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:
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.
Anxiety or worry
A tendency to worry can put you at risk for insomnia. Rumination, catastrophizing, and repressing emotions are also associated with insomnia.
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.
Even outside pregnancy, women report greater levels of insomnia than men.
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.
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.
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.
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.
- 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.
- The American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
- Román-Gálvez et al. (2018). Factors associated with insomnia in pregnancy: A prospective cohort study. https://doi.org/10.1016/j.ejogrb.2017.12.007
- Sedov et al. (2018). Sleep quality during pregnancy: A meta-analysis. https://doi.org/10.1016/j.smrv.2017.06.005.