According to an observational study conducted on nearly 3 million women over a five-year period, a lot of women suffer from insomnia during pregnancy—at least 50%. “Known as one of the most common complication of pregnancy, on the precipice of motherhood, it is natural to feel worried,” explains Dr. Jessica Zucker, PhD, a Los Angeles-based psychologist specializing in reproductive and maternal mental health and author of the forthcoming book I Had a Miscarriage: A Memoir, a Movement. While a sleepless night is bearable from time to time, persistent insomnia can be excruciating—especially when your body is working so hard to grow a human. Here’s everything you need to know about pregnancy insomnia, and what to do about it.

What causes insomnia during pregnancy?

As you stare at the clock at 3 a.m., you’re probably wondering, Why is this happening to me? While there are plenty of potential reasons, doctors believe that hormones and discomfort are largely to blame. “The pregnancy hormonal changes, as well as pressure from the growing uterus, can contribute to increased urge and frequency of needing to urinate,” explains Dr. Lucky Sekhon, MD, fertility specialist and board-certified OB/GYN. “This can lead to multiple wakings throughout the night and it can be difficult to fall back asleep. The growing uterus can cause cramping which can be painful and wake women up from their sleep.” And as your pregnancy progresses, fetal movement can keep you up at night. “Other sources of discomfort in pregnancy—heartburn, breast tenderness, abdominal discomfort, leg cramps, shortness of breath when lying down—can prevent women from being able to fall asleep easily and also contribute to waking up in the middle of the night,” notes Dr. Sekhon. Dr. Zucker adds that anxiety is another source of sleeplessness during pregnancy. “From a psychological perspective, sleep disturbance may be a symptom of depression or anxiety,” she says.

What can I take for insomnia during pregnancy?

Unfortunately, pregnancy takes many medications off the table, so Dr. Sekhon suggests starting by figuring out what’s actually causing insomnia in the first place. For example:

Heartburn

“If heartburn is keeping you up at night, avoid spicy foods and other triggers, eat a smaller dinner and make sure you have time to digest your food before lying down to sleep, drink a glass of milk to neutralize stomach acid, and if needed use over the counter solutions such as TUMS or, if advised by your doctor, more aggressive medical therapies to combat gastric acid reflux,” Dr. Sekhon says. “Eat a healthy dinner before bedtime, and eat slowly to try and reduce the risk of indigestion and heartburn. Having a high protein diet will help you stay full longer, and also avoid nighttime hunger or cravings which could also keep you up.”

Back pain or pressure

“Sleeping with a pregnancy pillow can help to alleviate strain and pressure on the lower back,” she says. “It is safe to take Tylenol during pregnancy to treat aches and pains.”

Peeing all the time

“There may not be much you can do about this, but symptoms can be minimized by avoiding caffeine and not drinking large volumes of fluid close to bedtime,” Dr. Sekhon notes. 

Stress

“Anxiety and stress may contribute to insomnia,” she says. “Meditation, exercise, and talking about your feelings with your support system and a licensed mental health professional may all help to address anxiety or stress that could be keeping you up at night.” Also, don’t forget to practice good sleep hygiene: Try to go to bed and wake up at the same time every day, avoid screens before bedtime, and keep your room cool and dark. “If these measures are not helpful and you have persistent insomnia in pregnancy which is impacting your ability to function or is making you feel unwell, your doctor may recommend sleep-inducing supplements or medications which are deemed safe in pregnancy (ie. Benadryl),” Dr. Skekhon says. “But you should always consult your OB before taking anything to help you sleep while pregnant.”

How long does insomnia in pregnancy last?

While the duration and severity of pregnancy insomnia vary from person to person, “most women will experience more sleep issues during the first trimester (due to adjusting to hormonal changes and pelvic cramping) and the third trimester (where aches and pains and urinary symptoms are much more prevalent),” says Dr. Sekhon. While there’s no question that insomnia is a common, not-so-fun side effect of pregnancy, there is quite a bit you can do about it—so get started today and start catching those Zzs. Next up, check out these 100+ insomnia quotes.

Sources

Dr. Jessica Zucker, PhD, a Los Angeles-based psychologist specializing in reproductive and maternal mental health and author of the forthcoming book I Had a Miscarriage: A Memoir, a MovementDr. Lucky Sekhon, MD, fertility specialist and board-certified OB/GYNObstetrics & Gynecology: “Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth” Pregnancy Insomnia  What Causes Trouble Sleeping While Pregnant  - 55