When does pregnancy insomnia start

Almost all pregnant women have trouble sleeping at some point. And it's not surprising, considering that when you're pregnant, nausea, heartburn, and a constant need to pee often come with the territory. For many women, sleeping gets even harder as pregnancy progresses and new challenges (like restless leg syndrome, leg cramps, and an expanding belly) arise.

Read on to find out what kind of sleep patterns and problems you can expect during your first trimester. Don't forget to visit our sleep disturbances and coping strategies area for more pregnancy sleep tips.

You need to nap

Early in your pregnancy, you'll start feeling very sleepy during the day. High levels of progesterone bring on this sudden craving for naps. Progesterone is a hormone that helps regulate a woman's reproductive cycle. It also makes you drowsy.

The flood of this hormone can make a normal day at work seem as taxing as running a marathon. You may feel so worn out that you think you're coming down with the flu.

Strangely enough, progesterone can disrupt your sleep at night, leading to even more fatigue during the day. All you can do is rest as much as possible and grab a quick catnap whenever you can. By the way, researchers have found that those day naps aren't likely to interfere with your nighttime sleep quality, probably because they're helping make up for the overnight shortage.

You have trouble getting comfy

Your newly tender breasts may make it hard to find a comfortable sleeping position, especially if you're used to sleeping on your stomach.

The first trimester is the perfect time to start training yourself to sleep on your side. That position improves the flow of blood and nutrients to your fetus and uterus and helps your body get rid of waste and fluids. The left side is often recommended as best, but there's no hard evidence that it's better than the right; either is fine.

You may also feel generally uncomfortable in bed if you're dealing with other maladies that might be new to you now, such as headaches and tummy troubles as your digestive system slows down.

You have a constant need to pee

The amount of blood in your body increases dramatically when you get pregnant. As a result, extra fluid is processed by your kidneys and winds up in your bladder. At the same time, your growing uterus starts to put pressure on your bladder and sends you scrambling for the bathroom more often than you thought possible.

If you're tired of the bathroom shuffle, drink plenty of fluids during the day but cut down in the late afternoon and evening. Avoid coffee and tea later in the day. And be sure to stop by the bathroom right before you get into bed.

You're not alone

If you feel caught in a cycle of wakefulness at night and exhaustion during the day, you're not alone. The National Sleep Foundation reports that 78 percent of women say their sleep was more disturbed during pregnancy than at any other time of their lives. More than half of pregnant women take at least one nap during the workweek, and 60 percent take at least one weekend nap. The bottom line: Expect your first trimester to be tiring, and listen to your body when it tells you to slow down or rest.

Find out about other first-trimester sleep stealers, including nausea and vomiting, vivid dreams, and hunger.

Learn more:

You’re lying awake, unable to get to sleep, and you start to wonder: is insomnia a sign of pregnancy? Could all this tossing and turning be telling you something?

Insomnia, which is defined by the American Academy of Sleep Medicine (opens in new tab) as "persistent difficulty with sleep initiation, duration, consolidation or quality", is a common complaint in the population at large. According to the American Sleep Association (opens in new tab), it is the most common specific sleep disorder in the US,  with short-term issues reported by about 30% of adults and chronic insomnia by 10%.

Add pregnancy to the mix and insomnia can be even more of an issue. In one study of pregnant women (opens in new tab) published in the European Journal of Obstetrics, Gynecology and Reproductive Biology, which tracked nearly 500 women’s sleep patterns at different points during their pregnancy, insomnia rates rose from 6% before pregnancy to 64% in the course of the pregnancy. According to James Wilson, a sleep behavior expert known as The Sleep Geek (opens in new tab) and co-founder of wellbeing company beingwell (opens in new tab), "I have never come across a pregnancy that doesn’t include poor sleep at some point."

Here we look at the science behind insomnia during pregnancy and find out how you can sleep more soundly without causing harm to your unborn child. But above all, we'll answer the question, is insomnia a sign of pregnancy?  

How does pregnancy affect sleep?

