If you're one of the 25 to 30 million Americans who suffer from insomnia each year, it's safe to say you're not alone. However, this widespread sleep disorder is particularly common among pregnant women. According to the American Pregnancy Association, up to 78% of pregnant women struggle with insomnia over the course of their pregnancy. Difficulty sleeping can be caused by a wide range of factors, such as back pain, heartburn, anxiety, hormonal changes and frequent urination. 

Getting enough sleep is crucial when you're expecting a baby. Although insomnia in pregnancy is common, it's important not to just dismiss this condition as a passing phase. Understanding the causes behind your sleep difficulties will allow you to address them properly. Once you have a clear answer to the question, "Why can't I fall asleep?" you can take steps to improve your sleep hygiene and keep your growing baby healthy. 

The Hormonal Rollercoaster 

Pregnancy hormones have a major impact on various areas of your well-being, from your moods to your sex drive. Hormonal changes during pregnancy can also affect the quality of your sleep. During the third trimester, higher levels of estrogen increase the size of your blood vessels, which can cause your legs and feet to swell. Increased estrogen levels can also lead to nasal congestion, which may disrupt your breathing patterns during sleep. 

Progesterone is another key pregnancy hormone that plays an important role in supporting your growing baby. However, it may also trigger a swath of unpleasant symptoms, such as heartburn and frequent urination. In high levels, progesterone can even reduce the amount of time you spend in REM sleep, which is the stage of sleep most crucial to promoting healthy cognitive function. 

Physical Discomforts 

In addition to hormonal changes, there are many physical changes taking place in your body that can disrupt your sleep and can cause pregnancy insomnia. These disruptions can depend on how far along in the pregnancy you are. For example, if you’re pregnant and can’t sleep during the second trimester, it could be due to leg cramps or lower back pain. One of the most common sources of physical discomfort for pregnant women is their growing bellies – especially in the third trimester. As your stomach expands to accommodate your developing baby, you might find it difficult to settle on a comfortable sleeping position. Many expecting mothers also experience back pain and hip pain as a result of increased strain on their joints. 

Fortunately, there are several ways to alleviate physical discomfort and enjoy better sleep. If you can, try to incorporate some light exercise into your routine. Staying active can help strengthen your back, pelvic and abdominal muscles to keep pain at bay. It's also important to be mindful of your posture and avoid sleeping on your back to stay comfortable at night. 

Frequent Bathroom Trips 

Thanks to increased levels of progesterone, you might find yourself heading to the bathroom more frequently while pregnant. This is because progesterone relaxes the muscles in your urinary tract, triggering the urge to urinate more often. If you regularly wake up in the middle of the night to use the bathroom, you might have trouble falling back asleep, which can cause you to feel groggy in the morning. 

To avoid frequent bathroom trips at night, try not to drink water too close to bedtime. We recommend not drinking any fluids at least two hours before bed. Additionally, be sure to avoid consuming any caffeinated beverages, which can give you the urge to pee more often. 

Anxiety and Pregnancy Stress 

Because your body is undergoing so many changes during pregnancy, it's common to experience some anxiety and stress. You may have worries about how your pregnancy will turn out or about motherhood. While it's normal to have concerns, excessive stress can take a toll on your sleep. 

If anxiety and stress are preventing you from getting a good night's sleep, there are some strategies you can use to help alleviate your worries. First, be sure to reach out to a trusted friend or family member if you need someone to talk to. It's also a good idea to practice deep breathing or yoga to encourage relaxation. In addition, be sure to fit some exercise into your routine to keep your blood flowing and promote a better mood. 

Sleep Environment Optimization 

Setting up a comfortable sleep environment is crucial to maintaining good sleep hygiene. When your bedroom is as cozy and inviting as possible, you'll find yourself looking forward to getting some shut-eye! Start by choosing the right mattress and pillows designed specifically for pregnant women. This will help ensure that you have the proper support you need for your back, keeping discomfort at bay. 

It's also important to establish a soothing bedtime routine. Try to stay off of electronic devices at least two hours before bedtime and engage in a relaxing activity, like reading or meditating. This will signal to your brain and body that it's time to sleep, which will allow you to fully relax. 

Nutrition and Sleep 

Your diet plays a direct role in the quality of your sleep. To optimize your sleep, it's important to be mindful of the food you eat every day. Healthy foods that help promote better sleep include bananas, milk, yogurt, almonds and berries. It's also important to ensure that you're drinking plenty of water throughout the day. Water helps lubricate your joints and prevents congestion, keeping pain at bay and promoting better breathing while you sleep. 

In addition, be sure not to eat too close to bedtime. Eating a large meal before you head off to bed might trigger indigestion or gastroesophageal reflux disease (GERD), which can make it difficult to fall asleep. 

Exercise During Pregnancy 

Establishing an exercise routine can have amazing benefits for your overall health and well-being. By regularly engaging in moderate exercise, you can enjoy a longer, more restful sleep. Exercising is even shown to reduce sleep onset, which is the total amount of time it takes you to fall asleep. 

To create an exercise routine that's safe and suitable for your needs, be sure to consult a trainer or healthcare professional. That said, there are several types of exercises you can try that are safe for most pregnant women. Examples include pilates, yoga, cycling, swimming, walking and light jogging. The key is to get your blood flowing without putting too much strain on your joints, which can lead to pain. 

