Whilst there is limited evidence specifically for pregnant women, there is evidence that physical activity can improve sleep in the general population. This can be extrapolated to individuals who are pregnant. A systematic review of physical activity intervention RCTs has shown a statistically significant improvement in overall sleep quality, as well as apnoea-hypopnoea index, global score, subjective sleep and sleep latency (1). A systematic review of physical activity interventions in patients with insomnia demonstrated a statistically significant improvement in sleep quality in adults with insomnia disorder (4 out of 4 studies), and in those with insomnia symptoms (3 out of 4 studies) (2), and another systematic review & meta-analysis of physical activity in patients with insomnia (9 studies, n=557) suggested that physical activity can improve sleep quality (measured with the Pittsburg Sleep Quality Index and Insomnia Severity Index), without adverse effects (3).
A prospective study of 132 healthy pregnant women (18-22/40) allocated women to a 10-week intervention (4). They report that, although sleep attenuation occurred at that same rate in the intervention group as the controls, sleep quality was improved in the intervention group, with reduced restless sleep, snoring, and reduced diurnal tiredness/excessive daytime sleepiness.
Quality of evidence
Strength of recommendation
There are small studies and weak evidence that sleep quality is improved in pregnant women. This recommended has been adapted from evidence in the general population that physical activity is associated with improved sleep.
1. Kelley GA & Kelley KS Exercise and sleep: a systematic review of previous meta-analyses J Evid Based Med. 2017 Feb;10(1):26-36
2. Lowe H, Haddock G et al Does exercise improve sleep for adults with insomnia? A systematic review with quality appraisal Clin Psychol Rev. 2019 Mar;68:1-12
3. Banno M, Harada Y et al Exercise can improve sleep quality: a systematic review and meta-analysis PeerJ. 2018 Jul 11;6:e5172
4. Kocsis I, Szilagyi T et al Effect of a gymnastic program on sleep characteristic in pregnant women Taiwan J Obstet Gynecol. 2017 Apr;56(2):204-209