There are multiple reasons for insomnia during pregnancy, says Leah Hazard, an NHS midwife, author of the memoir Hard Pushed: A Midwife’s Story (opens in new tab), and host of the podcast What The Midwife Said (opens in new tab). "Sleep can be challenging in pregnancy for any number of reasons: the increasing discomfort of a growing bump, pelvic girdle pain, heartburn, nausea, increased frequency of urination and leg cramps can all play a part."

As the pregnancy progresses, it can be hard to get comfortable, especially if the baby starts kicking in the night or is pressing on your bladder; you may also need to get up to go to the bathroom more often during the night. 

According to a study (opens in new tab) published in the journal, Sleep Science, many women experience sleep disorders during pregnancy, such as obstructive sleep apnea. This is particularly the case, says midwife Leah Hazard, for those who are already at risk (especially women who smoke or have a higher BMI). "Restless legs and leg cramps can also be an issue", she adds. Mental and emotional issues - anxiety about the pregnancy or parenthood or restless dreams - all are additional causes of poor sleep.

Can insomnia be an early sign of pregnancy?

According to research on insomnia in pregnancy published in the Journal of Sleep Research (opens in new tab), the rate of insomnia increases as a pregnancy progresses, so you’re more likely to suffer from it in the third trimester (opens in new tab) (weeks 28-41) than earlier in the pregnancy. One study in the Scientific World Journal (opens in new tab) suggested that the risk of insomnia was two times higher for those in the third trimester than those in the first and second trimesters. This is hardly surprising given the changes that are taking place in your body and the increased size of the baby that you’re carrying by months seven to nine. 

"I wouldn’t particularly say insomnia could be seen as an early indicator of pregnancy," says James Wilson, although he does note that so-called morning sickness - which can last 24 hours a day - can affect your sleep, particularly in early pregnancy.

So if you’re lying awake at night, it’s not necessarily a big red flag letting you know you’re likely to be pregnant (opens in new tab). If you do think you might be expecting a baby, a much more reliable way of finding out is to take a pregnancy test, available from pharmacies everywhere.

How to cope with pregnancy insomnia

When you’re considering the sleep aids to help you get a good night’s sleep during your pregnancy, It’s important to make sure you’re not putting your own health or that of your unborn child at risk, so check any medication you’re considering taking with your physician first. 

"I would absolutely not recommend melatonin or any other herbal/alternative sleep remedy that has not been rigorously tested and proven to be safe in pregnancy," advises Leah Hazard.

If physical discomfort caused by the size of your bump is stopping you from sleeping, James Wilson has some practical suggestions. "Sleeping on your left side and buying a body or maternity pillow can be priceless, or tuck a pillow between your legs to keep the pelvis in a neutral position."

Reflux and heartburn are common symptoms during pregnancy (opens in new tab), so if this is the case for you try leaving a longer gap between eating and going to bed. One study, published in the Journal of Clinical Gastroenterology (opens in new tab), showed that the shorter the time between eating, the greater the problem with reflux. Some pregnant women find it helpful to prop themselves up with pillows to achieve a more upright position. 

As for leg cramps, there’s no hard and fast cure, says midwife Leah Hazard. "Try not to panic if they wake you up – flex and relax your feet, and the cramp should ease within minutes."

It’s also important to follow general principles of good sleep hygiene, says Leah. "Stop using screens and electronics at least an hour before bedtime for a ‘digital sundown’, ensure that your room’s ambient temperature is pleasantly cool with enough bedcovers to keep your body warm and your head fresh, and keep any bedtime snacks plain but satisfying (i.e toast, banana, chapati, cereal). Avoid overly hot baths at bedtime as they can exacerbate dry/itchy skin in pregnancy."

It can be helpful to talk to someone else about sleep issues, advises James Wilson. "I find many pregnant couples benefit from compassionate conversation around sleep, particularly if sleeping apart might help the person experiencing the pregnancy have more space to sleep in."

Above all, says James, try not to let your insomnia add to your stress. "Like anything that causes us to sleep poorly, it is best to try not to force sleep, make sure you wind down before bed, and try a warm bath to help relax and drop your heart rate."