Pregnancy and Insomnia

Insomnia And Pregnancy

Sleep is an extremely important parameter that determines everyday health and progress. Its importance increases further for people in certain life circumstances, such as pregnancy. Unfortunately, many women constantly face difficulties sleeping well when they are expecting, with research pointing out that up to 80 percent of them report insomnia. [1]

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Further research has confirmed the association between pregnancy and insomnia. While the condition remains manageable, you must familiarize yourself with what it is, how the association occurs, and what you can do about it.

What Causes Insomnia in Pregnancy?

Insomnia describes facing problems falling or staying asleep to the extent that it causes daytime fatigue. When this problem occurs primarily due to pregnancy or other associated factors, some people call it pregnancy insomnia. For many women, insomnia may appear during the first pregnancy, forcing them to experience poor-quality sleep or get minimal sleep. Moreover, many such females also start sleeping less deeply and constantly wake up during nighttime.

Females with pre-existing issues with sleep or a diagnosed sleep disorder are more likely to struggle with sleep insomnia. However, this does not make other people with no sleep issues history safe from developing it. Multiple factors can contribute to pregnancy insomnia, including the following:

  • Nausea
  • Anxiety about labor or motherhood
  • Fluctuating hormones
  • Increased heart rate and metabolism
  • Snoring
  • Physical discomfort, such as leg cramps and back pain
  • Heartburn
  • Frequent trips to the bathroom

Can Pregnancy Cause Insomnia? The Timeline

Pregnancy insomnia may begin at any time following conception. However, the problem generally peaks during the latter half of the pregnancy as the symptoms intensify. Many begin feeling sleeplessness as early as six to seven weeks into pregnancy. Ultimately, the main triggering factor behind insomnia determines when it begins and how it changes with the course of time.

Insomnia Early Pregnancy

Insomnia during early pregnancy mainly occurs due to a hormonal shift and the consequent symptoms it leads to, such as frequent urination, nausea, and vomiting. For this reason, insomnia during the early stages of pregnancy causes a woman difficulty sleeping and maintaining it. Even if they manage to fall asleep, they may wake up a couple of hours later.

Insomnia Late Pregnancy

Third-trimester insomnia is very common in females and occurs due to intensified symptoms of pregnancy. For some, this insomnia is also driven by anxiety around becoming a new parent and its responsibilities. By the third trimester, many women find it difficult to get into comfortable positions, and the increasing baby weight constantly puts pressure on the hips and back, causing them to ache all night.

Pregnancy and Insomnia: How to Sleep Better with Lifestyle Tips?

Insomnia during pregnancy can lead to significant disruptions in everyday life and put a female’s mental and physical health at stake. Experts recommend following the tips mentioned below to improve their sleep habits during pregnancy:

Maintain a regular sleep schedule

Try going to bed and waking up at the same time every day. While napping can help you compensate for lost sleep and energize your mind and body, do not nap too frequently, particularly during evening hours.

Use pillows for comfort

Support your lower back, midsection, and knees with pillows to reduce pain. Many women prefer getting a specially designed pregnancy pillow that keeps their body in a good, well-supported position as they sleep.

Make the sleep environment comfortable

Make your bedroom dark, cool, and quiet to promote sleep. Avoid using any electronic gadgets when you enter the room with the intention to sleep. This includes mobile phones, laptops, and e-readers. Do not use an overhead light and instead invest in a dim nightlight to avoid disturbing sleep when you wake up for bathroom trips during the night.

Exercise in the morning hours

Regular exercise has dual benefits for both pregnancy and insomnia. Moreover, it can also help pregnant females regulate their mood much better. However, ensure that you do not overexert yourself while exercising and try to work out during morning hours.

Avoid using stimulants

Cut out alcohol and nicotine during pregnancy as both disturb sleep and put the baby’s health at risk. Moreover, do not consume any caffeine products this afternoon.

Get treatment for a stuffy nose

Some females routinely experience nose stuffiness during pregnancy, which may disturb their sleep and cause insomnia. To sleep better, focus on addressing the issue with nasal sprays, nasal irrigation, or strips.

Sleep on your left side

Sleeping on the left side improves the blood flow to the fetus and all other major organs of the body. Moreover, this position also helps reduce swelling in ankles and legs and is easier on the heart and lungs. Avoid sleeping on the back as it is uncomfortable and may carry certain risks for the fetus.

Practice relaxation techniques

Relaxation or soothing activities, such as a massage or a warm bath, prepare pregnancy women to prepare for sleep in a better way. However, before you consider trying a relaxation technique, talk to a doctor about their safety.

Many women report experiencing sleep issues because of the worries about becoming a parent. It may be helpful for them to invest in things they enjoy or seek help and support from trusted friends and family members to reduce the underlying stress. Sharing concerns with a healthcare provider or attending childbirth classes can also help manage worry and allow a mother to sleep better.

If the lifestyle changes are not causing any improvements in pregnancy insomnia, talk to a doctor and update them about your situation. Depending on the triggering factor, they may provide specific treatment for the cause.

