# Pregnancy Insomnia

Source: https://www.pregnancypowerhour.com/conditions/insomnia-pregnancy
Last updated: 2026-07-15

> Pregnancy insomnia, or trouble sleeping, is a common experience that can be managed with practical strategies and support.

## What it is

Pregnancy insomnia refers to the challenges many expectant parents face in getting restful sleep throughout their pregnancy. It's a very common experience, particularly as pregnancy progresses into the later trimesters. This isn't just about feeling tired; it's about the physical and emotional shifts that can make falling asleep, staying asleep, or achieving deep, restorative sleep difficult.

## What it tends to feel like

For many, trouble sleeping in pregnancy can manifest as frequent waking, difficulty falling asleep, or simply feeling uncomfortable in bed. You might find yourself needing to urinate frequently during the night, or feel your baby's movements more acutely when you're trying to rest. Heartburn can also be a significant disruptor, as can general physical discomfort that makes finding a comfortable position challenging. Beyond the physical, feelings of [Pregnancy Anxiety](/conditions/pregnancy-anxiety) or worry can keep your mind racing, making it hard to settle down. Some also experience restless legs, an uncomfortable urge to move their legs, which can be particularly bothersome at night. It's a cycle where lack of sleep can heighten anxiety, and anxiety can further disrupt sleep, leaving you feeling overwhelmed and exhausted.

## What the evidence says helps

Navigating sleep challenges in pregnancy often involves exploring several supportive strategies. When it comes to sleeping position, after about 20 weeks, evidence suggests favoring sleeping on your left side. While brief turns to your back are not considered dangerous, prolonged back sleeping in the third trimester has been associated with an increased risk for stillbirth. Your care team can offer personalized guidance on this.

For persistent insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered a first-line, evidence-based treatment, and there are pregnancy-adapted programs available online that can be incredibly helpful. Simple sleep hygiene practices can also make a difference: aim for a cool, dark room, try to maintain a consistent sleep schedule, and avoid screens for 30–60 minutes before bed. Many find substantial relief from physical discomfort by using body pillows, wedge pillows, or pregnancy-specific pillows to support their changing body. If underlying mood conditions like [Perinatal Depression](/conditions/perinatal-depression) are contributing to your sleep struggles, addressing these can often lead to significant improvements in sleep quality.

Regarding medication, some over-the-counter options may be discussed with your provider. Doxylamine (found in Unisom SleepTabs) is often used for pregnancy nausea and can also aid sleep, while diphenhydramine (found in Benadryl) may be used occasionally. However, habitual use of diphenhydramine is generally discouraged. Always have a conversation with your care provider before introducing any new medication.

## Working with your care team

Open communication with your obstetrician or midwife is key when you're experiencing sleep difficulties. They are your best resource for understanding your specific situation and can help you weigh the options available. As a doula, I often see how much relief comes from simply having a clear plan and understanding the 'why' behind what you're experiencing. We can explore comfort measures, discuss ways to create a more supportive sleep environment, and help you prepare questions for your next appointment. If physical discomfort, like [Pregnancy Back Pain](/conditions/back-pain-pregnancy), is a primary driver of your insomnia, your provider can also help you explore solutions or referrals to address those specific concerns. Remember, you get to decide what feels right for you, and your care team is there to support those informed decisions.