How to cope with pregnancy insomnia

Any new parent will know the reality of sleepless nights in the first few months with their newborn. Nothing can quite prepare you beforehand for what it’ll feel like to be doing the fourth feed overnight before the day breaks. But what if difficulty sleeping kicks in before you give birth? 

For some, pregnancy insomnia is a real problem. Whether it's a fear of giving birth that's keeping you awake at night, or the need to pee every five minutes (that's how it feels, anyway) it can be frustrating. But as your body goes through the monumental physical and emotional changes that come with being pregnant, it’s hardly surprising that your sleep schedule can become interrupted. 

Having trouble sleeping might not have been at the top of your list of expected pregnancy symptoms, and it can be tough when you’re trying to get as much rest as you can. But you don’t have to tackle pregnancy insomnia by yourself. Here, a Flo expert explains everything you need to know, from how it affects both you and your baby to the best ways to cope with it and what not to do if you’re struggling to get your full eight hours of sleep.  

What is pregnancy insomnia? 

Struggling to fall asleep, waking up during the night, and waking up too early are all symptoms of insomnia. It’s a common sleep disorder that affects around one in three of us at some point in our lives and a massive 60% of pregnant people. Insomnia can fall into two categories: short term and chronic.

Short-term insomnia is exactly what it sounds like — lasting anywhere from a few days to a few weeks. On the other end of the scale, symptoms that occur at least three times a week for more than three months would be considered chronic insomnia.

Pregnancy insomnia is just like any other kind of insomnia, only (as the name suggests) it affects you when you’re pregnant. So if you’re expecting and have been struggling to get some decent shut-eye, remember that you’re certainly not the only one. 

Symptoms 

First things first, it’s really important to remember that it’s totally normal to be tired while you’re pregnant. Your body is growing another human, after all. However, there are certain signs and symptoms to look out for that might suggest you’re dealing with a bout of pregnancy insomnia rather than just expected fatigue. They include: 

• Not being able to get to sleep at night 
• Waking up frequently for no apparent reason
• Not being able to get back to sleep once you’ve woken up 
• Waking up much earlier than you normally would and not being able to fall back to sleep
• Having delayed responses during the day due to tiredness 
• Feeling anxious or irritable 

Causes

With so much rapid change happening to your body during pregnancy, it’s no surprise that this can affect your ability to get a good night’s rest. Generally, stress is a primary cause of insomnia, and pregnancy can be a time of big emotions. 

Dr. Hrayr Attarian, professor of neurology at Northwestern University, Illinois, US, says, “Hormonal changes definitely play a role, as do other sleep disorders such as restless legs syndrome and other pregnancy-associated symptoms.”

Sometimes insomnia when you’re expecting can be caused by other pregnancy symptoms. For example, you might have noticed that from as early as your first trimester, you haven’t been able to go a whole night without having to get up to pee at least once. This is because you have more blood circulating around your body during pregnancy, so your kidneys have to work extra hard to filter out impurities — not exactly the perfect recipe for a good night’s sleep. 

There’s no shortage of other things that can disturb your sleep during pregnancy, too. These can include: 

• Your baby’s movement during the night
• Obstructive sleep apnea (where the walls of your throat relax and narrow during sleep, which can change how you breathe) 
• Heartburn 
• Tender breasts
• Leg cramps
• Restless legs syndrome (when you have the overwhelming urge to move your legs)
• Discomfort around your bump as it grows 
• Shortness of breath 
• Anxiety surrounding labor
• Not being able to settle your mind before bed

When does it start?

While it would be ideal to be able to time your pregnancy symptoms like clockwork, you’ve probably figured out by now that it doesn’t quite work like that. Ultimately, everyone is different. Some people experience insomnia in early pregnancy. Other research shows that as your pregnancy progresses, you’re more likely to have a sleepless night, with third-trimester insomnia proving to be particularly challenging. Keep reading to find out more about when pregnancy insomnia might start. 

Early pregnancy insomnia 

It’s thought that your sleep schedule might be interrupted during early pregnancy due to increases in progesterone. You may find yourself feeling more tired or needing to nap throughout the day. Throughout your pregnancy, progesterone levels rise around 10 times higher than they were before you were pregnant. This happens to support your baby and prevent your uterus from contracting throughout the pregnancy. 

High levels of progesterone can impact the neurotransmitters and receptors in your brain. At the same time, estrogen levels are high during pregnancy and may affect how much rapid eye movement sleep you get. This is the stage of sleep where you dream, make memories, process emotions, and your brain develops. So together, these changes can wreak havoc on your sleep patterns.

