Is It Safe to Sleep on My Back During Pregnancy?

Sleep Back Pregnancy

It is estimated that one-third of your life is spent sleeping.1 Getting adequate sleep is important especially when you are pregnant. Good sleep hygiene can help you to have a healthier baby. But, did you know that sleep position is also important during pregnancy?

It is recommended that pregnant women sleep on their left side with knees bent to prevent any blood flow restriction to the fetus.2,3 When a pregnant woman sleeps on her back, there is a greater potential for compressing blood flow to the uterus and lowering oxygen supply to the developing fetus.2 Pregnant women who are in their second or third trimesters, when the fetus is heavier, have a particular benefit from sleeping on their left sides.1 Sleeping on your left side relieves pressure on major blood vessels and can decrease the potential for blood flow restriction. Sleeping on your side also decreases sleep-disordered breathing during pregnancy, which is more common if you sleep on your back.1

Sleep position during pregnancy is also associated with changes in fetal heart rate and placental blood flow.4,5 Two Australian studies found that pregnant women, who self-reported that they slept on their back for the last month or more of their pregnancy, had a higher rate of late term stillbirth compared to women who reported sleeping on their left side.1,5

There is still a need for larger studies to determine just how much sleeping on your back during pregnancy can affect your baby. But, for now, most experts agree that you should sleep on your left side while you are pregnant. If you start out sleeping on your left side, you may change position while sleeping but you are more likely to remain on your left side.4 If you wake up in another position like on your back, just try to remember to move back to your left side.4

Pillows and wedges may help you stay on your left side while you sleep.2,3 You can place these pillows and wedges between your bent knees, under your stomach, or behind your back.3 Sleep training techniques such as the tennis ball technique may also be used.2 The tennis ball technique uses some type of object to make sleeping on your back uncomfortable.

The American Congress of Obstetricians and Gynecologists (ACOG) provide guidance on back pain during pregnancy. They recommend sleeping on your side and putting one or two pillows between your legs to provide more back support.6

The American Academy of Sleep Medicine (AASM) recommends that pregnant women maintain good sleep practices to have a healthy baby. Good sleep behaviors include:3,7

  • Maintaining a good sleep routine
  • Go to bed and wake up around the same time each day
  • If you are going to nap, do it earlier in the day
  • Reducing the amount of fluids you drink at night
  • Drink plenty of fluids during the day to stay hydrated
  • Don’t drink too much at night
  • Eating a healthy and well-balanced diet
  • Avoid spicy or fried foods that upset your stomach
  • Eat small, but frequent meals
  • Participating in regular physical activity (with physician approval)
  • Reduced leg cramps at night
  • Prevents excessive weight gain
  • Practicing relaxation and breathing techniques before bed
  • Reduces tension
  • Promotes sleep
  • Relieving nasal congestion that can interrupt sleep
  • Maintaining a dark, cool, and comfortable environment to promote sleep
  • Avoiding staying in bed and trying to fall asleep
  • Don’t watch the clock
  • Avoiding alcohol and caffeine
  • Stimulating substance that can interfere with sleep

Additional resources on sleep position:

References:

  1. https://www.ncbi.nlm.nih.gov/pubmed/21673002
  2. https://www.ncbi.nlm.nih.gov/pubmed/24661447
  3. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/basics/healthy-pregnancy/hlv-20049471
  4. https://www.ncbi.nlm.nih.gov/pubmed/29023736
  5. https://www.ncbi.nlm.nih.gov/pubmed/25568999
  6. https://www.acog.org/Patients/FAQs/Back-Pain-During-Pregnancy
  7. https://aasm.org/pregnant-women-good-sleep-is-one-of-the-best-ways-to-assure-a-healthy-baby/
Lauren McMahan
Dr. Lauren McMahan has a Doctor of Pharmacy from Lipscomb University College of Pharmacy in Nashville, TN. She currently works for a large national healthcare company, where she provides her research and writing expertise to support evidence-based initiatives to improve patient care. She enjoys exercising, reading, and thrifting in her spare time.

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