Pregnancy Insomnia

Medically Reviewed by Traci C. Johnson, MD on June 09, 2023
Written by Stephanie Watson
5 min read

Remember when you used to shut off your bedroom light and drift right to sleep? Now that you're pregnant, getting 8 to 9 straight hours of blissful slumber may seem like a distant dream.

If it's not the nagging pressure on your bladder that's keeping you awake, then it's the gnawing backache or leg cramps, or sheer inability to get comfortable in a bed that once gently cradled you to sleep.

What makes pregnancy insomnia even harder to handle? It's knowing that now is the time when you need sleep the most. Once your baby arrives, a good night's rest will be even harder to come by.

When you’re pregnant, many things can cause you to lose sleep, including:

  •  Backaches. As your center of gravity shifts forward, your back muscles overcompensate and become sore. Plus, your ligaments loosen thanks to pregnancy hormones, making you more likely to hurt your back.
  •  Breast tenderness. Your breasts might feel sore and tender while you’re pregnant.
  •  Gas. Pregnancy hormones slow digestion, making you feel bloated and gassy.
  •  Heartburn. Those same hormones also relax muscles in your digestive tract, making it easier for stomach acids to burn their way back up your esophagus.
  •  Hot flashes. Some pregnant women get hot flashes -- when you suddenly feel very warm in your chest, face, and neck.
  •  Leg cramps and restless legs. Changes in your circulation and pressure from the baby on nerves and muscles can make your legs cramp up. You may also get a creepy-crawly feeling in your legs known as restless legs syndrome.
  •  Lots of trips to the bathroom. Having to go to the bathroom during the night happens a lot when you’re pregnant and can keep you up at night.
  •  Vivid dreams. When you’re pregnant, it’s common to have a lot of vivid dreams.
  •  Nausea or throwing up. You might feel nauseous or throw up during the night.
  •  Shortness of breath. Your growing uterus is also putting pressure on your diaphragm, which sits just under your lungs. This pressure can make it hard to catch your breath.
  •  Snoring. Your nasal passages may swell up during pregnancy, which can make you snore. Extra pressure from your growing girth can also make snoring worse. Changes like these may briefly block breathing over and over during sleep (sleep apnea).
  •  Anxiety. You've got a lot to think about right now with your baby on the way. The many thoughts and worries spinning through your head can keep you from sleep.

It's important to address pregnancy insomnia. Your body needs rest right now to care for your growing baby. Pregnancy insomnia or obstructive sleep apnea (OSU) in pregnant women may be exacerbated by smoking, obesity, age, or a family history of it and this could make you more likely to have a premature delivery, a longer labor, or a C-section delivery, all of which could put your baby at risk.

Untreated sleep apnea may also lead to pregnancy complications, such as high blood pressure, and difficulty sleeping after birth.

It may also make you more vulnerable to depression after you deliver.

Treating insomnia is a little more challenging when you're pregnant, but it's not impossible. Many sleep medicines aren't considered safe for pregnant women and their babies.

Lifestyle changes -- including adjustments to your sleep routine -- can safely improve your sleep. Stick to a set (early) bedtime, and start with these steps.

  • Limit caffeinated beverages. Not only do they keep you awake, but they make it harder for your body to absorb the iron you and your baby need.
  • Drink plenty of water during the day, but stop drinking a couple of hours before bedtime so you don't have to wake up to go to the bathroom.
  • Ditch the screens. Scrolling through social media on your phone or watching television on your tablet can keep you up at night.
  • Eat smaller meals more often and eat earlier.
  • Consider steering clear of heartburn triggers like chocolate, and greasy or spicy foods.
  • Avoid eating for a few hours before bedtime if you have heartburn.
  • Get out and walk for about 30 minutes a day. Exercise helps you sleep better. Just don't exercise within 4 hours of bedtime because it can keep you awake.
  • Take short naps.
  • Take a warm bath, or ask your partner for a massage to relax you.
  • Take prenatal yoga or learn other methods to relax.
  • Talk through your worries. You can talk to a partner, a friend, or a therapist. Talking to someone can help get your anxieties off your chest.
  • Gently stretch your leg muscles before bed if you have leg cramps at night.
  • Keep your bedroom quiet, dark, and cool at night to help you sleep.
  • Have a bedtime routine.
  • Download a sleep or meditation app on your phone.
  • Sleep on your side with your knees bent for comfort. This eases backaches, heartburn, and hemorrhoids. Sleep on your left side to improve circulation and reduce foot swelling.
  • Use extra pillows. Put one between your legs. Bunch one under the small of your back to ease pressure. Experiment.

If you've tried these tips and you still can't get to sleep or stay asleep, see your doctor. You may need treatment for a sleep problem such as snoring or restless legs syndrome.

  • If you have restless legs syndrome, get plenty of folic acid and iron from your prenatal vitamins and from foods such as whole-grain breads and cereals.
  • If you're overweight or snore, your doctor may monitor you for sleep apnea. You may need a special mask that delivers steady air pressure to keep your airway open. This helps you breathe more easily at night.
  • If you have heartburn, try over-the-counter antacids. If possible, prop up the head of your bed a few inches so acid goes back down, instead of up into your esophagus. Don't do the propping with pillows. That can make matters worse.
  • If you have anxiety, talk to your doctor, who may refer you to extra sources of support.