Treatment for Pregnancy Insomnia

Since there is not much research on how to treat pregnancy insomnia, most experts recommend going for the lifestyle changes mentioned above. Where these tips fall short, an expert may advise using the following non-medicinal therapies to address sleep issues while avoiding any risk to the fetus.

Melatonin and sleep aids

Most experts generally advise pregnant females to avoid using all types of sleep medications, including melatonin-based supplements. This is because melatonin is already produced at a higher level during pregnancy, particularly in the third trimester. This naturally synthesized melatonin crosses the placenta to reach the growing baby’s body and help establish their sleep-wake cycle. When pregnant women use sleep supplements, they may accidentally deliver too much melatonin to the baby’s body and interfere with their sleep-wake cycle development.

That said, many research studies have found melatonin supplements safe to use during pregnancy. [2] If you have tried everything else with no improvement, consider talking to a doctor first and avoid starting a sleep supplement alone.

Cognitive behavioral therapy

Cognitive behavioral therapy for insomnia or CBT-I is a type of psychotherapy in which an individual closely works with a therapist to overcome any behaviors or thoughts that are potentially affecting their sleep. A therapist may analyze pregnant women’s anxious thoughts, assess their goals for sleeping during pregnancy, and provide suggestions based on their answers. They may also recommend techniques like progressive muscle relaxation and meditation.

Studies have proven that the use of CBT-I can help reduce insomnia symptoms while improving sleep during pregnancy. Moreover, it also helps people control their anxiety, depression, and fatigue. Fortunately, many rehabs now provide CBT-I online over different platforms to entertain people who cannot come to rehab every day.

Treating acid reflux and heartburn

Gastroesophageal reflux disease, or GERD, is one of the most common issues in pregnancy that particularly worsens during the third trimester, causing sleep disruptions. Eating smaller portions, avoiding lying down right after a meal, and avoiding greasy, oily, and spicy food are some ways to manage its symptoms. If the heartburn associated with GERD is particularly happening at night, consider getting a new mattress or purchase a wedge pillow.

Managing leg discomfort

Leg discomfort, also known as restless legs syndrome, is one of the primary reasons why pregnant women struggle to sleep at night. [3] To reduce the symptoms of this syndrome, try performing gentle stretches and talk to a doctor regarding the need to take calcium supplements. Other tips to manage leg discomfort include wiggling the legs and raising them, standing on the legs, calf stretches, walking, etc.


What are the risks of pregnancy insomnia?

Going short on sleep for a long time during pregnancy is known to have risks for both the mother and baby. The problem can exacerbate the vulnerability of a mother to develop gestational diabetes, pre-eclampsia, pre-term birth, and longer labor. Sleep deprivation may become particularly dangerous during pregnancy if its driving factor is sleep apnea, a sleep disorder that causes momentary lapses in a person’s breathing as they sleep. If continued, pregnant women with insomnia may develop anxiety and depression, particularly during late pregnancy or following birth. Moreover, they are also at risk of acquiring postpartum depression

How much sleep is needed for the body during pregnancy?

Pregnancy can be a demanding time for both mental and physical health. Hence, getting adequate hours of high-quality sleep is imperative for overall wellness. Most experts recommend aiming for 8 to 10 hours of sleep every night.

Can insomnia be a sign of pregnancy?

While insomnia may be one of the signs of an early pregnancy, it is not the one to be picked up first. Pregnancy insomnia usually happens later after the rest of the symptoms have presented themselves, such as morning sickness and breast tenderness.

Can trouble sleeping early in pregnancy help determine the growing baby’s sex?

It is a popular old wives’ table that females who develop insomnia during pregnancy give birth to baby girls. However, remember that this claim has no scientific fact. The relationship between insomnia during pregnancy and sex prediction usually has to do with how a body responds to the fluctuating hormonal levels during this time period. These fluctuations can greatly vary from one person to another. For instance, one pregnant woman may crave salty snacks while others may prefer sweet treats. Similarly, some women have more severe insomnia while others face no such problems, regardless of the sex of their babies. Hence, there is no truth in the statement that the presence or absence of insomnia can determine the gender of the unborn baby.

How long will pregnancy insomnia last?

Pregnancy insomnia has variable duration for every woman. For some, it lasts for the entire length of pregnancy, while for others, the issue may come and go. Fortunately, most women who struggle with sleeplessness during the first-trimester experience improvements during the second one due to their hormones slowly stabilizing. However, the problem worsens in the third trimester for most women as their belly grows, and they find it challenging to achieve a comfortable position and maintain it for hours. Moreover, a growing baby may exert more pressure on their bladder, forcing them to wake up frequently to empty their bladder.


1 Nodine PM, Matthews EE. Common sleep disorders: management strategies and pregnancy outcomes. Journal of midwifery & women’s health. 2013 Jul;58(4):368-77.

2 Vine T, Brown GM, Frey BN. Melatonin use during pregnancy and lactation: A scoping review of human studies. Brazilian Journal of Psychiatry. 2022 May;44(3):342.

3 Hashmi AM, Bhatia SK, Bhatia SK, Khawaja IS. Insomnia during pregnancy: diagnosis and rational interventions. Pakistan journal of medical sciences. 2016 Jul;32(4):1030.