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Pregnancy insomnia? Expert advice for restful sleep

medico-author

Written byMedico Digital

Dr Maja Schaedel

Reviewed byDr Maja Schaedel

Pregnant female laying on bed in pyjamas asleep
Struggling to sleep through the night? Pregnancy insomnia is common, but better rest is within reach. Learn why pregnancy affects sleep as we ask an expert for tips to help you drift off

Summary

1What’s pregnancy insomnia?

Pregnancy insomnia means struggling to fall asleep, stay asleep or get quality rest when you’re expecting. It’s different from regular…

2Why does insomnia happen in pregnancy?

When it comes to pregnancy insomnia, several factors could be at play, including…

3Sleeping position during pregnancy

Getting comfortable in bed can feel like a nightly challenge, especially as your bump grows. Experts recommend…

Explore related topics

Pregnancy is full of surprises – some wonderful, others… not so much. One of the more frustrating ones? Insomnia. Just when you need sleep the most, you may find yourself wide awake at 3 a.m., staring at the ceiling, wondering how you’ll make it through the next day.1 

If that sounds familiar, you’re not alone. Pregnancy insomnia affects many expectant parents, and while it’s common, it’s not something you have to endure.1 To help, we asked Dr Maja Schaedel – a sleep disorder specialist and co-founder of The Good Sleep Clinic – for her expert advice. With a few simple tweaks to your routine, you can set yourself up for better rest and more refreshing sleep.2

What’s pregnancy insomnia?

Pregnancy insomnia means struggling to fall asleep, stay asleep or get quality rest when you’re expecting.3 It’s different from regular sleeplessness – physical discomfort, hormonal changes or heightened anxiety about the upcoming arrival of your baby can all team up to disrupt your sleep.1

Research suggests that up to 76.3% of pregnant people experience sleep disturbances at some point during pregnancy.1 For some women, it’s an occasional hassle, while for others, a full night’s rest feels out of reach.1

Unlike chronic insomnia, which can last for months or years, pregnancy insomnia is temporary and often resolves after birth.3 But understanding what’s causing it and how to manage it can make all the difference to your comfort and energy levels.

When does pregnancy insomnia start?

Pregnancy insomnia can begin as early as the first trimester, thanks to hormonal fluctuations and rising progesterone levels.3

However, for many, it becomes more noticeable in the second and third trimesters when physical discomfort, leg crampsheartburn and baby movements ramp up.4,5

By the third trimester, insomnia tends to peak. Your growing bump makes it tough to find a comfortable sleeping position, while frequent bathroom trips, baby kicks and even Braxton Hicks contractions can keep you wide awake. Add in the pre-labour jitters, and it’s no wonder sleep feels like a distant dream.6-8

Unsure if it’s pregnancy insomnia you’re experiencing? Common symptoms include:3,9
  • difficulty falling asleep
  • waking up frequently during the night
  • feeling restless despite being tired
  • more vivid dreams or nightmares than usual
  • waking up too early and struggling to fall back asleep
If you’re encountering insomnia early on, don’t panic – each pregnancy is different, and sleep troubles can ebb and flow. Tracking your sleep, spotting patterns and building good sleep habits early can help you find ways to manage your sleep better and prevent long-term disruptions.2,10

Why does insomnia happen in pregnancy?

When it comes to pregnancy insomnia, several factors could be at play, including:

Hormonal shifts

Hormonal fluctuations during pregnancy, particularly changes in progesterone and oestrogen, may influence your sleep patterns.11 

While progesterone can promote sleep, oestrogen may increase wakefulness. These rapid hormonal shifts may disrupt your usual sleep patterns and make restful nights harder to come by.
 

Increased need to urinate

Your kidneys work harder during pregnancy, filtering more blood and producing more urine. At the same time, your growing uterus can lead to frequent nighttime trips to the bathroom and disrupted sleep.12
 

Physical discomfort

From aches and cramps to back pain and a growing bump that keeps shifting, finding a comfortable sleeping position can become a real challenge.13 As your pregnancy progresses, sleeping on your back becomes less advisable, narrowing your options even more.10,14
 

Heartburn and indigestion

Pregnancy hormones relax the muscles in your digestive tract, lowering the pressure in the lower oesophageal sphincter, which can lead to more acid reflux.15 Lying down can make symptoms worse, leaving you uncomfortable and unable to sleep soundly.
 

