- What is pregnancy insomnia?
- Is it normal to have insomnia during pregnancy?
- What causes insomnia during pregnancy?
- What are the common symptoms of pregnancy insomnia?
- Tips to deal with pregnancy insomnia
- Natural remedies for pregnancy insomnia
- Treatment for pregnancy insomnia
- Is it safe to take sleeping pills when pregnant?
- Which over-the-counter sleeping pills are safe during pregnancy?
- What are the risks and side effects of taking sleeping pills when pregnant?
- Frequently asked questions
Sleep deterioration is one of the natural consequences of pregnancy. The growing bump, frequent urination, leg cramps or even the anxiety about the baby’s arrival can all make it difficult for you to sleep.
A study by the US National Sleep Foundation states that 78% of pregnant women report of sleep disturbances (1).
What Is Pregnancy Insomnia?
Pregnancy insomnia is the difficulty in falling asleep or remaining asleep. In general, you may perceive it as a poor-quality or inadequate sleep. Though a miserable condition, it is unlikely to harm your growing baby.
Is It Normal To Have Insomnia During Pregnancy?
Yes, it is normal to experience insomnia throughout the pregnancy. The incidence is highest in the third trimester than it is in the first and second trimesters because of the increasing abdomen size and perception of labor (2).
[ Read: Sleep During Pregnancy ]
What Causes Insomnia In Pregnancy?
You could experience sleepless nights because of:
- A backache: With the growing bump, the back muscles are strained and develop soreness. Also, the ligaments loosen as the pregnancy hormone levels increase, hurting your back and limiting your sleep (3).
- Heartburn and acid reflux: The growing uterus misplaces the intestines and the lower esophageal sphincter, which push the stomach acids up, back to the esophagus. They become bothersome in the third trimester and can severely disrupt sleep (4).
- Leg cramps and restless leg syndrome: Improved blood circulation and the bump’s pressure on the nerves and muscles will cause leg cramps. They are common during the first and third trimesters. Also, RLS is common in the third trimester and is associated with frequent limb movements during sleep. These changes will cause a disturbance in the sleep, leading to insomnia.
- Shortness of breath: Your growing bump applies pressure on the diaphragm, which is underneath the lungs. This increased pressure will make it difficult to hold the breath making it difficult to sleep (5).
- Snoring: The nasal passages swell during pregnancy, increasing your risk of snoring. Also, the extra pressure from the growing circumference will make the snoring worse. This would block breathing during sleep, forcing you to wake up multiple times during the night.
- Anxiety: The excitement, worry, and thoughts about the baby, labor, and changes in lifestyle can give you sleepless nights.
- Stress: Though pregnancy is a time of relaxation, you will be often filled with stress. Stressing about labor and parenthood can give you the jitters and disturb your sleep pattern.
Identifying the actual cause will help in finding an effective solution for pregnancy-related insomnia.
What Are The Common Symptoms Of Pregnancy Insomnia?
Symptoms of insomnia in pregnancy include (6):
- Trouble in falling asleep during the night
- Waking up frequently during the night
- Waking up too early
- Not feeling that you have adequately rested, even after a full night’s sleep
- Feeling sleepy during the day
- Daytime tiredness
- Depression and irritability
- Difficulty paying attention
- Increasing worries about sleep
[ Read: Back Pain During Pregnancy ]
Tips To Deal With Pregnancy Insomnia
The following tips will greatly help in reducing the sleep disturbances, and optimize your pregnancy sleep.
- Do not drink water before sleep time: If your sleep is getting disturbed due to frequent bathroom trips in the night, limit your intake of fluids before you go to sleep.
- Limit caffeine intake: Avoid caffeine before the bedtime. Tea, coffee, chocolate, and beverages have caffeine content that will keep you active during the night.
- Drink lots of water during the day: Dehydration can lead to leg cramps, so have enough water during the day. Keeping your body hydrated is an effective way to eliminate toxins.
- Include a balanced diet: Eat a healthy and balanced diet of organic fruits and vegetables, proteins, good fats, and leafy greens and vitamin B-rich foods. Deficiency of vitamin B6 can also lead to insomnia (7). Also, leg cramps associated with insomnia could be due to insufficient intake of some nutrients, especially magnesium (8).
- Follow exercise routine: Aim to exercise for at least 30-minutes every day. You may walk, or enroll in specialized swimming or prenatal yoga or pregnancy exercise classes. Exercising releases hormones in the body and helps lower the risk of anxiety and depression.
- Have a warm water bath every evening: A warm bath is relaxing and refreshing and promotes a good night’s sleep. It also helps reduce the pregnancy pains and aches.
