A: Insomnia in pregnancy is common. As your pregnancy advances, physical changes add to the emotional and hormonal upheavals. Your baby grows, stretching and stressing your body in new ways. Pressure on your bladder leads to frequent nighttime trips to the bathroom, your baby's movements provide unexpected interruptions to your sleep, your growing uterus expands your belly and can cause you to feel short of breath when lying down, and you'll discover a range of new aches and pains that make sleeping less comfortable. Additionally, your excitement and apprehension about delivery can stimulate vivid or even disturbing dreams, which can also affect your slumber.

While you won't be able to eliminate all of these disturbances, there are some ways to improve your sleep.

First, don't do anything that stimulates you at night. Exercise early in the day rather than right before bedtime. Also, avoid caffeinated beverages in the afternoon and evening.

Second, establish a clear bedtime routine. Your room should be calm, quiet and darkened when you sleep. Keep your bed sacred for sleeping, rather than using it as an evening activity center. Make your bed as comfortable as possible. Try a pillow between your knees and propped behind your back when sleeping on your side, or curl around a full-length body pillow for some extra support and coziness. Before retiring try meditation, taking a warm bath, reading or listening to soothing music. Or, see if your partner's willing to give you an evening massage.

Since most pregnant women wake frequently during the last trimester, establish a plan to get back to sleep. Relaxation or meditation tapes can be helpful and can teach you valuable skills. Keep something to read nearby or listen to a book on tape. If you are awakened because of pregnancy-related anxieties, writing in a journal may help. Furthermore, you may want to record these concerns so you remember to discuss them with your health care provider.

Some people feel that a pregnant woman's sleep interruptions may be her body's way of preparing her for life with a newborn. If you're not feeling sleep-deprived during daytime hours, don't be anxious about changes in your sleep pattern; accept them as a normal part of pregnancy. However, if you are constantly fatigued or drowsy, and the above recommendations don't help, speak to your health care provider for additional assistance.