What To Know About Pregnancy Insomnia

Pregnancy insomnia refers to difficulty falling asleep, staying asleep, or getting restful, high-quality sleep while pregnant. Sleep issues are extremely common during pregnancy—affecting between 66% and 94% of expectant mothers at some point. As pregnancy progresses, insomnia symptoms often become more frequent and more intense.

In addition to hormonal changes, pregnant individuals are more likely to experience restless leg syndrome (RLS) and obstructive sleep apnea (OSA), both of which can worsen sleep problems. While pregnancy insomnia is generally not dangerous, it can significantly affect your energy, comfort, and emotional well-being. In some cases, persistent sleep deprivation may increase the risk of pregnancy-related complications. Fortunately, safe and effective strategies exist to manage this condition and improve sleep quality.

How Early Pregnancy Insomnia Starts

Sleep disturbances can begin as early as the first trimester and often worsen with time. According to research, insomnia peaks during the third trimester when physical discomfort and hormonal fluctuations are at their highest.

A large analysis found that:

• About 38% of pregnant individuals experience insomnia at some point.

• The rate rises to nearly 40% during the third trimester.

• It’s lower during early pregnancy—25% in the first trimester and 27% in the second.

Causes Of Pregnancy Insomnia

Pregnancy triggers numerous physical and hormonal changes that can make restful sleep more difficult. Rising levels of estrogen and progesterone influence body temperature, muscle tone, and mood—all of which can interfere with sleep.

Common causes include:

• Morning sickness and frequent nausea

• Increased urination, especially at night

• Muscle aches and back pain

• Leg cramps or restless legs

• Heartburn and acid reflux

• Shortness of breath as the uterus expands

• Baby movements during nighttime hours

Other factors such as anxiety, smoking, or a history of depression can heighten the likelihood of experiencing pregnancy insomnia.

Side Effects And Health Risks

Most people with pregnancy insomnia primarily deal with fatigue, low mood, or irritability. However, chronic or severe sleep deprivation can also raise the risk of several health complications, including:

• Increased inflammation in the body

• Gestational diabetes

• Preeclampsia (high blood pressure during pregnancy)

• Mood disorders such as anxiety or depression

• Excess labor pain or prolonged delivery

• Higher chance of cesarean (C-section) birth

• Low birth weight in newborns

While these risks are relatively uncommon, maintaining adequate sleep is important for both maternal and fetal health.

Treatment Options For Pregnancy Insomnia

Though uncomfortable, pregnancy insomnia is treatable. Effective care focuses on natural, safe approaches before turning to medication. Healthcare professionals usually recommend a combination of lifestyle adjustments, sleep hygiene improvements, therapy, and—in specific cases—medical interventions.

Lifestyle Changes

Small daily changes can make a big difference in your sleep quality:

• Limit caffeine intake, especially after noon.

• Engage in light exercise or gentle stretching.

• Try prenatal yoga or relaxation breathing.

• Reduce water intake right before bed.

• Use a pregnancy pillow for body support.

• Apply heat therapy (with medical approval) for sore muscles.

• Practice meditation or mindfulness before sleep.

Sleep Hygiene Habits

Maintaining consistent routines encourages better sleep patterns. Consider:

• Going to bed and waking up at the same time every day.

• Dimming lights and keeping the room cool before sleep.

• Avoiding screens (phones, tablets, TVs) close to bedtime.

• Limiting naps, especially late in the day.

• Getting out of bed if you can’t fall asleep instead of tossing and turning.

Therapy And Stress Management

Cognitive Behavioral Therapy (CBT)—especially CBT for insomnia (CBT-I)—can help change unhelpful sleep-related thoughts and behaviors. Although most research is done on non-pregnant populations, CBT is known to improve sleep, reduce stress, and enhance mood during pregnancy.

Therapy sessions often teach techniques like progressive muscle relaxation, guided imagery, and mental reframing, which reduce anxiety and help prepare the body for rest.

Medical Interventions

If underlying medical issues are causing your insomnia, treating them can improve your sleep. Examples include:

Medication Considerations

Most sleep medications are not recommended during pregnancy because of potential risks to the fetus. Doctors typically exhaust natural methods before considering prescriptions.

However, in certain cases, medications such as antihistamines, low-dose benzodiazepines, or specific psychiatric drugs may be used cautiously under strict medical supervision. Always consult your healthcare provider before taking any sleep aid or supplement during pregnancy.

When To Contact A Healthcare Provider

Occasional sleepless nights are normal in pregnancy, but persistent insomnia that disrupts your daily life should be evaluated by a professional. Contact your healthcare provider if you:

• Can’t sleep for more than a few nights in a row

• Feel excessively tired or moody during the day

• Experience snoring, anxiety, or leg discomfort that interrupts rest

Your provider can recommend safe therapies, refer you to a sleep specialist, or identify any underlying issues such as sleep apnea, reflux, or anxiety disorders.

A Quick Review

Pregnancy insomnia affects most expectant mothers at some stage, particularly in later trimesters. While typically harmless, ongoing sleep problems can affect mood, energy, and pregnancy outcomes.

If lifestyle changes and relaxation techniques aren’t improving your sleep, talk to your healthcare provider. Getting quality rest benefits both you and your baby, supporting healthy development and emotional well-being.