Rest for Two: How Physical Therapy and Chiropractic Care Transform Sleep Quality During Pregnancy

For expecting mothers in Manhattan, sleepless nights often begin long before the baby arrives. Between back pain that makes finding a comfortable position impossible, hip discomfort that wakes you every time you roll over, and the general physical strain of carrying new life, quality sleep can feel like a distant memory. Yet adequate rest during pregnancy isn’t just about feeling refreshed—it’s essential for both maternal health and fetal development.

The good news? Manhattan women struggling with pregnancy-related sleep disturbances don’t have to simply “tough it out” until delivery. At Manhattan Sports Therapy, Dr. Rolland Miro and Dr. Rachel Berenbaum specialize in conservative, hands-on care that addresses the musculoskeletal issues robbing pregnant women of restful sleep.

The Pregnancy Sleep Crisis: Understanding the Statistics

If you’re pregnant and exhausted, you’re far from alone. Research reveals that sleep problems during pregnancy are remarkably common and tend to worsen as the months progress.

Studies show that approximately 78 percent of pregnant women experience insomnia symptoms by the third trimester. The overall prevalence of insomnia during pregnancy hovers around 38 percent, but this figure varies dramatically by trimester. About 25 percent of women struggle with insomnia in the first trimester, rising to 27 percent in the second trimester, and peaking at nearly 40 percent in the third trimester.

Other research indicates even higher rates, with up to 80 percent of women reporting insomnia symptoms by late pregnancy. An estimated 76 percent of pregnant women experience a lack of sleep, poor sleep quality, daytime drowsiness, and frequent nighttime wakings during the first seven months of pregnancy.

The impact extends beyond feeling tired. Sleep disturbances during pregnancy are associated with increased risk of gestational diabetes, gestational hypertension, longer labor times, and postpartum depression. Given these serious consequences, addressing pregnancy-related sleep problems isn’t a luxury—it’s a necessity.

Why Pregnancy Disrupts Sleep

Understanding why sleep becomes so elusive during pregnancy helps explain how targeted physical therapy and chiropractic interventions can help. Multiple factors converge to create the perfect storm for sleep disruption.

Hormonal changes play a significant role. Progesterone levels rise throughout pregnancy, reaching ten times higher than peak menstrual cycle levels by 36 weeks. While progesterone has some sedating effects, it also impacts smooth muscles and the nervous system in ways that can interfere with quality sleep. Rising estrogen levels reduce REM sleep, further compromising sleep quality.

The physical changes are equally challenging. As your center of gravity shifts forward to accommodate your growing baby, your lumbar lordosis increases—the natural curve in your lower back becomes more pronounced. This postural adaptation creates stress on the spine, pelvic muscles, and ligaments, leading to the back pain that keeps so many Manhattan mothers awake at night.

During pregnancy, women release a hormone called relaxin that allows muscles and soft tissues to become more pliable. While this is vital to accommodate the growing fetus and prepare for delivery, it creates the risk for hypermobile joints. This joint instability can lead to sacroiliac joint dysfunction, hip pain, and pelvic discomfort—all of which make finding a comfortable sleeping position nearly impossible.

Additional factors compound the problem:

• Frequent Urination: The need to visit the bathroom multiple times per night disrupts sleep cycles, accounting for 39.3 percent of reported insomnia causes
• Positional Discomfort: Finding a comfortable sleeping position becomes increasingly difficult, cited by 30.7 percent of pregnant women as a cause of insomnia
• Restless Legs Syndrome: This uncomfortable sensation affects 13.7 percent of pregnant women and can make falling asleep challenging
• Fetal Movement: As the baby becomes more active, nighttime movements can wake the mother
• Heartburn and GERD: Gastroesophageal reflux commonly worsens at night during pregnancy
• Shortness of Breath: As the uterus expands and presses on the diaphragm, breathing can become more labored, especially when lying down

The Connection Between Musculoskeletal Pain and Sleep

Research consistently demonstrates a strong connection between musculoskeletal pain and poor sleep quality during pregnancy. Approximately 50 percent of pregnant women experience back pain at some point before delivery. This pain doesn’t confine itself to waking hours—it follows women into bed, making comfortable rest impossible.

Studies examining sleep complaints in pregnant women found that not finding a comfortable sleeping position ranks among the top three reasons for insomnia. The relationship is bidirectional: pain interferes with sleep, and poor sleep can lower pain thresholds, making discomfort feel even worse the following day.

This is precisely where physical therapy and chiropractic care become game-changers. Unlike medications—which many pregnant women understandably want to avoid—conservative manual therapies directly address the structural issues causing pain and sleep disruption.

How Chiropractic Care Improves Pregnancy Sleep

Dr. Miro’s specialized approach to prenatal chiropractic care at Manhattan Sports Therapy focuses on establishing pelvic balance and optimizing spinal alignment throughout pregnancy. His conservative, hands-on techniques are specifically designed to accommodate the unique needs of pregnant women.