Stress and anxiety

Excitement, worry and the endless to-do list before your baby’s arrival can keep your mind racing at night. Research shows that poor sleep quality during pregnancy is linked to increased stress levels, and this relationship may go both ways.16 Some women can also feel worried about not getting enough rest due to difficulty sleeping, which can make it harder to feel relaxed and therefore harder to sleep.
 
Pregnant female laying on bed in pyjamas asleep

Sleeping position during pregnancy

Getting comfortable in bed can feel like a nightly challenge, especially as your bump grows. Experts recommend sleeping on your side – either left or right – since it helps with circulation and reduces the risk of complications later in pregnancy.19

Here are some tips to help you sleep more comfortably:10,19-22
  • use a pregnancy pillow: a full-body, wedge pillow or pregnancy pillow can support your bump, back and knees, helping reduce pressure and strain. Don’t be afraid to experiment with different pillow placements to find the most comfortable position for you
  • prop up your upper body: if heartburn is keeping you up, use extra pillows to elevate your torso and ease discomfort
  • avoid lying flat on your back: as your pregnancy progresses, lying flat on your back can put pressure on your spine and major blood vessels, particularly the inferior vena cava. This can cause dizzinesslow blood pressure and decreased circulation, making it harder to sleep soundly
  • try elevating your legs: swollen ankles and feet can be a real discomfort at night. Prop up your legs slightly with a pillow to help reduce fluid retention and ease the pressure
  • try different mattress toppers: if your bed feels too firm, a memory foam topper may offer additional support and cushioning for your growing body

How to sleep better during pregnancy

A sleep routine can work wonders for improving rest. Here’s how to optimise your environment and habits:

Establish a bedtime routine

A consistent bedtime routine signals to your body that it’s time to wind down:23-26
  • go to bed and wake up at the same time every day, even on weekends
  • engage in a relaxing pre-bed ritual, such as reading, gentle stretching or a warm bath
  • avoid screens before bed, as blue light can interfere with your body’s melatonin production
 

Optimise your sleep environment

Making simple adjustments to your bedroom setup can improve comfort and help you fall asleep more easily:2
  • keep your bedroom cool, dark and quiet
  • if external light or noise is an issue, use blackout curtains and a white noise machine
  • invest in a supportive mattress and breathable bedding to stay comfortable
  • declutter your bedroom to create a calming, sleep-friendly space that invites rest
 

Adjust your diet and hydration

What you eat and drink before bed can impact sleep quality. Making mindful choices can help prevent discomfort and nighttime wakeups:20,27,28
 

Try relaxation techniques

If racing thoughts or tension are keeping you up, relaxation techniques can help you unwind. Small changes to your nighttime habits can make it easier to settle into sleep:29,30
  • practise deep breathing, meditation or prenatal yoga to calm your mind and body 
  • listen to soothing music or guided sleep meditations to gently ease you into sleep
  • try progressive muscle relaxation to release tension and make it easier to drift off
 

Seek support

Sometimes, a little extra support makes all the difference. Don’t hesitate to speak to those around you for guidance and reassurance.10,31
  • talk to your partner about ways they can help make you more comfortable
  • if anxiety is keeping you up, consider speaking with a healthcare professional for reassurance or support
  • join a pregnancy support group where you can share experiences and gain advice from others going through the same journey
 

Is insomnia bad for pregnancy?

Occasional sleep struggles are common and generally harmless. However, ongoing sleep deprivation can impact your mood, energy levels and even increase the risk of complications, such as high blood pressure.32 Poor sleep may also make labour longer and increase the perception of pain during labour.33

If you’re experiencing severe insomnia, consult your midwife or doctor for personalised advice. They may recommend safe, pregnancy-friendly strategies to help you sleep better and feel more rested.10

The final say

Pregnancy insomnia can be frustrating, but you’re not powerless against it. By making small changes to your bedtime routine, sleep environment and daily habits, you can help improve your rest and feel more energised.2

And remember, this phase won’t last forever – before you know it, you’ll be trading sleepless nights for those sweet newborn cuddles.

