy, on the positions to avoid, on how to use the pregnancy pillow to improve sleep and avoid back pain during pregnancy.

Sleep during pregnancy is a hot topic; especially from the second trimester of pregnancy onwards when the quality of sleep worsens and the mother struggles to sleep due to frequent urination and difficulty breathing (dyspnea).

During this period, women feel heavy legs, may suffer from night cramps and back pain: all factors that compromise night sleep.

In this article I show you how to sleep during pregnancy, the best positions to sleep during pregnancy and how to use the pregnancy pillow to improve sleep (and avoid back pain).

You can find many other videos on our Instagram profile drsilva.com_official .

To stay healthy , it is advisable to sleep 7/8 hours a night.

In the case of a pregnant woman, the sleep requirement can reach 10 hours a day.

Since it can be difficult to get as much sleep as you would like at night due to problems such as back pain , it is a good idea to rest during the day when you feel the need.

To explain how to sleep during pregnancy and the best positions to do so, we must distinguish the first half of pregnancy from the second.

In the first trimester of pregnancy, many women feel more tired and need more sleep, probably due to the hormonal effect of progesterone.

During this period, sleep is not disturbed and you can sleep peacefully in a prone, supine or side position .

In short, you can choose the position in which you feel most comfortable without the risk of compromising your baby's health.

From the fourth month of pregnancy onwards, hormonal changes and the baby growing in the belly cause the mother's center of gravity to move anteriorly, increasing the physiological lumbar lordosis and the dorsal kyphotic curve; these variations increase the muscular overload of the spinal column.

This explains why many pregnant women begin to struggle to sleep well because they suffer from swollen legs, night cramps, back pain or neck pain.

Another big problem that negatively affects sleep is the weight of the belly which, in the side position, stretches the abdominal muscles creating tension in the lower abdomen and pubalgia.

In this paragraph I will explain why the mother should avoid sleeping in the supine position from the 4th/5th month of life onwards when the belly starts to get bigger and bigger.

The reason is simple and is based on body anatomy.

Running through the center of the abdomen are the vena cava and the abdominal aorta , two major blood vessels that carry blood from the heart to the lower body and vice versa.

In the supine position , these vessels would be compressed by the weight of the uterus and the baby , with the risk that this pressure would reduce blood flow to the fetus (altering fetal oxygenation) and to the mother's organs (altering cardiovascular parameters).

In addition, the supine position can also exacerbate respiratory disorders (such as shortness of breath, nighttime snoring, obstructive sleep apnea and hypopnea).

Instead, when the pregnant mother sleeps on her side or semi-prone , the uterus does not push towards the back and does not compress the blood vessels, thus ensuring optimal blood flow , correct fetal oxygenation and better drainage (even of the lower limbs).

As we anticipated in the previous chapter, the best positions for sleeping during pregnancy are two:

1. the side-lying position
2. the correct prone or semi-prone position
   
   

In both positions I strongly recommend you use a good pregnancy pillow.

The pregnancy pillow is essential to improve sleep as it corrects the mother's posture, improves drainage of the lower limbs, ensures the right support for the belly and decreases those tensions on the spine that worsen back pain.

For the pregnancy pillow to be truly effective in its purpose, it must space the legs and hips well, support the belly (avoiding its weight from weighing on the back and creating abdominal tension/lower abdominal pain), allow for correct alignment of the spine , avoid rotations of the trunk and tension in the back muscles.

To sleep on your side and use the pregnancy pillow correctly, you need to lie down on the bed and follow the steps below.

Bend your hips and knees slightly; the goal is to reduce tension on your back and pelvic joints.

After lying on your side, take the lower part of the pregnancy pillow and insert it between your legs; be careful to position the pillow well, starting from the thighs, continuing on the knee, calves, ankles and foot.

It is very important to use and position the pregnancy pillow correctly because it allows you to space out all your legs well, without creating rotations that would negatively affect the tension in your back and pelvis.

After having correctly positioned the lower part of the pillow, we move on to the middle and upper part of the pregnancy pillow, which must support the belly, neck and head.

Always on your side, take the pregnancy pillow and place it gently under your belly, sliding it between the mattress and your belly until you feel you have found the ideal height to support it.

The second best sleeping position during pregnancy in the second and third trimester is certainly the correct prone or semi-prone position.

Most mothers don't know it but it really is a panacea for the back and for improving sleep.

How to sleep in a semi-prone position during pregnancy?

Lie on your side on the bed and take the middle part of the pregnancy pillow.

Next, bend your top leg (the one that is higher up) and extend your bottom leg (the one that is in contact with the mattress).

At this point, rotate your back and belly towards the bed until it gently touches the mattress.

To avoid squashing your belly too much, place the pregnancy pillow under the knee of your bent leg.

In this way, your baby rests gently on the mattress without being compressed; furthermore, the back muscles are relieved and benefit greatly.

It is very important to position the pillow well under the bent knee to find the correct semi-prone position and avoid excessive rotation of the pelvis.

If you are comfortable and your baby is fine (when they are uncomfortable they make themselves felt with kicks), it means you are using the position correctly.

Back pain during pregnancy is a very common discomfort among pregnant women, and can appear either from the beginning of pregnancy (first trimester), or worsen over time and appear in the second or third trimester (as happens more frequently).