Research demonstrates impressive results for chiropractic care during pregnancy. One study of pregnant patients with low back or pelvic pain receiving chiropractic treatment found that 73 percent reported good or excellent outcomes. These improvements weren’t just about daytime comfort—many patients specifically noted better sleep quality.

A collaborative study between chiropractic and medical professionals revealed that 75 percent of pregnant women receiving chiropractic care reported pain relief. Importantly, patients in multimodal care groups also reported greater improvement in their quality of life, with the greatest improvements seen in their sleep patterns.

The mechanisms behind these improvements are clear. When the spine and pelvis are properly aligned, pressure on nerves decreases, muscle tension diminishes, and the body can relax more fully. This allows pregnant women to find comfortable sleeping positions and maintain them throughout the night without waking due to pain or discomfort.

Chiropractic adjustments during pregnancy offer several sleep-related benefits:

• Reduced Back Pain: Spinal manipulation and gentle adjustments relieve the lower back pain that keeps many women awake at night
• Hip and Pelvic Alignment: Proper pelvic positioning reduces hip discomfort and allows for more comfortable side-sleeping positions
• Decreased Muscle Tension: Soft tissue work on the glutes, hamstrings, lower back, and hip flexors releases tension that interferes with relaxation
• Nerve Pressure Relief: Addressing sacroiliac joint dysfunction and other alignment issues takes pressure off nerves, including the sciatic nerve that can cause shooting pains
• Improved Positioning Options: When the body is properly aligned, more sleeping positions become comfortable, giving women greater flexibility

Dr. Miro’s techniques are safe and gentle, adapted specifically for pregnancy. He uses methods like the Webster Technique, which focuses on pelvic alignment, and activator adjustments that don’t require uncomfortable positioning. His approach creates optimal conditions for the body to heal and rest.

Physical Therapy’s Role in Better Pregnancy Sleep

Physical therapy offers complementary benefits that work alongside chiropractic care to improve sleep quality. At Manhattan Sports Therapy, the team recognizes that addressing sleep issues requires a comprehensive approach that includes strengthening, stretching, and education.

A physical therapist can identify muscular imbalances contributing to pain and sleep disruption. During pregnancy, certain muscles work overtime while others weaken, creating imbalances that stress the body. The piriformis muscle, for instance, is often overworked during pregnancy and can compress the sciatic nerve, causing pain that radiates down the leg—a condition that makes comfortable sleep nearly impossible.

Physical therapy addresses these issues through targeted interventions:

• Strengthening Weak Muscles: Building core stability and strengthening underused muscles helps support the changing body and reduces strain
• Stretching Tight Muscles: Targeted stretching of the hip flexors, hamstrings, and back muscles releases tension and improves flexibility
• Postural Training: Learning proper posture for sitting, standing, and lying down reduces daytime strain that carries over into nighttime discomfort
• Exercise Prescription: Regular, appropriate exercise improves overall comfort, reduces pain, and promotes better sleep quality
• Sleep Position Education: Physical therapists teach optimal sleep positions and recommend proper pillow placement for support

Research supports these approaches. Studies show that pregnant women who exercise regularly experience less back pain and better sleep quality. Exercise also reduces the risk of gestational diabetes and preeclampsia—conditions that can further interfere with sleep.

The team at Manhattan Sports Therapy provides specific guidance on sleep hygiene for pregnant women. This includes recommendations on supportive mattresses, body pillow positioning, and techniques for getting in and out of bed without straining the back or pelvis.

Real Results: What Manhattan Women Can Expect

The outcomes for pregnant women receiving physical therapy and chiropractic care are consistently positive. In studies of pregnant patients undergoing chiropractic treatment, the average pain score decreased from 5.9 at initial presentation to 1.5 at termination of care. More than 94 percent of cases demonstrated clinically important improvement.

These improvements translate directly to better sleep. When back pain decreases from moderate-to-severe levels to mild or minimal levels, women can lie down without discomfort, change positions without waking, and achieve the deeper sleep stages necessary for restoration and healing.

Long-term follow-up studies show that these benefits persist. Research tracking pregnant women receiving chiropractic care found that the majority continued to report improvement at one week, one month, three months, six months, and even one year after beginning treatment. This suggests that the care doesn’t just provide temporary relief—it helps establish healthy patterns that continue benefiting women throughout pregnancy and beyond.

The Multidisciplinary Advantage

At Manhattan Sports Therapy, Dr. Miro’s integrated approach combines the best of chiropractic care, physical therapy techniques, and sports medicine expertise. This multidisciplinary perspective offers significant advantages for pregnant women.

Rather than addressing symptoms in isolation, Dr. Miro and Dr. Berenbaum evaluate the entire musculoskeletal system to identify root causes of pain and sleep disruption. They recognize that a problem in one area—such as pelvic misalignment—can create compensatory issues throughout the body, affecting everything from lower back comfort to neck tension.

