Pregnancy Insomnia: Why You Can’t Sleep & What To Do

Published July 15th, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Dr. Angel Rivera

Not being able to sleep when your body needs it the most can feel frustrating, especially when it happens at the most inopportune times, like when you become pregnant. 

Your body needs adequate rest to support a healthy pregnancy and healthy baby, but many pregnant people find it difficult to fall asleep and stay asleep while pregnant.

We’ll look at what insomnia is and why pregnant people experience it. We’ll also talk about what to do when you can’t get to sleep.

What Is Insomnia?

When someone says they have insomnia, we automatically assume they just can’t sleep.

The truth is, insomnia is a little more complicated than just not being able to sleep.

Insomnia includes difficulty falling asleep, staying asleep, or simply getting enough quality sleep.

Typically, insomnia isn’t diagnosed as an actual disorder until you have a lengthy period of sleep-related issues like:

  • Inability to fall asleep within 30 minutes
  • Trouble staying asleep throughout the night
  • Waking earlier than needed
  • Anxiety about sleep
  • Feelings of fatigue or tiredness during the day 

Insomnia can take a massive toll on your health and wellness, and matters become even more complicated if you experience it while pregnant. 

What Is Pregnancy Insomnia?

You’ve heard that once your baby arrives, there won’t be much time for sleep, but what you weren’t expecting was trouble sleeping before you give birth. 

Many pregnant people are surprised to learn that pregnancy can play host to sleep deprivation and sleep-related issues, even though you are likely experiencing extreme fatigue and exhaustion from creating a new life. 

Symptoms of Pregnancy Insomnia

Unlike traditional insomnia, pregnancy insomnia only happens when you are pregnant.

However, it can start in the first trimester, magically disappear during the second trimester, and return in the third trimester. 

Symptoms of pregnancy insomnia include:

  • Inability to fall asleep
  • Trouble getting comfortable
  • Not being able to stay asleep
  • Feeling tired during the day
  • Inability to focus or concentrate during the day

You may experience some or all of these symptoms if you have experience insomnia. 

What Causes Pregnancy Insomnia?

From conception, it can feel like you were hit by a freight train of fatigue.

Hormonal changes, particularly progesterone and estrogen, begin immediately after implantation. \

Progesterone (paired with relaxin) is also known as the “relaxation” hormone, which can cause you to feel more tired than you usually would. As such, it’s no surprise that one of the earliest pregnancy symptoms is fatigue.

Unfortunately, if you experience pregnancy insomnia, it can be hard to get relief from the exhaustion of creating a new life. There are several reasons why your body is having trouble sleeping. 

1. Frequent Urination

Your growing uterus places pressure on your bladder, and that pressure can send you to the bathroom more frequently, especially at night.

You’re also increasing your water intake to support amniotic fluid levels, which will also cause more frequent urination. 

2. Heartburn

While heartburn doesn’t usually peak until the late second and third trimester, it can make it very difficult to fall asleep and stay asleep.

Because your expanding uterus pushes other organs out of the way, you may experience digestive discomfort, like heartburn that worsens when you lie down. 

3. Morning (and Night) Sickness

Whoever coined the term “morning” sickness must have never experienced the all-day nausea some pregnant people experience.

Pregnancy-related nausea can start and stop during the day and can also plague you at night when you are trying to get a good night’s sleep. 

4. Leg Cramps

Researchers aren’t sure why pregnant people develop leg cramps.

Added weight, low levels of magnesium, and changes in the way your blood flows during pregnancy could all be causes for the aches and cramps you experience in your lower extremities. 

Unfortunately, most of these cramps happen at night, waking you up from sleep and making it virtually impossible to fall back asleep. 

5. Breast Soreness

Your breasts will likely become sore in early pregnancy as estrogen levels rise. Milk ducts also begin to expand, preparing to hold milk, regardless of whether or not you plan to breastfeed. These changes can make sleeping uncomfortable and make it less possible for you to find a comfortable sleeping position to get rest. 

6. Back Pain

As you gain weight during pregnancy, the added stress on your spine causes the muscles that support the spine to ache. It’s not uncommon to begin experiencing back pain in the second trimester, but it’s in full swing by the third trimester. 

An aching back can cause discomfort when you lie down to sleep, and it can be hard to find a position that alleviates the pressure on your back. 

7. Stress

A new baby is a life change that many people find themselves unprepared for. If you feel stressed, anxious, or nervous about your upcoming birth, raising a child, or how you’ll do as a parent, these feelings can cause many sleep problems. 

Stress causes your body to produce the hormone cortisol, which places your body in a “fight or “flight” mode.

Stress stimulates the sympathetic nervous system and makes it hard for the parasympathetic nervous system to engage and help you relax. It is essential to support your mental health during pregnancy. 

How Can I Combat Pregnancy Insomnia?

Some parts of pregnancy may be sleepless. Many factors can make it difficult for you to sleep, and you might find it exhausting (pun intended) to try to tackle them all.

However, it’s crucial to your body and your developing baby that you get enough rest. 

When pregnancy tries to thwart your bedtime plans, here are some ways you can fight back and get the rest you need.

