Pregnancy Insomnia: What Causes It & How to Treat It

If you’re having trouble sleeping, you’re experiencing something called pregnancy insomnia. Unfortunately, this is a common complaint among expectant mothers.

Read on to learn what causes insomnia during pregnancy and how to tackle it.

Insomnia means having trouble sleeping. This includes having trouble getting to sleep in the first place, as well as having trouble staying asleep when you get there.

When you have insomnia, you may also feel that what little sleep you do get isn’t as restful as it should be.

It’s estimated that as many as 75% of pregnant women experience a form of insomnia at some point during their pregnancy. Most women get it during the first and third trimesters, though it tends to ease up during the second trimester. 1 2

What causes pregnancy insomnia?

There’s no single cause for insomnia during pregnancy. It can be caused by many factors, either alone or in combination, including any or all of the following: 1

Hormonal shifts

During pregnancy, your hormones fluctuate a great deal. When it comes to insomnia, the main offenders tend to be estrogen and progesterone. Between these and your other pregnancy hormones—which may variously include prolactin, oxytocin, cortisol, and growth hormone—you’ve got a recipe for disruptions to your natural sleep-wake cycle. 3

Physical discomfort

Throughout your pregnancy, you’ll likely have to deal with plenty of discomfort, including: 4

• Backaches
• Shortness of breath
• Tender breasts
• Heartburn
• Sleep apnea 1
• Frequent urination
• Nausea and vomiting (morning sickness)
• Restless legs syndrome (RLS) 5

Unsurprisingly, all of this can make it hard to get a restful night’s sleep.

Vivid dreams and anxiety

It’s not just the physical toll of pregnancy that can cause problems sleeping—your mind can keep you up at night, too.

Pregnancy often brings about intense and sometimes disturbing dreams. On top of the nightmares, any (understandable) anxieties you have about labor, delivery, and parenthood may leave you tossing and turning.

While the occasional sleepless night won’t do much harm, chronic insomnia during pregnancy can have dangerous consequences. It elevates your risk of: 6 1

• Gestational diabetes
• Gestational hypertension
• Depression
• Preterm birth
• Longer labor (potentially requiring a C-section) 7

Even in the short term, insomnia can impair your memory and other cognitive functions. This puts you more at risk of having an accident (e.g., on the stairs or while driving).

Beyond that, of course, having insomnia can be miserable. It isn’t anything anybody wants to deal with if they can help it.

Because insomnia during pregnancy is often caused by physical discomfort and stress, you don’t necessarily need medication for it.

Try taking these steps to maintain good sleep hygiene and keep insomnia at bay: 4

Establish a relaxing bedtime routine

One of the best ways to signal to your body that it’s time to hit the hay is with a consistent, relaxing bedtime routine. You could:

• Loosen your muscles with a warm bath or gentle yoga
• Read a book (opt for a physical book or an e-ink device without a backlit screen—not your phone)
• Put on calming music
• Just settle down with a cup of caffeine-free herbal tea

Regular physical activity can improve your sleep. However, you won’t get that benefit if your workout is too close to bedtime. Exercise earlier in the day and focus on slowing down at bedtime. 8

Optimize your bedroom for sleeping

Give yourself the best chance of getting a good night’s sleep by making your bedroom calming and comfortable, starting with a comfy mattress and pillows.

Make sure your room is cool by lowering your thermostat or raising it to a comfortable temperature, and put up blackout curtains or block out light with an eye mask. If you have a lot of distracting ambient noise where you live, try masking it with a white noise machine or fan.

Your bedroom should be a place for rest and relaxation (and, of course, intimacy), so leave your work, bills, and social life outside. And yes—that goes for social media, too.

Get comfortable

You may need more support to sleep comfortably during your pregnancy. Most experts recommend that you sleep on your left side to improve blood flow to your organs and take some pressure off your body. 4

A pregnancy pillow can be a great help, but you can use any pillows you have to support your belly and knees. You could also try sleeping in a recliner to relieve heartburn.

Mind your diet and fluid intake

Your nightly bathroom trips are obviously influenced by when you take your last drink before bed, but what you eat also affects your sleep (or lack of it). Here’s what you should keep in mind:

• Avoid large meals and sugary snacks close to bedtime
• Limit your caffeine intake, especially in the afternoon and evening
• Reduce your fluid intake in the hours before bed to minimize your nighttime bathroom trips

If you’re feeling peckish at bedtime, choose healthy pregnancy snacks that combine protein and carbs, like whole whole grain cereal with milk or peanut butter and crackers. The protein and carbs will give you that feeling of fullness, prevent a blood sugar spike, and release tryptophan, the chemical that makes you sleepy after a big meal. 9

Get out of bed

If you just can’t seem to fall asleep after trying out some of these tips, ironically enough, you may be focusing so hard on sleeping that you’re keeping yourself awake.

Letting your body and mind take a break from trying to fall asleep can, paradoxically, make it easier to relax. Sit in another room and read a book or do a quiet hobby (like knitting) for a while before you go back to bed. 10

If your insomnia doesn’t improve with these lifestyle changes, it’s time to talk to your doctor about other treatment options.

You could try over-the-counter antihistamines, such as doxylamine succinate (Unisom SleepTabs) and diphenhydramine (Benadryl). While they’re generally considered safe to use while pregnant, always get your doctor’s approval first, even if you can readily buy them. 11

If your insomnia is severe, your doctor may prescribe you more powerful sleep medication. However, sleep aids aren’t without risk, so they probably won’t do that lightly.

If you have the time and can afford it, consider visiting with a sleep specialist to get to the root of your insomnia and work out the best way to treat it together.

What medication should you be wary of?

While there are plenty of medication options for insomnia, there are certain treatments that aren’t recommended for pregnant women.

Take melatonin, for instance: your body produces this hormone to regulate your sleep, and the supplement form of melatonin is a common choice for those dealing with insomnia. However, there aren’t enough studies on the effects melatonin could have on your developing baby, so you should avoid taking it, at least without getting the all-clear from your doctor. 12

The same applies to herbal remedies touted as being beneficial for insomnia. These generally haven’t been well-studied, so it’s hard to know the risks. 4 As a rule, you should never introduce any new medication or supplement to your pregnancy diet without talking to your doctor first, even if it’s a remedy that’s advertised as pregnancy-safe or all-natural.

No one is at their best without a good night’s sleep. Luckily, moms-to-be can often get their sleep back on track with a few simple lifestyle changes and good sleep practices.

Your doctor is always on call if you need a more thorough treatment plan. Either way, you’ll soon get the beauty sleep you deserve.