When designing a fitness regimen, it's important to remember to keep it balanced. Try not to overwork the same muscle group, as this can lead to fatigue or injury. Instead, be sure to sample a variety of workouts, such as cardio and aerobic exercises. This will help ensure that you're getting the most out of your exercise routine. 

Seeking Professional Help 

Although insomnia in pregnancy is a very common struggle, it's important to seek help if your sleep difficulties are significantly disrupting your everyday life. Be sure to consult a healthcare professional to manage your sleep in a safe, healthy way. Communicating openly with your physician will help ensure that you have access to custom-tailored treatments for your needs. 

After discussing your concerns with your doctor, he or she will be able to prescribe you the appropriate treatment for your needs. You may be recommended a sleep aid if your sleep troubles are significant. Your doctor might also prescribe you an antidepressant if you have an underlying mental condition contributing to your sleep difficulties. 

Enjoying a Restful Sleep During Pregnancy 

There are a variety of reasons why many pregnant women struggle to get a good night's rest. From shifting hormone levels to pregnancy stress, there are a wide range of factors at play. Understanding your unique situation is crucial to finding the relief you need from pregnancy-related insomnia. Once you have a better understanding of your sleep troubles, you'll be better prepared to enhance the quality of your sleep and keep you and your baby healthy. 

Additional Resources 

https://www.sleepfoundation.org/pregnancy/pregnancy-insomnia 

https://www.nytimes.com/article/pregnant-sleep-issues-guide.html 

https://medlineplus.gov/ency/patientinstructions/000559.htm 

https://www.healthline.com/health/pregnancy/early-insomnia 

https://www.sleepfoundation.org/pregnancy/pregnancy-sleep-aid 

FAQs 

Q: Why is it difficult to sleep during pregnancy? 

A: Difficulty sleeping is a common complaint during pregnancy. There are several factors that contribute to this issue, including hormonal changes, increased urination, physical discomfort, heartburn, restless leg syndrome (RLS), anxiety and stress, fetal movements and temperature regulation. 

Q: When can pregnancy insomnia occur? 

A: Insomnia can happen early in the pregnancy during the first trimester, but it is more common to face second and third trimester insomnia due to the progression of pregnancy symptoms.  

Q: How can hormonal changes affect sleep patterns during pregnancy? 

A: Pregnant women experience various hormonal changes that can negatively impact their sleep. The key hormones involved include progesterone, estrogen and human chorionic gonadotropin (hCG). Higher progesterone levels can lead to feelings of drowsiness, while heightened estrogen levels can negatively affect sleep regulation. Meanwhile, hCG triggers a slew of changes in the body, which can indirectly impact sleep quality. 

Q: What are common physical discomforts that impact sleep for pregnant women? 

A: Pregnant women are prone to various types of discomfort, namely their expanding bellies. As their bellies grow to accommodate their developing baby, they might struggle to sleep comfortably at night. Many expecting mothers also suffer from back pain and hip pain due to increased strain on their joints. 

Q: Is it normal to experience frequent bathroom trips at night during pregnancy? 

A: Yes, this is a completely normal aspect of pregnancy. High levels of progesterone relax the muscles in your urinary tract, which can give you the urge to urinate more frequently throughout the day. This is particularly common at night, which may interfere with your sleep. 

Q: How does anxiety and stress impact sleep during pregnancy? 

A: Because your body experiences so many changes during pregnancy, it's perfectly normal to feel some anxiety and stress. Many women worry about how their pregnancy will turn out or about their future as a new mother. Excessive stress can cause rumination, which may make it difficult to fall asleep at night and pregnancy insomnia. 

Q: What can I do to create a comfortable sleep environment during pregnancy? 

A: To create a comfortable sleep environment, be sure to choose a mattress and pillows designed to support your growing belly and prevent back pain. Moreover, avoid all electronic devices at least two hours before bedtime and engage in a relaxing activity, like reading or meditating. 

Q: Are there specific foods that can help improve sleep for pregnant women? 

A: Foods that help promote good sleep hygiene include bananas, milk, yogurt, almonds and berries. Be sure to drink plenty of water throughout the day as well. 

Q: Is it safe to exercise during pregnancy, and how does it affect sleep? 

For most pregnant women, it's perfectly safe to engage in light exercise. Regular exercise can help you fall asleep faster and enjoy a more restful sleep. However, be sure to consult your physician to determine which forms of exercise are best for your needs. 

Q: When should I consult a healthcare provider about sleep issues during pregnancy? 

A: If your pregnancy insomnia is interfering significantly with your everyday life, be sure to reach out to a trusted healthcare provider. Your physician may prescribe a sleep aid or antidepressant depending on your needs. Be open about your concerns to ensure you receive the optimal treatment for you. 

Q: Are there any real-life stories of women overcoming pregnancy-related sleep challenges? 

A: Many real-life women have shared useful strategies for overcoming pregnancy-related sleep challenges and insomnia. Some of these include adjusting their sleep positions, creating a relaxing bedtime routine, limiting fluid intake before bed, taking naps when necessary and using specialized pregnancy pillows.