How to Deal With Insomnia During Pregnancy

The early days of pregnancy can bring an onslaught of symptoms such as nausea, breast tenderness, and fatigue—not to mention a rollercoaster of emotions. For some, these new body changes lead to one of the most frustrating side effects of pregnancy: insomnia. A common sleep disorder, insomnia refers to challenges with falling asleep, staying asleep, or getting a quality night’s sleep.

If tossing, turning, or staring at the ceiling have replaced your once-peaceful night, try not to be too hard on yourself—you’re growing a tiny human, after all! But in the meantime, we’ll take a closer look at why insomnia happens in early pregnancy and how to cope with your newfound lack of sleep.

What Causes Insomnia During Pregnancy?

Pregnancy insomnia, especially during the first trimester, is caused mainly by a flux in hormones.

“In early pregnancy, you can blame your hormones for not being able to fall asleep,” explains Rachel Mitchell, a certified Pediatric and Maternity Sleep Consultant and founder of My Sweet Sleeper. The sudden surge of hormones like human chorionic gonadotropin (hCG) and progesterone can bring their fair share of side effects, which explains why you’re feeling so off during those first weeks of pregnancy—ultimately leading to a poor night’s sleep.

A rise in hCG is often associated with nausea and vomiting in early pregnancy, which are two symptoms that can also play a role in disrupted sleep. And although progesterone can make you sleepy during the day, it can also cause sleep fragmentation at night, says Brandon Peters, M.D., a board-certified Sleep Physician at Virginia Mason Medical Center and the author of Sleep Through Insomnia.

“Increased urinary frequency, back pain, breast tenderness, increased appetite, and anxiety may all cause trouble sleeping during the first trimester,” he adds.

Mitchell notes that contrary to its name, morning sickness—a common early sign of pregnancy—can happen at any point of the day, which can also cause sleep disruptions. Of course, any discomfort you feel during pregnancy can potentially lead to a poor night’s sleep. “Ultimately, when you’re not feeling well, it can affect your ability to sleep,” says Mitchell. 

When Does Pregnancy Insomnia Start?

You may be wondering, "Is insomnia a sign of pregnancy?" Not quite, though pregnancy insomnia can start as early as the first few weeks of pregnancy, thanks to all of your recently-developed symptoms. 

Although insomnia is often present during the first trimester, Dr. Peters mentions that it typically improves during the second trimester. That said, every pregnancy is different, which leads to varying experiences with sleep troubles. 

“Every trimester brings its fair share of challenges as the body is changing,” explains Mitchell.

She adds that restless leg syndrome is a common complaint she hears during the second and third trimesters, along with heartburn, sciatica or lower back pain, discomfort from sleeping with a growing belly, or severe pelvic pain known as symphysis pubis dysfunction (SPD).

Can Pregnancy Insomnia Hurt My Baby?

Although more research is needed, there are studies that indicate that insomnia during pregnancy may lead to potential negative impacts on you and your growing baby. For example, sleep deprivation while pregnant may be associated with longer or more painful labor, higher C-section rates, and preterm labor.

In some cases, sleep-disordered breathing (SDB) can occur during pregnancy, which describes sleep problems ranging from snoring to obstructive sleep apnea. Those who struggle with SDB are at an increased risk for gestational diabetes, high blood pressure, and preeclampsia.

If you're concerned that your lack of sleep is leading to more serious issues during pregnancy, it's best to contact an OB-GYN or health care provider to discuss any symptoms you're experiencing. 

Remedies for Insomnia During Pregnancy

Luckily, if you’re desperate for a decent night’s sleep during pregnancy, there are different ways to cope, depending on what’s causing your insomnia. 

Make simple lifestyle changes

While pregnancy symptoms can definitely be the culprit, Mitchell points out that many times, insomnia can be triggered by daily habits. One of the biggest issues? Scrolling your smartphone too close to bedtime. 

“Being exposed to blue light from your phone can easily suppress your melatonin and could also increase cortisol, which may be slightly elevated in pregnancy anyway,” she explains. “So it’s important to make sure you shut screens off 90 minutes to two hours before bed.”

She also stresses the importance of going to bed when you’re tired—which she refers to as your natural sleep window—rather than forcing yourself to stay up. “When we stay up past that natural sleep window, we get a surge of adrenaline,” she says. 

By going to bed during your “sweet spot,” or the window in which you’re naturally tired, you’re more likely to get a better night’s sleep. 

If frequent urination is the cause of your nighttime struggles, cutting down on the amount you drink before bed can help. Mitchell recommends taking smaller sips of water or other beverages in the evening, rather than consuming a large amount.

Maintain healthy sleep hygiene

According to Mitchell, the best thing you can do to combat pregnancy insomnia is to maintain a healthy routine that facilitates a good night’s sleep. 

“Many parents skip their own bedtime routine,” she says. “It’s important to have time to decompress.” Anything from meditation to breathing exercises, or an app that helps you calm down, can help. She also recommends light stretching and yoga during all three trimesters, explaining, “As you’re making space for baby, you’re being pulled in a million directions. So getting some really good stretching can help.”

She adds that even if you’re feeling a little on the sick side, just 30 minutes of exercise in the afternoon can be crucial to helping your hormones stay somewhat consistent, which leads to more restful sleep.

Lastly, it’s important to speak with a health care provider about any possible vitamin deficiencies. “Because hormone changes are so significant throughout pregnancy, you could be deficient in other areas, like iron or magnesium,” says Mitchell. A physician may prescribe a supplement that can help get your body and sleep back on track. 

Try cognitive behavioral therapy

If natural remedies aren’t doing the trick, Dr. Peters recommends cognitive behavioral therapy for insomnia (CBTI). 

“This is a 6-week program that teaches ways to normalize sleep,” he explains. “It helps to strengthen the sleep drive, stabilize the circadian pattern, and reduce anxiety that can disturb sleep. It's helpful for [those who are] pregnant and anyone else who is bothered by insomnia.”

If you believe CBTI may be the solution to your sleep troubles, an assessment by a board-certified sleep physician may be helpful. Dr. Peters notes that CBTI is a great choice to improve sleep without the risk of any medication side effects.

The Bottom Line

Remember, insomnia can be a normal part of pregnancy, along with all the other changes your body is experiencing—so try not to stress! That said, it's always helpful to express any concerns to an OB-GYN or health care provider, particularly if you're experiencing any symptoms that are severe, or if you're worried about how your insomnia could be affecting you and your baby.