- Write a to-do list: Make a comprehensive list of all the things to do at this time. Create a schedule and stick to it. Having a rigid plan will help you to be in control and lower stress levels, and promotes peaceful sleep.
- Be open: If you are worried, stressed or anxious, talk about it with your partner or anyone you feel comfortable with. Talking about your feelings can lighten the burden and keep your stress levels under control. Have a support system of people that can reassure you and help you in need.
- Pillows for comfort: Use extra pillows to support your bump, and in between your knees for a comfortable night’s sleep. Invest in a pregnancy pillow, which is specifically designed to support pregnant women.
- Try doing something if not sleepy: If you are not able to sleep, get off the bed and try reading a book, listening to music or doing anything else that can make you feel drowsy. Also, gentle yoga and relaxation exercises will make you feel sleepy.
- Sleep at different intervals: Take naps during the daytime whenever possible. Go to bed early, or sleep for extended hours in the morning. This will help you to make up for the sleep you lost during the night.
- Stay away from electronic gadgets: Electronic screens and devices will affect your mind by interrupting your sleep pattern. Try not to use them at least one hour before bedtime. It is even better if you keep such devices in another room.
- Indulge in sex: It helps in releasing feel-good chemicals, the endorphins that relax you and help you sleep.
- Visualization exercise: Lie down in a cozy place and think that you are in a beautiful location, such as the countryside or the beach. Breathe deeply and focus on your exhalation (9). As you breathe, your body and mind relax, promoting sleep.
Use of herbs can also promote a good night’s sleep. More about it next.
[ Read: Depression During Pregnancy ]
Natural Remedies For Pregnancy Insomnia
Here are a few natural ways to induce sound sleep.
1. Aromatherapy with essential oils:
- Oils of lavender, chamomile, and ylang-ylang help comfort your nerves (10). Take around two to three drops of any of these oils on a tissue and place them under your pillow.
- A warm shower before you go to bed offers both warmth and relaxation. Adding a few drops of essential oil to the bath water makes it better.
- Avoid using a vaporizer, if you are, for more than 20 minutes as it can cause nausea or a headache.
- Get a neck and shoulder massage with the recommended essential oils, after diluting them with grapeseed oil or olive oil.
2. Bach’s flower remedy:
The homeopathy solution contains brandy and extracts of flowers. It helps ease the tension and general stress. There is no proper evidence to support this theory, but most women find it helpful.
- If you happen to wake up in terror at night, due to a bad or a vivid dream, take two drops of Mimulus to beat fear and Rock Rose to fight terror (11).
- Weariness, which could be a result of improper sleep during the night, could be treated by hornbeam.
- Physical exhaustion during daytime could be managed by olive remedy (12).
3. Herbal teas:
Herbs have relaxing and soothing properties and are effective in inducing peaceful sleep (13).
- Valerian, kava, and St. John’s wort are helpful.
- Add one tablespoon of these dried herbs to one cup of boiled water. Allow it to steep for one hour, strain and warm it up again before consumption.
- You can have one cup each in the morning, afternoon and night.
- Do not take Valerian tea during daytime as it has sedative properties.
4. Cherry juice
Tart cherries are a great source of melatonin and a good alternative to hypnotic drugs. Consuming cherry juice twice a day will reduce the intensity of insomnia (14).
If the natural and herbal remedies don’t help, your doctor may recommend pharmacological or non-pharmacological treatments.
Treatment For Pregnancy Insomnia
Some of the treatment options that your doctor would suggest include:
- Cognitive behavioral therapy (CBT): It works by identifying and dealing with the thoughts and actions that affect your sleep pattern. The treatment employs different methods to target your sleep problems to improve sleeping habits and mood (15).
- Acupressure and acupuncture: These therapies are helpful in reducing anxiety, stimulating melatonin production and promoting undisturbed sleep, thus minimizing the risk of insomnia (16). Pressure points for relieving insomnia include the Heart 7 (inner wrist crease towards the little finger side), Urinary bladder 10 (in the depression of the nape), Conception vessel 17 (center of the breastbone) and Kidney 6 (inside of the ankle bone).
- Massage therapy: Studies report improved mood, reduced anxiety, better sleep, less back pain and decreased stress levels with massage and relaxation therapies (17).
[ Read: How To Sleep During First Trimester ]
Is It Safe To Take Sleeping Pills During Pregnancy?
It is good to avoid sleeping pills on a regular basis when you are pregnant, although occasional intake is considered harmless. It also depends on the type of medication you take.