If sleep issues are ongoing, speak with your doctor or midwife for additional guidance.10

Interested to know whether what you eat can help you drift off faster? Check out these 9 foods to help you sleep.

Disclaimer - The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

While we strive for accuracy and balance, please be aware that this article may discuss products available for purchase through Holland & Barrett. Consult a healthcare professional before making any health-related decisions.

Sources

1. Wong PF, et al. Sleep disorders in pregnancy. Breathe. 2022;18(2):220004. https://doi.org/10.1183/20734735.0004-2022
2. NHS. How to fall asleep faster and sleep better [Internet]. [cited 2025 Feb 21]. Available from: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-fall-asleep-faster-and-sleep-better/
3. Hashmi AM, et al. Insomnia during pregnancy: Diagnosis and rational interventions. Pak J Med Sci. 2016;32(4):1030–7. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5017073/
4. Al-Musharaf S. Changes in sleep patterns during pregnancy and predictive factors: A longitudinal study in Saudi women. Nutrients. 2022;14(13):2633. https://doi.org/10.3390/nu14132633
5. Office on Women’s Health. Body changes and discomforts [Internet]. [cited 2025 Feb 21]. Available from: https://womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts
6. Salari N, et al. A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy. BMC Pregnancy Childbirth. 2021;21(1):284. https://doi.org/10.1186/s12884-021-03755-z
7. Mislu E, et al. Sleep quality disparities in different pregnancy trimesters in low- and middle-income countries: A systematic review and meta-analysis. BMC Pregnancy and Childbirth. 2024;24:627. https://doi.org/10.1186/s12884-024-06830-3
8. Raines DA, Cooper DB. Braxton hicks contractions. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470546/
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12. Cheung KL, Lafayette RA. Renal physiology of pregnancy. Adv Chronic Kidney Dis. 2013;20(3):209–14. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4089195/
13. National Library of Medicine. Aches and pains during pregnancy [Internet]. [cited 2025 Feb 21]. Available from: https://medlineplus.gov/ency/patientinstructions/000580.htm
14. Wilson DL, et al. Polysomnographic analysis of maternal sleep position and its relationship to pregnancy complications and sleep-disordered breathing. Sleep. 2022;45(4):zsac032. https://doi.org/10.1093/sleep/zsac032
15. Altuwaijri M. Evidence-based treatment recommendations for gastroesophageal reflux disease during pregnancy: A review. Medicine. 2022;101(35):e30487. https://doi.org/10.1097/MD.0000000000030487
16. Gao M, et al. Association of sleep quality during pregnancy with stress and depression: A prospective birth cohort study in China. BMC Pregnancy Childbirth. 2019;19(1):444. https://doi.org/10.1186/s12884-019-2583-1
17. Mansur A, et al. Restless leg syndrome. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430878/
18. Restless legs syndrome: Treatment [Internet]. [cited 2025 Feb 21]. Available from: https://www.nhs.uk/conditions/restless-legs-syndrome/treatment/
19. National Institute for Health and Care Excellence. Maternal sleep position during pregnancy. London: NICE; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK573947/
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21. Hughes EJ, et al. The effect of maternal position on venous return for pregnant women during MRI. NMR Biomed. 2021;34(4):e4475. https://doi.org/10.1002/nbm.4475
22. NHS. Swollen ankles, feet and fingers in pregnancy [Internet]. [cited 2025 Feb 21]. Available from: https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/swollen-ankles-feet-and-fingers/
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29. NHS. How can meditation help with sleep? [Internet]. [cited 2025 Feb 21]. Available from: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/how-to-fall-asleep-faster-and-sleep-better/how-can-meditation-help-with-sleep/
30. Azward H, et al. Prenatal yoga exercise improves sleep quality in the third trimester of pregnant women. Gac Sanit. 2021;35(2):S258–S262. https://doi.org/10.1016/j.gaceta.2021.10.030
31. Liu S, et al. Family support moderates the relationship between pregnancy stress, depressive symptoms, and insomnia. Nat Sci Sleep. 2025;17:261–270. https://doi.org/10.2147/NSS.S496205
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