It is 3am and your mind is wide awake: sleep worries in pregnancy

The house is silent. Your partner is asleep, or you are alone, and the clock says 3:07. You need the toilet again, your hips ache, and as soon as you lie back down the thoughts arrive: Am I lying the wrong way? Was that a movement? How will I cope with a newborn if I cannot even sleep now?

Broken sleep in pregnancy is very common, and the worry about not sleeping can keep you awake more than the bump does. Here is a gentle guide to the night, from bedtime to morning.

Before bed: setting up a kinder night

• Wind down for half an hour. Dim the lights, put the phone on the other side of the room and do something slow: a bath, a short Bible reading, folding baby clothes.
• Eat a light snack if hunger or nausea wakes you. Big meals right before bed can make heartburn worse, so try to have dinner a little earlier and stay upright for a while afterwards.
• Drink well in the day and a little less in the last hour or so before bed, to cut down on night toilet trips without getting dehydrated.
• Build a pillow nest. A pillow between your knees, one behind your back and one under your bump can ease hips and back.

About sleep position, so you can stop worrying

From around 28 weeks, the advice in many countries is to go to sleep on your side, left or right, rather than flat on your back. That is a simple, sensible step. It does not mean you must lie awake guarding your position. If you wake up on your back, just roll onto your side and go back to sleep. You have not done anything wrong. In earlier pregnancy, sleep in whatever position is comfortable.

Midnight to 2am: when you wake and cannot settle

Try not to check the time. Clock-watching turns a short wake into a long one as you start counting the hours left.

• Breathe slowly, making the out-breath longer than the in-breath.
• Relax your body from the toes up: feet, calves, knees, hips, all the way to your jaw and forehead.
• Pray a simple line on each out-breath, such as Lord, you are here.

3am: when the worries get loud

Night has a way of making every worry look bigger. A problem that seems manageable over breakfast can feel enormous in the dark. Keep a notebook and pen by the bed. Write the worry in a few words, close the notebook and tell yourself, I will look at this in daylight. Most of those notes look smaller in the morning.

If you have been awake for what feels like more than twenty minutes, get up. Sit somewhere dim and comfortable, sip water or warm milk, and read something gentle until you feel sleepy again. Lying in bed fighting sleep teaches your body that bed is a place to struggle.

A worry that should not wait until morning

Some night thoughts are worth acting on straight away. Later in pregnancy, if you notice your baby moving less than usual, or a change in the pattern of movements, call your midwife or maternity unit now, even at night. Do not wait to see if things pick up, and do not rely on a home heart monitor. The same goes for bleeding, fluid leaking, severe pain, a bad headache with vision changes, or feeling very unwell. Maternity units expect calls at night.

5am: the early hours

If you have had a broken night, let the day be gentler. Rest when you can, even if you do not sleep: lying down with your feet up for twenty minutes still helps. Ask for help with one task. Lower the bar on housework.

When it is more than ordinary broken sleep

Talk to your midwife or doctor if:

• You are lying awake most nights with racing, anxious thoughts.
• Low mood is keeping you up, or you wake early feeling dread.
• Your partner notices you snoring loudly or pausing in your breathing.
• Restless, crawling feelings in your legs stop you settling.
• You are too exhausted to function during the day.

These are common and there is help. Please do not take any sleeping tablets or herbal sleep remedies without checking with your doctor or pharmacist first.

Rest that is deeper than sleep

David wrote of lying down in peace, knowing that God was the one keeping him safe:

I will both lay me down in peace, and sleep: for thou, LORD, only makest me dwell in safety. (Psalm 4:8)

Even on nights when sleep does not come easily, you can lie down in that peace. You are not on watch alone. God does not need you to stay awake to hold your baby together.

A prayer for the middle of the night

Lord, it is dark and my thoughts are loud. Quiet my mind and loosen my shoulders. Keep my baby and me safe in your care, and give me the rest I need for tomorrow. Amen.