Sedative-hypnotics such as Ambien (zolpidem), Sonata (zaleplon) and Lunesta (eszopiclone) are usually avoided as there are limited studies on them.
Which Over-The-Counter Sleeping Pills Are Safe During Pregnancy?
Benzodiazepines including clonazepam and lorazepam could be safe (18). Antihistamines such as diphenhydramine and doxylamine are safe to take at recommended dosages. These compounds are present in Benadryl, Sominex, Unisom, and Diclegis (19).
Note that sleeping pills are only recommended under severe conditions since they can adversely impact the mother and the baby.
What are the Risks and Side Effects of Taking Sleeping Pills When Pregnant?
Benzodiazepines might be addictive and may result in withdrawal symptoms in the baby. They include short-term effects such as muscle weakness, difficulty in breathing and jitters. Antihistamines could lead to extended drowsiness the following day, and difficulty concentrating (20).
Next, we address a few frequent queries by our readers.
Frequently Asked Questions
1. Can insomnia be an early sign of pregnancy?
Yes, insomnia can be an early sign of pregnancy. It develops along with other symptoms such as nausea, vomiting, frequent urination and back pain.
2. Is insomnia in late pregnancy a sign of labor?
Yes, insomnia is common before labor due to the secretion of oxytocin, a hormone that has wake-promoting properties. It might also be nature’s way of preparing you for the sleepless nights after delivery.
3. How many hours of sleep should you get when you are pregnant?
You should get at least eight hours of sleep during night time. Sleeping less than six hours in the night increases the likeliness of longer labors and cesarean section (21).
4. Can a pregnant woman take melatonin to sleep?
Melatonin helps improve sleep, but it is not recommended for pregnant women as there aren’t enough studies about its suitability or safety during pregnancy (22).
Sound sleep is vital for a healthy pregnancy and to promote good outcomes for both the mother and the baby. So, talk to your doctor if you have trouble sleeping, to prevent any complications during pregnancy and labor. Also, do not take any supplements, herbs or medications without consulting your doctor.
How did you deal with insomnia during pregnancy? Tell us about it in the comments section below.
2. A Kızılırmak, S Timur, B Kartal; Insomnia in Pregnancy and Factors Related to Insomnia; ScientificWorldJournal. (2012)
3. Maayan Agmon, Galit Armon; Increased Insomnia Symptoms Predict the Onset of Back Pain among Employed Adults; PLoS One. (2014)
4. Edited by Hrayr P. Attarian, Clinical Handbook of Insomnia, p. 163
5. The last 3 months of pregnancy – the third trimester; Women’s And Children’s Health Network
6. Reviewed by S Pusalavidyasagar, A Manvikar; Manage Insomnia Naturally; University of Minnesota
7. K L Lichstein; Vitamins and Sleep: An Exploratory Study; Sleep Med. (2009)
8. Phyllis A. Balch, Prescription for Nutritional Healing, p. 36
9. Overcoming insomnia; Harvard Mental Health Letter
10. Aromatherapy; Mercer University
11. Dr. B Deekshitulu P V; Coping With Stress the Bach Flower Way; The International Journal of Indian Psychology (2014)
12. L M Haden; Esoteric Remedies: Essential Oils and Bach Flower Remedies: A Potent Healing Combination, eBook -Page 27
13. M Sharma et al.; A Comprehensive Pharmacognostic Report On Valerian; International Journal of Pharmaceutical Sciences And Research (2010)
14. C McIlvaine; Foods That Will Help You Sleep Better; The National Personal Training Institute (2016)
15. Tomfohr-Madsen LM et al.; Sleeping for Two: An Open-Pilot Study of Cognitive Behavioral Therapy for Insomnia in Pregnancy; Behav Sleep Med. (2017)
16. da Silva JB et al.; Acupuncture for insomnia in pregnancy–a prospective, quasi-randomized, controlled study; Acupunct Med. (2005)
17. D Hollenbach et al.; Non-pharmacological interventions for sleep quality and insomnia during pregnancy: A systematic review; J Can Chiropr Assoc. (2013)
18. Treatment of Insomnia During Pregnancy; MGH Center for Women’s Mental Health (2007)
19. Principles and Practice of Sleep Medicine E-Book (Meir H. Kryger, Thomas Roth, William C. Dement, p. 439
20. C A Reichner; Insomnia and sleep deficiency in pregnancy; Obstet Med. (2015)
21. C Marcus, B A Seaman; Maternal Sleep & Sleep In Infants; University of Rochester Medical Center (2017)
22. Melatonin treatment protocol – chronic sleep disturbances in children; NHS
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