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Tips for Quality Sleep During the Third Trimester

Last Updated on 9 June 2024 by Brisbane Livewell Clinic

Pregnancy can produce a range of symptoms and the 3rd trimester can particularly impact getting quality sleep. The fact is that the majority of women develop sleep impairments during pregnancy,(1) with statistics showing that over 75% of pregnant women experience insomnia, non-refreshing sleep and frequent awakenings during both the 2nd and 3rd trimester. (2) From bad dreams and nightmares to backache and Restless Legs Syndrome, sleep disturbance in pregnancy can be supported with complementary treatments including massage, acupuncture and naturopathic medicine.

Dream Baby

A study showed that 3rd trimester pregnant women reported more bad dreams, overall lower sleep quality and more night awakenings. (1) It’s somewhat natural to feel apprehensive in late-stage pregnancy about the impending birth and arrival of a newborn which can contribute to the nature of dreams. Anxiety, stress and tension are powerful psychological mechanisms impacting sleep duration and quality, especially in first-time mothers. (3) Emphasising the need for better sleep hygiene, findings support avoiding physically, emotionally, or cognitively arousing activities before bedtime, especially during pregnancy. (4) Supporting a healthy stress response, nervous system support and relaxation techniques can help to reduce poor sleep quality, with massage being high on the list of solutions for better sleep.

Baby Bumps and Backaches 

Massage of course has a multitude of benefits beyond better sleep. Pregnancy-induced hormonal and physiologic changes increase the risk of musculoskeletal problems in pregnancy,(5) while the application of therapies such as acupuncture and massage can be a helpful aid in improving comfort levels. One of the most frequent musculoskeletal complaints reported during pregnancy is low back pain experienced most in the 3rd trimester. (5) As belly size increases, body repositioning difficulties affect sleep continuity. (3) Side-lying positions in massage can help to get acquainted with better comfort levels as you adjust your sleeping style to accommodate your growing baby.

Restless sleep due to Restless Legs Syndrome

Sleep disturbance may be the result of Restless Legs Syndrome (RLS), a neurosensory disorder that typically begins in the evening and often prevents a person from falling asleep. (6) During pregnancy, up to 26% of women can be affected (7) with the highest severity occurring in the 3rd trimester. (8) In RLS, uncomfortable and unpleasant sensations involve an urge to move the legs, often worse during periods of rest or inactivity such as sitting or lying down and relieved by movement such as walking or stretching. (9)

Obviously contributing to poor sleep quality, RLS is definitely on your Naturopath’s radar. Nutrient deficiencies can play a role, with iron and other vitamin and mineral deficiencies found to be risk factors. (9) RLS can be an indicator of additional medical problems – especially if associated with iron deficiency – as well as night cramps, and excessive daytime sleepiness. (9) The Livewell Naturopaths can prescribe therapeutic dosing of nutrients to suit your individual needs, contributing to improved sleep quality and help to manage RLS.

Rest is Best

The fact is, sleep may not be perfect by the time you reach the 3rd trimester but seeking ways to improve sleep quality and quantity is worthwhile. Some daytime fatigue is also common, for example, more than 75% of women report a need to nap during pregnancy. (2) Making time for adequate daytime rest and practising good sleep hygiene can pay dividends. Guided relaxation exercises have been shown to be effective in improving sleep quality (10) and breathing techniques are a perfect addition to prepare your body and mind for childbirth.

It’s always best to report sleep and energy complaints to your healthcare providers to help determine what is “normal”. When in doubt, seek a second opinion and complementary treatments. Pregnancy is truly the time to seek guidance and support and here at Brisbane Livewell Clinics, we are always honoured to be part of your pregnancy journey!


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1. Lara-Carrasco J, Simard V, Saint-Onge K, Lamoureux-Tremblay V, Nielsen T. (2014) Disturbed dreaming during the third trimester of pregnancy. Sleep Med. 15(6):694-700.
2. Neau JP, Texier B, Ingrand P. Sleep and vigilance disorders in pregnancy. (2009) Eur Neurol. 62(1):23-9.
3. Silvestri R & Arico I. (2019) Sleep disorders in pregnancy. Sleep Sci.12(3): 232–239.
4. Tsai SY, Lee CN, Wu WW, Landis CA. (2016) Sleep Hygiene and Sleep Quality of Third-Trimester Pregnant Women. Res Nurs Health. 39(1):57-65.
5. Kesikburun S, Güzelküçük Ü, Fidan U, Demir Y, Ergün A, Tan AK. (2018) Musculoskeletal pain and symptoms in pregnancy: a descriptive study. Ther Adv Musculoskelet Dis. 10(12):229-234.
6. Lee KA, Zaffke ME, Baratte-Beebe K. (2001) Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med. 10(4):335-41.
7. Hensley JG. (2009) Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health. 54(3):211-8.
8. Manconi M, Govoni V, De Vito A, Economou NT, Cesnik E, Mollica G, Granieri E. (2004) Pregnancy as a risk factor for restless legs syndrome. Sleep Med. 5(3):305-8.
9. Tunç T, Karadağ YS, Doğulu F, Inan LE. (2007) Predisposing factors of restless legs syndrome in pregnancy. Mov Disord. 22(5):627-31.
10. Özkan SA, Rathfisch G. (2018) The effect of relaxation exercises on sleep quality in pregnant women in the third trimester: A randomized controlled trial. Complement Ther Clin Pract. 32:79-84.


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