Pregnancy insomnia: why you can’t sleep & what to do about it

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Editorial Team

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July 4, 2021

pregnant woman in bed resting in bed after treating pregnancy insomnia
Learn why you’re experiencing insomnia during pregnancy and what you can do to get enough restful sleep.

You’re literally growing another human inside your body. You deserve the physical and mental health benefits of plentiful rest more than ever. So what’s this pregnancy insomnia about? Why isn’t your body cooperating?

Sleeplessness in pregnancy is common—66 – 94% of women report some type of sleep issue during pregnancy, including insomnia. Learn about the most common causes of pregnancy insomnia and how to cope with it.

For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
Learn why you’re experiencing insomnia during pregnancy and what you can do to get enough restful sleep.

You’re literally growing another human inside your body. You deserve the physical and mental health benefits of plentiful rest more than ever. So what’s this pregnancy insomnia about? Why isn’t your body cooperating?

Sleeplessness in pregnancy is common—66 – 94% of women report some type of sleep issue during pregnancy, including insomnia. Learn about the most common causes of pregnancy insomnia and how to cope with it.

What is pregnancy insomnia?

The definition of insomnia is a lack of restorative sleep that happens because you’re unable to fall asleep, stay asleep during the night, or sleep until your desired wake time. Pregnancy insomnia is when this occurs during pregnancy.

Some people are short sleepers, meaning they need less sleep than average, but feel fine the next day. This wouldn’t be considered a disorder since insomnia disorder is only diagnosed when this lack of sleep also causes significant disturbances during waking hours. These include symptoms like difficulty focusing or fatigue.

That being said, you can also have trouble sleeping without the level of distress that characterizes a sleep disorder. The causes below discuss both—general sleeplessness in pregnancy and pregnancy insomnia.

Common causes of sleeplessness in pregnancy

Why do you have sleep issues during pregnancy? Here are some of the most common reasons.

Here’s a breakdown, using research provided by Dr. Cristina Reichner in Obstetric Medicine.

  • Common causes of poor sleep in the first trimester include nausea, waking up to urinate, and an aching back.
  • Common causes of poor sleep in the second and third trimesters include feeling the baby move, heartburn, tingly sensations, or shortness of breath.
  • Right before labor, the body starts to release elevated oxytocin, which promotes nighttime wakefulness. Think of this as your body’s way of helping you stay alert when your new baby needs nighttime feeding.

How likely is pregnancy insomnia?

Most women report some type of sleep issue during pregnancy, including insomnia.  What might surprise you is that the likelihood of insomnia changes depending on how far along you are.

  • Although insomnia during pregnancy can occur anytime, insomnia in early pregnancy is less common than later in pregnancy. In fact, studies show that sleep tends to increase in early pregnancy, though, of course, there is always variation.
  • Data shows that 12.6% of women experience insomnia in early pregnancy, compared to 73.5% at 39 weeks.
  • One study found that 44% of women in their first trimester experienced insomnia, which becomes more prevalent in later months.
  • By the end of pregnancy, nearly all women report night wakings. But waking up at night doesn’t necessarily indicate a disorder such as insomnia.

Other risk factors for insomnia & pregnancy

Yes, there are pregnancy-specific factors like the ones listed above. But pregnant women are also more likely to experience the general factors associated with insomnia.

It may be helpful to know that a risk factor isn’t the same as a cause. Having one or several risk factors doesn’t necessarily mean you’ll experience insomnia. For example, we know that being a woman doesn’t cause insomnia. But for many possible reasons, women may be more likely to experience insomnia.

Risk factors for insomnia that apply to pregnancy include:

Hormone levels

You may have heard about PMS insomnia or menopause insomnia. Insomnia can be associated with hormonal changes in general, and, in pregnancy, elevated estrogen and progesterone levels can play a role, causing symptoms like night sweats.

Learn how to get relief from night sweats—starting tonight.

Anxiety or worry

A tendency to worry can put you at risk for insomniaRuminationcatastrophizing, and repressing emotions are also associated with insomnia.

If you have insomnia from anxiety, try these tips to relax your mind at night.

Change

Pregnancy is a massive change on all levels—emotional, physical, relational, financial, and more. Even when they’re highly positive, these changes can cause stress, which can impact sleep.

Learn more about how to take care of your mental health during periods of significant change.

Even outside pregnancy, women report greater levels of insomnia than men.

Sleep hygiene

Many factors influence sleep, including your sleep environment. Is your room dark, quiet, and dedicated to sleep? These are all aspects of positive sleep hygiene.

Habits

Napping late, drinking caffeine late in the day, or the stimulation of screens before bedtime can all detract from quality sleep. Exercise early in the day can promote quality sleep, while a workout later in the day can detract.

Discover healthy sleep habits to get enough rest without taking meds.

When and how to take action

Not all disturbances in sleep are cause to concern. After all, there’s a human the size of a pumpkin inside you, pressing on your bladder, kicking, and doing the occasional somersault. It’s hard to imagine not having some nighttime awakenings in late-stage pregnancy.

In a survey of 127 pregnant women, 97% reported some type of sleep disturbance, but only 33% self-identified as having a sleep disorder. In other words, not all sleep disturbances need to be disturbing.

At the same time, it’s essential not to ignore sleep issues that are causing distress. Sleep disorders are both common and diagnosable. There are safe actions you can take to help yourself get enough rest while you’re pregnant. If in doubt, reach out.

Especially reach out to your provider if your sleep issues are:

  • Happening at least 3 times per week
  • Happening despite ample opportunity for sleep
  • Making it difficult to function at work, in your responsibilities, relationships, or other critical areas of your life

If left unaddressed, pregnancy insomnia disorder may contribute to depression, difficult labor, or both.

Talk to a healthcare provider now who can help diagnose insomnia or another type of sleep disorder. 

With a better understanding of your sleep issue, you and your provider can determine the next steps. These steps can include medication deemed safe for pregnancy, home remedies, or behavioral approaches like CBT for insomnia.

Takeaway

  • The majority of women experience some type of sleep disturbance in pregnancy.
  • Sleep issues can happen anytime but are far more common in the 3rd trimester than the 1st trimester.
  • There are many causes for pregnancy insomnia, including physical discomfort, worry, and hormones.
  • If sleeplessness impacts your capacity to function, it’s essential to discuss this with your healthcare provider.
  1. The American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  2. Román-Gálvez et al. (2018). Factors associated with insomnia in pregnancy: A prospective cohort studyhttps://doi.org/10.1016/j.ejogrb.2017.12.007
  3. Sedov et al. (2018). Sleep quality during pregnancy: A meta-analysishttps://doi.org/10.1016/j.smrv.2017.06.005.

By

Editorial Team

|

July 4, 2021

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.