Give Your Sleep Hygiene a Check-Up

You’re getting regular check-ups for your body and baby, but have you considered checking in on how you promote a good night of rest?

Sleep hygiene refers to the habits you create that help you fall asleep and stay asleep.

Good sleep hygiene includes:

  • Going to bed at the same time every night
  • Waking up at the same time every morning 
  • Keeping your bedroom dark and cool
  • Eliminating distracting noises and sounds
  • Using white noise
  • Turning on a fan to help circulate air
  • Choosing comfortable, cool bed linens
  • Sleeping in clothing that allows you to move freely
  • Limiting screen time before bed (blue light can affect melatonin production)

Sometimes a simple change, like lowering your air conditioner a few degrees, can help you get better sleep quality. Try a consistent bedtime routine to prepare your body for rest every night.

Limit Caffeine

You’re probably already limiting the amount of caffeine you drink. Most experts agree that keeping your caffeine intake under 200mg per day is best when you are pregnant.

That’s roughly two cups of coffee daily.

Be sure to drink your last caffeinated beverage early enough in the day that it won’t interfere with your bedtime.

Caffeine has a half-life of about five hours. That means that half of the caffeine is circulating in your veins five hours after you drink a caffeinated beverage, which can cause unwelcome sleep disturbances.  

Eat Healthfully

A balanced diet supports healthy sleep patterns and helps ensure you gain the right amount of weight during pregnancy.

Avoid sugary snacks before bed, which can cause a rise and fall in blood sugar levels that could keep you awake. Additionally, try to eat your last meal a few hours before you want to go to bed to give your body enough time to digest it.

If you feel hungry before bed, choose something high in protein and low in carbohydrates, which your body turns into energy that could potentially keep you awake. Ask your doctor about foods that promote restful sleep and whether over-the-counter sleep aids are an option. 

Exercise

Staying active during pregnancy can be a challenge, but as long as your healthcare provider has given you the green light, it’s a vital part of a healthy pregnancy and one that can encourage healthy sleep patterns. 

Using up energy during the day helps build your sleep drive (your body’s need for sleep). As you expend energy during the day, your sleep drive increases. If you don’t use enough energy, your sleep drive won’t be strong enough to signal your body to sleep. 

While exercise can help you sleep, it’s important to do it a few hours before you plan to go to bed.

Exercise can raise your heart rate and make you feel more alert for several hours after you’ve finished your workout. 

Getting Comfortable

The safest way to sleep during pregnancy is on your side. If you prefer your back or stomach, it can be harder for you to fall asleep.

Try using a maternity pillow or sleeping with a pillow or rolled towel between your legs to help alleviate pressure on your back and get more comfortable. 

Stop Drinking Water Before Bed

You need between 64 and 80 ounces of water daily during pregnancy.

If you’re drinking most of that within three hours of bedtime, you’ll wake numerous times at night to use the restroom. 

As such, try to drink all of your water at least three hours before you plan to go to sleep. It won’t eliminate your need to get up to use the restroom, but it will likely decrease the number of trips you have to make. 

De-Stress

Pregnancy is challenging. Combined with the normal stress of being pregnant, supporting your body, and planning for a new baby, your hormones are surging unlike ever before.

It’s normal to feel overwhelmed and emotional. Several relaxation techniques can bring calm to your pregnancy.

Prenatal yoga, meditation, and therapy can help ease your mind. If you have thoughts of hopelessness, sadness, or self-harm, talk to your doctor immediately, as you could experience prenatal depression. 

Take Naps

Even if you can get the sleep you need at night, your changing body requires even more rest.

Try taking naps throughout the day to give your body and mind the rest it needs. We recommend keeping these naps short (20 to 30 minutes) so as not to affect your nighttime sleep.

A Warm Bath

While regulating your body temperature is essential while pregnant, taking a warm bath (no hotter than 100 degrees Fahrenheit) can help to relax your body and mind for sleep.

Put on soft music and light a couple of candles to prepare yourself for quality sleep. 

Taking a calming bath may not ultimately lower your pregnancy-related high blood pressure, but it can settle the mind a bit. 

When To Call a Doctor

Pregnancy-related sleep disorders are very common, but if you are unable to get any rest or feel you are experiencing periods of mental fatigue and sleepiness that make it dangerous for you to drive or do your job, you should talk to your doctor. 

Your doctor can help you decide if it needs to be addressed and help you find a therapist for heavy emotions that can be the cause of insomnia. 

Thriving During Pregnancy

Sleeplessness is no fun, especially during pregnancy. If you’re missing the rest you used to have before you were pregnant, try some of the remedies above to help promote an atmosphere of rest. While you might experience a little more insomnia after your baby arrives, your body will likely find it much easier to rest once you have given birth. 

References, Studies and Sources:

Diagnosing Insomnia | Sleep Foundation 

Tips to avoid leg cramps during pregnancy. | Mayo Clinic 

Stress and pregnancy | March of Dimes 

Moderate Amounts of Caffeine Not Linked to Maternal Health Risks | Penn Medicine