Struggling to sleep during pregnancy is more common than you might think. Many pregnant individuals report difficulties falling asleep, staying asleep, or getting restful sleep. Research suggests that between two-thirds and nearly all pregnant people experience insomnia at some point during pregnancy. These sleep disturbances often become more pronounced as pregnancy advances, especially in the third trimester.

While pregnancy insomnia doesn’t typically pose a direct threat to the baby, it can affect your well-being and increase the risk of certain complications in some cases. The good news is that there are several effective and safe strategies to help you sleep better while pregnant.

When Can Pregnancy Insomnia Begin?

Pregnancy insomnia may start as early as the first trimester and can continue throughout pregnancy. For many, it gets worse over time, with the highest prevalence during the third trimester.

A review published in the Journal of Sleep Research found:

• Around 38% of pregnant people report insomnia overall

• Insomnia is most common in the third trimester (nearly 40%)

• In the first and second trimesters, about 25%–27% experience it

What Causes Insomnia During Pregnancy?

Pregnancy triggers significant hormonal, physical, and emotional changes. The rise in estrogen and progesterone levels, along with weight gain and shifts in body shape, can lead to:

• Body aches and discomfort

• Restless leg syndrome

• Obstructive sleep apnea

• Increased snoring

Each trimester presents different sleep challenges:

• First trimester: frequent urination, nausea, hormonal shifts, fatigue

• Second and third trimesters: back pain, fetal movements, shortness of breath, heartburn, leg cramps

Other contributing factors include anxiety, past experiences with depression, and smoking, which may increase the likelihood of sleep problems.

Potential Effects of Pregnancy Insomnia

While many people only feel tired or irritable, persistent insomnia may increase the risk of certain pregnancy complications, such as:

• Increased inflammation

• Gestational diabetes

• Preeclampsia

• Depression or mood disorders

• More intense pain during labor

• Higher chance of C-section

• Low birth weight in newborns

How to Manage Pregnancy Insomnia

Insomnia can significantly affect your daily routine and mood. However, several treatment approaches can help you regain better sleep quality and emotional balance.

1. Lifestyle Adjustments

• Reduce caffeine intake, especially in the afternoon

• Engage in light exercise or prenatal yoga

• Avoid drinking large amounts of water before bed

• Use pregnancy pillows for better comfort

• Apply gentle heat to soothe body aches (with doctor’s approval)

• Practice meditation or breathing exercises

2. Sleep Hygiene Habits

• Maintain a consistent bedtime and wake-up time

• Avoid screens before sleep

• Dim bedroom lights before bedtime

• Limit naps, especially late in the day

• If you wake up during the night, get out of bed for a few minutes instead of tossing and turning

3. Cognitive Behavioral Therapy (CBT)

CBT is a proven approach that helps improve sleep and manage anxiety or depression. It focuses on identifying thoughts and behaviors that interfere with sleep and replacing them with healthier patterns. Although most studies on CBT are conducted in non-pregnant populations, this therapy is widely recognized as safe and effective.

4. Addressing Underlying Medical Issues

Some sleep issues stem from medical conditions. Treatment may include:

5. Medications

Most sleep medications are not recommended during pregnancy unless necessary. In some cases, doctors may consider options such as:

• Antihistamines

• Certain psychiatric medications

• Short-term use of benzodiazepines

Always consult your doctor before taking any sleep aid, including over-the-counter remedies.

When to Talk to a Doctor

Occasional sleep disturbances during pregnancy are usually harmless. But if your insomnia becomes persistent and interferes with your functioning, it’s important to seek help. Your provider may suggest non-drug strategies, refer you to a sleep therapist, or assess whether an underlying condition like anxiety or sleep apnea is contributing to your symptoms.

Summary

Insomnia is a common experience during pregnancy and can affect how you feel physically and emotionally. In some cases, poor sleep may also be linked to pregnancy complications. Fortunately, many people find relief through lifestyle changes, better sleep habits, therapy, or safe medical guidance.

Don’t ignore prolonged sleep problems—support is available. Speaking with a healthcare provider can help you protect both your well-being and your baby’s health.