Pregnancy insomnia during the second trimester 

During your second trimester, your bump may start to get larger. The skin on your belly may feel itchy, and you might feel your baby’s movements for the first time. This is all really exciting, but these physical changes can be really disruptive to sleep. 

Your doctor may suggest from the start of your second trimester that you should sleep on your side. This is suggested so you aren’t putting too much weight on the big blood vessels that supply your uterus, as this can restrict blood flow. If you like nothing more than napping on your front or back, it can be difficult to change your natural sleeping position and may mean that you find it difficult to get to sleep.

Later pregnancy insomnia 

From 28 weeks onward, your body is getting ready to give birth. You might experience Braxton-Hicks contractions for the first time, which can be uncomfortable and may wake you up. As your baby grows and presses down on your bladder, you might need to pee a lot more, and that includes during the night, which again may mean that you’re up and about at times you wouldn’t normally be. 

And it isn’t just physical changes that can increase your risk of experiencing pregnancy insomnia. In your third trimester, you will reach the point where you’re starting to get your head around the idea of giving birth. It’s perfectly normal if you feel anxious or worried about birth; this may trigger pregnancy insomnia as stress is one of the leading causes of difficulty sleeping. 

How long can it last?

Pregnancy insomnia can make nights feel endless, so it might be comforting to know when it will end. But it’s hard to tell when that will be. While some people experience short-term insomnia for a few days or a week, others experience chronic insomnia that can last months. 

If you’re struggling to sleep, don’t necessarily brush it off as a natural part of pregnancy. Speak to your doctor about what might be triggering it and ask for some coping mechanisms which may help you feel more rested. 

Is pregnancy insomnia a sign of your baby’s sex?

Pregnancy and old wives’ tales seem to go hand in hand. Whether it’s swinging a chain above your belly or determining whether you’re carrying “high” or “low,” there are a lot of fun ways that people might guess the sex of your baby. However, they’re just that — fun. Sorry to break it to you, but pregnancy insomnia isn’t a sign of your baby’s sex, so try not to read into anything there.

Is it a sign that you are having twins?

In the same way that you can’t find out the sex of your baby from the recurrence of sleepless nights, pregnancy insomnia also isn’t a sign that you’re having twins (despite the myths around this, too). The only way to know if you are carrying more than one baby is by seeing your doctor and getting an ultrasound. 

Is it a sign that you are in labor?

As we now know, physical discomfort can be a cause of pregnancy insomnia, especially the closer you get to labor. Feeling aches and twinges in the night can be worrying. However, pregnancy insomnia isn’t a sign that you’re in labor. Some of the earliest signs that may signal the early start of labor as you get closer to your due date include: 

• Your baby bump feels tight at regular intervals
• Painful backache
• Losing your mucus plug. When this happens, you might experience a small amount of bleeding. 
• An urge to poop
• Water breaking. This can be different for everyone; it might feel like a splash or more of a trickle.

Health effects of pregnancy insomnia

Whether you’re pregnant or not, being unable to sleep can be frustrating, and it may cause you to worry about the effects it’s having on your overall health. Firstly, it’s really important to remember that while insomnia has been linked to certain health issues, it’s incredibly rare that you’ll experience other negative health effects while you’re pregnant as a result. It only occurs in very extreme cases, so try not to worry. If you’re concerned, reach out to your doctor for support and some tips and tricks for getting the shut-eye you need. 

Can it affect the baby?

It’s totally normal to be concerned that if you’re not getting the rest you need, your baby isn’t either. But that isn’t the case. Rest assured: Even when you’re wide awake, your baby will be getting the sleep they need. So, try to go easy on yourself and keep your bedtime schedule consistent throughout the week if you’re struggling to sleep at night.

Natural pregnancy insomnia remedies 

You might feel like you’re running on low reserves, but the good news is there are things you can do to help overcome pregnancy insomnia. Dr. Hrayr recommends mindfulness exercises and cognitive behavioral therapy (CBT) as the best treatment options for insomnia — with or without pregnancy. Both mindfulness and CBT can help you feel calmer before bed and break any negative associations you might have about going to sleep. 

There are also some easy habits you can try to adopt at home which may improve the quality of your sleep, such as:

Developing a sleep routine 

Going to bed and waking up at the same time throughout the week will regulate your body’s internal clock, which can make it easier for you to sleep and wake up.

