What To Know About Pregnancy Insomnia

Medically reviewed by Cordelia Nwankwo, MD

Insomnia during pregnancy can cause the inability to fall asleep, stay asleep, or experience good quality sleep. Sleep problems are extremely common in pregnancy. In fact, studies estimate that between 66% and 94% of pregnant people experience trouble sleeping at one point or another during their pregnancy. It's also worth noting that insomnia tends to get worse as your pregnancy progresses.

Pregnant people are more likely to experience obstructive sleep apnea and restless leg syndrome—two underlying health conditions that can also contribute to insomnia. Although insomnia during pregnancy isn't a cause for concern, it can affect your quality of life. In a few cases, lack of good sleep may also increase your risk of experiencing some pregnancy complications. Fortunately, there are effective and safe ways to treat pregnancy insomnia and improve your sleep quality.

How Early Does Pregnancy Insomnia Start?

Pregnancy insomnia can start as soon as you become pregnant and may persist throughout your pregnancy. Many people notice that insomnia worsens as the weeks go on—and insomnia tends to peak during the third trimester of pregnancy.

A meta-analysis published in the Journal of Sleep Research found the following statistics:

  • 38.2% of pregnant people experienced insomnia overall during their pregnancies

  • Insomnia was most common in the third trimester, with 39.7% of pregnant people experiencing symptoms

  • Pregnant people experience insomnia at lower rates during the first and second trimesters, at 25.3% and 27.2% respectively

Causes

Being pregnant can lead to several intense changes in your body. Usually, insomnia during pregnancy occurs due to a combination of factors such as increases in the hormones estrogen and progesterone and normal pregnancy weight gain. These factors can also lead to aching muscles, body discomfort, sleep apnea, and snoring—all of which can contribute to and worsen insomnia.

The causes of pregnancy insomnia may vary from one trimester to another. For example, in the first trimester, the most common causes of insomnia are adjusting to morning sickness (nausea and vomiting), having to pee more frequently, and experiencing new aches and pains. In the second and third trimesters, leg cramps, feeling short of breath, baby movements, and heartburn are most likely to keep you awake at night.

Although anyone can experience insomnia during pregnancy, people who smoke, have a history of depression, or experience anxiety are more likely to develop symptoms of pregnancy insomnia.

Side Effects of Insomnia During Pregnancy

Insomnia during pregnancy is very common, and most people don’t experience adverse (or, harmful) health effects beyond feeling fatigued or irritable. However, there are certain health conditions related to insomnia that are important to know. Persistent sleep issues during pregnancy may increase your risk of the following:

Treatment

Insomnia during pregnancy can be challenging and greatly affect your quality of life—such as making you feel groggy and uncomfortable and limiting your ability to complete daily tasks. Fortunately, there are several remedies you can try to reduce your symptoms and improve your sleep quality and overall mood.

Healthcare providers recommend a variety of treatment options, including implementing lifestyle changes, developing a sleep hygiene routine, considering therapy, and trying medications or other medical interventions.

Lifestyle Changes

To help induce sleep and support your ability to stay asleep at night, consider the following lifestyle modifications:

  • Decreasing caffeine consumption

  • Moving your body through light exercise or physical activity

  • Trying yoga

  • Limiting your water intake before bed

  • Using a pregnancy pillow during sleep

  • Consult your healthcare provider about applying heat therapy to help reduce muscle aches

  • Practicing meditation, deep breathing, and other stress management techniques

Sleep Hygiene

Sleep hygiene refers to daily practices and routines that you can incorporate into your life to facilitate a good night’s sleep. This may involve:

  • Going to sleep and waking up at the time each day

  • Dimming the lights in your bedroom before you sleep

  • Limiting screen time before bed

  • Avoiding daytime naps, especially long ones or naps close to bedtime

  • Getting out of bed if you wake up at night, rather than lying in bed tossing and turning

Therapy

Pregnant people who experience insomnia may benefit from a type of therapy called cognitive behavioral therapy (CBT). Research has found that CBT is more effective than medication for insomnia. It's important to note that this research studied non-pregnant people. But, there is widespread evidence that CBT is effective in improving several health conditions, such as sleep concerns, mood problems, and overall functioning.

The practice of CBT involves becoming more mindful of your thoughts and feelings and understanding how they may affect your ability to sleep and overall life. Your mental health provider can also teach you techniques and tips to modify your behaviors and routines to promote better sleep.

Medical Interventions

Sometimes, managing underlying health conditions that are causing your insomnia can also help improve sleep. Here are some examples of medical interventions that your healthcare provider may consider, depending on the condition you have:

Health Condition

Treatment Recommendations

Acid reflux or heartburn

Avoiding laying down after eating a meal and keeping your head elevated while you sleep

Sleep apnea

Using a continuous positive airways pressure (CPAP) machine

Restless leg syndrome

Taking nerve pain medication or trying massage therapy

Medications

Generally, healthcare providers recommend lifestyle changes, therapy, and sleep hygiene improvement before considering medication. This is because many of the medications that treat insomnia are either unsafe for pregnant people or have not been widely tested among pregnant people.

However, there is some research that points to the safety of using benzodiazepines, antihistamines, and psychiatric drugs to help manage insomnia during pregnancy. If you have tried lifestyle modifications and other remedies and are still not seeing improvement in your symptoms, talk to your healthcare provider about options for medications. They can help you determine if medicine is right for you.

When to Contact a Healthcare Provider

Most cases of insomnia during pregnancy shouldn’t be a cause for worry. Experiencing sleep issues during pregnancy—though uncomfortable—are common and not life-threatening. Still, if lifestyle modifications and improvements in sleep hygiene aren’t bettering your sleep quality, you should reach out to your healthcare provider for support.

Your healthcare provider may be able to suggest therapists, prescribe pregnancy-safe medications, or diagnose and treat any underlying health conditions that may affect your sleep, such as sleep apnea, restless leg syndrome, anxiety, or acid reflux.

A Quick Review

Pregnancy insomnia is a common condition that affects the majority of pregnant people. Not being able to fall asleep and stay asleep at night can affect your quality of life and lower your ability to function or complete daily tasks. Less commonly, pregnancy insomnia can increase your risk of experiencing pregnancy complications like preterm labor, gestational diabetes, preeclampsia, and depression.

While common, pregnancy insomnia isn’t something you should try to push yourself through. Reach out to your healthcare provider if your symptoms don’t improve with simple lifestyle modifications or if your symptoms worsen over time. Getting the support you need can improve your quality of life, as well as the health of your baby.

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Read the original article on Health.