What To Know About Pregnancy Insomnia

Pregnancy insomnia refers to difficulty falling asleep, staying asleep, or achieving restful sleep during pregnancy. It’s extremely common—research shows that between 66% and 94% of pregnant people experience sleep issues at some point.

Insomnia often worsens as pregnancy progresses, especially in the third trimester, when physical and hormonal changes peak. While it’s not usually dangerous, ongoing lack of sleep can affect your mood, energy, and overall quality of life. In rare cases, it may also increase the risk of gestational diabetes, preeclampsia, or preterm labor.

The good news: there are safe and effective ways to improve sleep during pregnancy through lifestyle changes, therapy, and medical care when necessary.

How Early Does Pregnancy Insomnia Start

Insomnia can begin as soon as pregnancy starts and may persist through all three trimesters. Studies show that:

• 25.3% experience insomnia in the first trimester

• 27.2% experience it in the second trimester

• 39.7% experience it in the third trimester

Fatigue, hormonal changes, and body discomfort tend to make sleeplessness worse as your due date approaches.

Common Causes of Pregnancy Insomnia

Pregnancy triggers a series of physical and hormonal changes that can interfere with sleep. The main causes include:

• Rising estrogen and progesterone levels

• Increased body weight and pressure on internal organs

• Frequent urination, especially at night

• Morning sickness and nausea

• Leg cramps or restless leg syndrome

• Shortness of breath or heartburn

• Baby movements late in pregnancy

• Heightened anxiety or emotional stress

People who smoke, have a history of depression, or struggle with anxiety may also be more likely to experience severe insomnia during pregnancy.

Side Effects and Risks

Most people with pregnancy insomnia experience only fatigue, irritability, or poor concentration. However, long-term sleep deprivation can increase the risk of:

• Inflammation and weakened immunity

• Gestational diabetes

• Preeclampsia (high blood pressure in pregnancy)

• Mood disorders such as anxiety or depression

• Complicated labor or C-section delivery

• Low birth weight in newborns

If your sleep problems persist or worsen, it’s important to talk to your healthcare provider to prevent complications.

Ways To Treat Pregnancy Insomnia

Treatment focuses on improving sleep quality and reducing stress, while keeping both parent and baby safe.

Lifestyle changes

Making small adjustments to your daily habits can make a big difference. Try to:

• Limit caffeine and avoid it after noon

• Stay active with light exercise or prenatal yoga

• Use a pregnancy pillow for body support

• Avoid large meals and limit water intake before bed

• Practice deep breathing or gentle meditation

• Discuss using heat therapy for sore muscles with your doctor

Better sleep hygiene

Developing a relaxing nighttime routine helps train your body for rest. This may include:

• Going to bed and waking up at the same time daily

• Dimming lights in your bedroom an hour before bed

• Avoiding screens (phones, TVs, tablets) before sleeping

• Skipping long or late daytime naps

• Getting out of bed if you can’t sleep—do something calming, then try again

Therapy for better sleep

Cognitive Behavioral Therapy (CBT) is highly effective for insomnia—even more than medication in many cases.

CBT helps identify negative thought patterns and behaviors that keep you awake, while teaching coping strategies and relaxation techniques. Many pregnant individuals find CBT improves not just sleep, but also mood and overall well-being.

Medical interventions

If insomnia stems from an underlying condition, your doctor may recommend specific treatments such as:

Medications (when necessary)

Most sleep medications are not recommended during pregnancy, but in some cases, your doctor may consider options like antihistamines, benzodiazepines, or psychiatric drugs that have been shown to be relatively safe in low doses.

Medication should always be a last resort after trying lifestyle and behavioral therapies first.

When To Contact a Healthcare Provider

Insomnia itself isn’t life-threatening, but ongoing sleep loss can affect both mental health and pregnancy outcomes. Contact your healthcare provider if you:

• Can’t function normally due to fatigue

• Experience severe anxiety, mood swings, or depression

• Suspect sleep apnea (loud snoring, gasping, choking in sleep)

• Have leg cramps or restless leg syndrome

• Notice your symptoms worsening despite lifestyle changes

Your provider can recommend safe treatments, connect you with a therapist, or evaluate for conditions like acid reflux, anemia, or thyroid imbalance that may interfere with sleep.

A Quick Review

Pregnancy insomnia is a common and often temporary challenge that affects up to 9 in 10 pregnant people. While it’s usually harmless, poor sleep can impact your daily life and increase the risk of complications if left unaddressed.

Simple steps—like adjusting your routine, reducing caffeine, managing stress, and practicing good sleep hygiene—can significantly improve rest. If symptoms persist, reach out for medical or therapeutic support. Prioritizing sleep is one of the best things you can do for yourself and your baby.