Lower back pain during pregnancy is medically defined as '' lumbago '', or pain (algia) in the lower back (lumbar region) and can seriously affect the sleep of the expectant mother.

In the vast majority of cases, back pain during pregnancy is caused by an overload of the lumbar muscles due to the great postural change that the mother undergoes during the sweet wait.

Only by making a correct diagnosis of the muscles and joints that cause back pain, can it be effectively treated without resorting to drugs, thanks to osteopathic treatments and a good pregnancy pillow.

In cases of back pain, the best sleeping position during pregnancy is on your side .

This is because in this position the load on the back muscles and spine is as little as possible.

Osteopathy during pregnancy accompanies the postural development of the expectant mother from the first weeks of life and helps her prevent or resolve back pain during pregnancy.

Thanks to gentle and effective manual treatments on the musculoskeletal system, the osteopath supports the evolution of the center of gravity and the curves of the spine, relaxing the muscles and improving joint mobility in the various body regions.

Osteopathic treatments (specific massages and joint mobilizations) offer numerous benefits to pregnant women; massage has a decontracting effect, relieves back pain (and not only), stimulates tissues, improves microcirculation and lymphatic drainage.

During treatments, the osteopath not only evaluates the lumbar region but also performs a complete and in-depth postural assessment of the patient's posture.

The treatment will be aimed not only at resolving the back pain, but also at improving the posture that created the lumbar overload and the resulting lumbago.

In fact, during the treatments the osteopath will also evaluate and treat the legs, calves, feet, the entire back, the abdomen, the diaphragm and the main body joints (both of the lower limbs and the spine).

Osteopathy is both a remedy and an effective preventive method for the most frequent pains during pregnancy:

• backache,
• sciatica
• buttock pain,
• sacroiliac pain,
• lower abdominal pain,
• pubalgia,
• leg cramps,
• neck pain
• headache during pregnancy.

This explains why it is advisable to undertake an osteopathic path whether you suffer from back pain (or other pains), or to prevent it.

You can see an osteopath from the beginning of the second trimester of pregnancy or even earlier if you wish.

Another reason to start an osteopathic path during pregnancy is that, by treating the pelvis and the pelvic region, the tissues (muscles and joints) of the future mother are prepared for the birth itself, resolving the possible rigid and contracted areas that would make it more difficult.

It has been shown that some obstetric complications requiring episiotomy, ventouse, or other obstetric interventions during labor and delivery may be caused by joint stiffness and musculoskeletal tension in the woman's pelvis.

Please remember to always choose an osteopath with experience in treating pregnant women for an initial assessment and treatment visit.

Keeping your lower limb muscles loose, your back relaxed and other basic precautions can help you prevent back pain during pregnancy and improve your sleep.

Look for an osteopath who specializes in treating pregnant women with whom you can begin a therapeutic path from the first months of pregnancy, when you have no back pain or it is mild.

During pregnancy, take care to maintain a healthy and balanced diet , rich in fiber and nutrients for the development of your baby.

This allows you not to gain too much weight and to better nourish the health of your baby already in the womb.

Another tip is to maintain an active lifestyle , not by giving up physical exercise but simply by doing it in an intelligent and functional way.

Do moderate physical activities, without the risk of joint trauma and that do not require excessive physical effort.

Stay moving, because regular physical activity keeps your back muscles trained, improving tone, stability and joint mobility.

Recommended physical activities are simple walking, water aerobics, yoga or pilates during pregnancy .

Yoga and Pilates are fantastic activities because they combine diaphragmatic breathing with light muscle activation, stretching and mobilization of the main body joints.

These disciplines are perfect for both those who already do them and those who have never done so.

As for swimming during pregnancy , it is a perfect physical activity because it allows the pregnant woman to exercise in water, that is, in the absence of gravity that weighs on the spine.

During water activities, the mother improves muscle tone and improves flexibility without overloading the back and joints; water activities are a perfect activity that the mother can do until the last weeks of pregnancy.

Below I suggest other useful tips to prevent back pain during pregnancy and improve sleep.

First of all, wear comfortable clothes that do not compress the belly and allow plenty of freedom of movement for the back and legs.

Wear comfortable, low-heeled, well-cushioned shoes; I'm talking about sneakers or gym shoes.

Avoid high heels or shoes with hard soles; they overload the ankles, knees, hips and back; in addition they worsen the impact on the articular discs of the spine.

If your job is sedentary, make sure you have a chair with good lumbar support; if your chair doesn’t have it, use a pillow behind your lower back to keep it aligned (not flexed).

Try not to sit for too long and, if you can, take 4 steps at least every 45-60 minutes of work.

Sitting for too long strains the lumbar muscles and promotes the onset of back pain and neck pain, as well as straining the circulatory system and worsening drainage of the lower limbs.

Avoid sudden movements and sudden strains; if you have to get out of bed, turn onto your side and use your hand to lift your back.

Avoid lifting heavy objects and, if you have to do it, bend your knees and hips to avoid overloading your back.

Finally, make sure you sleep on a comfortable mattress that is not too hard; sleep on your side (preferably your left) and use a pregnancy pillow designed specifically for your needs.

Night sleep is a fundamental aspect for a healthy pregnancy and to prevent back pain; the pregnancy pillow is therefore a very important investment for you but you must choose it well.

Happy pregnancy and see you soon,
Dr. Silva