Their conservative care includes:

• Therapeutic Soft Tissue Techniques: Hands-on work to release muscle tension and improve tissue quality
• Gentle Joint Mobilizations: Careful adjustments that restore proper joint function without aggressive manipulation
• Targeted Stretching: Specific stretches that address pregnancy-related tightness
• Massage Therapy: Complementary massage to enhance relaxation and reduce muscle tension
• Exercise Guidance: Personalized exercise programs that are safe and effective during pregnancy
• Ergonomic Counseling: Advice on optimizing workspace, sleep environment, and daily activities

This comprehensive approach means Manhattan women don’t have to visit multiple providers for different symptoms. Everything is coordinated in one practice, with practitioners who communicate and collaborate to ensure the most effective care.

Safety Considerations and When to Start

Safety is paramount when treating pregnant women, and both Dr. Miro and Dr. Berenbaum have extensive experience working with expectant mothers. Chiropractic care and physical therapy are generally considered safe during pregnancy when performed by trained professionals who specialize in prenatal care.

However, certain situations require additional caution or may contraindicate manipulative therapy:

• Vaginal bleeding or placental complications
• Ectopic pregnancy
• Moderate to severe toxemia
• History of multiple miscarriages
• Certain high-risk pregnancy conditions

Always consult with your obstetrician before beginning any new treatment during pregnancy. Most OB-GYNs in Manhattan are familiar with conservative care approaches and support their use for managing pregnancy-related musculoskeletal issues.

The ideal time to start care is as soon as you notice discomfort, rather than waiting until pain becomes severe. Many women benefit from beginning treatment in the first or second trimester, establishing proper alignment and addressing minor issues before they progress. However, it’s never too late to seek help—women in their third trimester often experience dramatic improvements in comfort and sleep quality.

Beyond Sleep: Additional Benefits of Prenatal Care

While improved sleep is a significant benefit, the advantages of physical therapy and chiropractic care during pregnancy extend well beyond nighttime rest. Manhattan women receiving regular prenatal care often experience:

• Shorter Labor Times: Proper pelvic alignment can facilitate easier, faster delivery
• Reduced Need for Interventions: Women with balanced pelvises are less likely to experience posterior or breech presentations that lead to C-sections
• Less Postpartum Pain: Maintaining proper alignment during pregnancy often means faster postpartum recovery
• Better Fetal Positioning: Optimal pelvic alignment provides maximum room for the baby’s development and positioning
• Reduced Pregnancy Complications: Managing stress and pain may help reduce risks of gestational hypertension and other complications
• Improved Overall Function: Better alignment means easier movement and less limitation in daily activities

These benefits contribute to better quality of life throughout pregnancy and set the stage for easier postpartum recovery.

Practical Sleep Tips to Combine with Professional Care

While receiving care at Manhattan Sports Therapy, pregnant women can enhance their results with these practical sleep strategies:

• Side Sleeping with Support: Sleep on your left side with a pillow between your knees and another supporting your belly
• Elevation Adjustments: Use pillows to elevate your upper body slightly if experiencing heartburn or shortness of breath
• Temperature Control: Keep your bedroom cool, as pregnant women tend to run warmer
• Consistent Schedule: Go to bed and wake at the same times daily to regulate your body’s sleep-wake cycle
• Limit Fluids Before Bed: Reduce bathroom trips by limiting fluid intake in the two hours before bedtime
• Relaxation Techniques: Practice deep breathing, progressive muscle relaxation, or prenatal meditation before bed

These strategies work synergistically with professional care to optimize sleep quality.

Taking the First Step Toward Better Sleep

If you’re a pregnant woman in Manhattan struggling with back pain, hip discomfort, or sleepless nights, you don’t have to accept poor sleep as an inevitable part of pregnancy. The team at Manhattan Sports Therapy has helped countless expecting mothers throughout New York City find relief from pregnancy pains and achieve the restorative sleep they need.

Dr. Miro’s successful techniques for establishing pelvic balance help optimize both your baby’s room for development and your comfort, allowing your body to adjust in a more gradual, pain-free way. As drug-free pain relief is particularly important to expectant moms, his preferred treatments combine therapeutic soft tissue techniques with gentle joint mobilizations and targeted stretching—all approaches proven to improve both physical and emotional well-being.

Your Partner in Prenatal Care

Manhattan Sports Therapy’s Midtown location makes quality prenatal care accessible for busy New York City mothers. Whether you’re dealing with headaches during pregnancy, sciatica, lower back pain, hip discomfort, or the insomnia that so often accompanies these conditions, Dr. Miro and Dr. Berenbaum can provide the conservative, effective care you need.

Don’t spend another night tossing and turning, unable to find a comfortable position. Don’t let back pain rob you of the sleep you and your baby need. Contact Manhattan Sports Therapy today to schedule your appointment and discover how chiropractic care and physical therapy can transform your pregnancy experience. Your body is working incredibly hard to grow new life—it deserves the support, care, and rest necessary to do that job well.