Pregnancy insomnia? Expert advice for restful sleep

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 3am.¹

If that sounds familiar, you’re not alone. Pregnancy insomnia is common, but it’s not something you have to just endure.¹ To help us understand pregnancy insomnia and what might make sleep a little easier, we worked with Dr Maja Schaedel – a sleep disorder specialist and co-founder of The Good Sleep Clinic – who helped us understand why pregnancy can disrupt sleep and what may help.

Pregnancy insomnia means struggling to fall asleep, stay asleep or get quality rest when you’re pregnant.² While the symptoms may feel like any other sleepless night, pregnancy can bring its own sleep disruptors, with physical discomfort, hormonal changes and anxiety all teaming up to potentially 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, it’s an occasional hassle – for others, a full night’s rest can feel out of reach.¹ Unlike chronic insomnia which can last for months or years, pregnancy insomnia is often temporary and is likely to improve after birth.² But understanding what could be disrupting your sleep – and what you can do about it – can make all the difference to your comfort and energy levels.

Pregnancy insomnia can start as early as the first trimester, likely due to hormonal fluctuations and rising progesterone levels.² However, for many people, sleep becomes more disrupted during the second and third trimesters when physical discomfort, leg cramps, heartburn and baby movements ramp up.^3,4 Third trimester insomnia can be particularly common. 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 awake. Add worries about your baby’s arrival into the mix and winding down may become even more difficult.^5,6,7

Unsure if it’s pregnancy insomnia you’re experiencing? Common symptoms include:^2,8

• difficulty falling asleep

• waking up frequently during the night

• more vivid dreams or nightmares than usual

• waking up too early and struggling to fall back asleep

If you’re experiencing sleeplessness early in pregnancy, remember that sleep can change throughout pregnancy and everyone’s experience is different. Tracking your sleep, spotting patterns and building good sleep habits early can help you understand what’s disrupting your rest and find ways to manage it.^9,10

If you’re having difficulty sleeping during pregnancy, several factors could be at play.

Hormonal shifts

Hormonal fluctuations during pregnancy, particularly changes in progesterone and oestrogen, may influence your sleep patterns.¹¹ While progesterone can promote sleep and oestrogen may increase wakefulness, rapid hormonal shifts can disrupt your usual sleep patterns and make restful nights harder to come by.¹¹

Increased need to urinate

Your kidneys work harder during pregnancy, filtering more blood and making you need to pee more frequently. This can mean frequent nighttime trips to the bathroom and disrupted sleep.¹²

Physical discomfort

From aches and cramps to back pain and a growing bump, finding a comfortable sleeping position can become a real challenge.¹³ From 28 weeks, sleeping on your back becomes less advisable, so you may need to experiment with different positions to find what feels comfortable.^10,14

Heartburn and indigestion

Pregnancy hormones relax the muscles in your digestive tract, which can lead to more acid reflux.¹⁵ Lying down may 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.^16,17 Worrying about not getting enough sleep can add another layer of anxiety too, potentially making it even harder to relax at bedtime.⁹

Getting comfortable in bed can feel like a nightly challenge, especially as your bump grows. Experts recommend sleeping on your side later in pregnancy, as lying on your back can affect circulation and may increase the risk of complications.¹⁸ Here are some other tips on how to comfortably sleep when you’re pregnant:^10,18-21

• use a pregnancy pillow: a full-body, wedge pillow or pregnancy pillow can provide extra support for your bump, back and knees. 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’s keeping you up, use extra pillows to elevate your torso and ease discomfort

• try to 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 dizziness, low 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 swelling

• try different mattress toppers: if your bed feels too firm, a topper may help make it more comfortable

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

Stick to a bedtime routine

A consistent bedtime routine helps tell your body that it’s time to wind down:^22-25

• go to bed and wake up at the same time every day, even on weekends

• try relaxing activities before bed, such as reading, gentle stretching or a warm bath

• try to avoid screens before bed, as blue light can interfere with your body’s melatonin production

Make your sleep environment comfortable

Making simple adjustments to your bedroom setup can improve comfort and help you fall asleep more easily:^9,26

• 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

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:^19,27,28

• avoid heavy meals, caffeine and spicy foods in the evening to help reduce heartburn and discomfort

• stay hydrated throughout the day, but try to cut back on fluids closer to bedtime to minimise those nighttime bathroom trips

• if hunger is keeping you awake, a small evening snack may help – speak to your midwife or healthcare professional if you need personalised dietary advice during pregnancy

Try relaxation techniques

If racing thoughts are keeping you up, relaxation techniques can help you unwind:^30,31

• 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 better sleep starts with asking for a little support. If discomfort, anxiety or persistent insomnia is affecting you, don't feel you have to manage it alone:^10,31

• talk to your partner about ways they can help make you more comfortable

• if anxiety is keeping you up, consider talking to 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

Occasional sleep struggles are common. However, ongoing sleep deprivation can affect your mood and energy levels and has been associated with an increased risk of complications including high blood pressure.³² Poor sleep has also been associated with longer labour and greater perceived pain during labour.³³ That doesn't mean a few bad nights are a reason to worry. But if insomnia is severe, persistent or affecting how you feel during the day, speak to your midwife or doctor for personalised advice.¹⁰

Pregnancy insomnia can be frustrating, but small changes to your bedtime routine, sleep environment and daily habits may help make those restless nights a little easier.²⁹ And remember, this phase won’t last forever – before you know it, you’ll be trading sleepless nights for newborn cuddles.

If your sleep issues are ongoing, severe or affecting your mood or how you feel during the day, speak to your doctor or midwife for extra support.¹⁰ You don’t have to figure out those sleepless nights alone. Still struggling to get comfortable? Try our tips for sleeping when you’re too hot or discover the pregnancy vitamins and supplements that’ll support you and your baby.

Disclaimer – This article provides informational advice and is not a substitute for medical care. Working with experts for accuracy, we take great care to ensure the information is up-to-date and relevant. However, you should always consult your GP or healthcare professional before using supplements or alternative products, particularly if you have medical conditions or are under supervision.