It’s also recommended that you start to wind down and relax for at least an hour before you go to bed. For optimum results, try to make your room as dark and quiet as possible before you snuggle under the sheets. 

Temperature can also really impact your sleep, so make sure you’re not too hot or cold. Around 60 to 67 F (15 to 19 C) is optimal for sleep. And while it might feel like a big ask to give up phone time before bed, try not to look at a screen while you wind down — the stimulation of the light may make it harder to fall asleep. If you live in a noisy environment, you might find a white noise machine or gentle sounds soothing before you sleep. 

Staying active during the day 

If you’re able to fit some exercise into your day, you might find that you’ve stumbled across the solution to your sleep problem. In fact, research shows that people who do aerobic exercise report fewer sleep complaints. If the thought of working up a sweat while pregnant leaves you feeling less than enthused, remember that aerobics can vary from low-impact walking to activity that’s a little more vigorous. You don’t need to be doing 100 jumping jacks every day!

Remember to consult your health care provider with any questions or concerns before starting a new exercise program.

Cutting down on caffeine

The good news is that you’re already off to a head start with this one if you bid farewell to your usual number of caffeinated drinks at the start of your pregnancy. The American College of Obstetricians and Gynecologists recommends the equivalent of one 12-ounce cup per day if you’re pregnant, but you may want to cut this out completely if you’re struggling with sleep, as caffeine has long been linked to insomnia. Caffeine can be found in tea, coffee, soft drinks, and even food, so it’s always worth checking with your doctor and any labels. 

Staying hydrated

It’s recommended that you drink 8 to 12 cups of water a day during pregnancy, so make sure you keep glugging. If you’re not reaching that goal, you might find it encouraging to know that staying hydrated has been proven to improve the length of sleep. 

Exploring new sleep positions

Switching up your sleep positions can make a world of difference when it comes to comfort, especially as you get further along in your pregnancy. It’s recommended that from your second trimester, you should try to sleep on your side. If this isn’t comfortable for you, then you might want to invest in a pregnancy pillow, as many people find them to be a savior in the later months. Side note: If you want to find out the best positions for the dreamiest night’s sleep, read our top tips here. 

Treatment of pregnancy insomnia with medication

We’ve spoken about mindfulness, therapy, and daily habits that you can adopt to beat insomnia, but you might also be wondering if there are alternative medicinal options you could try. The answer? While there are countless sleeping pills on the market, it’s not advised that you use these if you’re pregnant. 

“We don’t have enough data on most medications to recommend them confidently in pregnancy,” says Dr. Hrayr. “The few with a reasonable amount of data in pregnancy are not safe.” So, if you want to explore the medication you can use to help sleep while pregnant, speak to your doctor first. 

Can you take melatonin when you’re pregnant?

Melatonin is a hormone produced by your body at night to help you sleep. It helps to regulate your sleep cycle, rising in the evening so you feel tired. If you’ve experienced insomnia, you might have heard of people taking melatonin in the form of a supplement tablet. It gives you a boost to help you sleep better. 

However, just like sleep medication during pregnancy, Dr. Hrayr says you should be wary of melatonin and other supplements if you’re expecting a baby. “Supplements are even more problematic because there are no real studies [relating to pregnancy], period. Because they’re not regulated by the Food and Drug Administration, they can claim anything and use a disclaimer,” he says. While melatonin isn’t regulated in the United States, it is classed as a medication in the UK, and you can access it with a prescription from your doctor. However, it isn’t recommended that you take it if you’re pregnant or breastfeeding. 

“It’s popular [during pregnancy] because people think it’s natural, it’s over the counter, and it should be safe,” says Dr. Hrayr. However, he highlights that melatonin can impact how your baby’s sleep cycle develops.

Pregnancy insomnia: The takeaway

We know that battling pregnancy insomnia can be challenging, to say the least, but thankfully, there are fuss-free and cost-free ways that you can try to improve your sleep at home. The key to most of this seems to be about improving your “sleep hygiene” by developing a healthy nighttime routine. 

If you find that you’re feeling anxious before bed, Dr. Hrayr recommends mindfulness and therapy. Creating a peaceful environment where you can focus on getting the rest you need may help you get a full night’s sleep. Similarly, exercise and drinking enough water may be the key to good sleep.

Insomnia is a common occurrence, but that doesn’t mean it’s something you should just have to live with, as there are ways to try to overcome it. Reach out to your doctor. They may be able to give you some hints and tips to help you get some shut-eye before your baby arrives.