Insomnia in pregnant women: how common is it and what helps?

What is insomnia, and what can cause it in pregnancy?

Insomnia is poor sleep that keeps coming back and leaves you worn out the next day. One broken night is not insomnia. A run of them that follows you into the daytime is, and that is the point where it is worth doing something about it.

The reasons for insomnia in women are mostly everyday ones. The NHS lists stress, anxiety, depression, noise, a room that is too hot or too cold, caffeine, alcohol, shift work and some medicines. That list is written for all adults, not for pregnancy, but several items on it are worth a look when you are expecting: a busy mind in the small hours, a bedroom that now feels too warm, a job with changing shifts, or a medicine you have recently started. We suggest going through the list gently and noting which ones sound like your nights.

How common is insomnia in pregnant women, and what helps?

If you are lying awake in late pregnancy, you have a lot of company. A 2021 meta-analysis by Salari and colleagues in BMC Pregnancy and Childbirth put the pooled third-trimester figure inside a 95% confidence interval of 32.9–52.5%. Common does not mean you just have to put up with it, though.

A good place to start is the everyday causes, because they are the ones you can change tonight. Many women find it helps to keep caffeine to the morning, to make the bedroom cooler and quieter, and to leave a few quiet minutes to wind down before bed. If stress or anxiety is doing most of the waking, it is worth saying so at your next prenatal (antenatal in the UK) appointment. How you are feeling is as much a part of your care as any other check.

Talking therapy is the other route. In the UK, the NHS says CBT (cognitive behavioral therapy) may be offered for insomnia; in the US the sleep-focused version is usually called CBT-I. Your prenatal team can tell you whether it is available to you and how a referral works. Medicines are a conversation for them too: before taking sleep aids (sleeping tablets in the UK) or a supplement such as magnesium glycinate, it is worth checking that it suits you in pregnancy.

For the years after this one, the picture changes: night sweats and early waking disrupt sleep for many women in menopause, CBT-I is the first-line treatment (NICE NG23, updated 2024), and our page on hot flashes is written for that stage.

How much sleep do you need, and how often is too often to struggle?

Adults ages 18–60 need 7 or more hours of sleep a night, according to the CDC. That figure is for adults in general, not for pregnancy in particular, and it is a guide to what your body needs, not a score to chase. It also does not say how many bad nights count as insomnia.

What matters more is the pattern. A few disturbed nights are normal and no reason to worry. When to see a doctor or midwife: if poor sleep keeps showing up and your days are suffering, if your nights are steadily getting worse, or if low mood or anxiety has arrived alongside the sleeplessness. The NHS names anxiety and depression among the causes of insomnia, and both are things your prenatal team would want to hear about soon, not at the end of a long list.

What did the studies show, and what did they not show?

The pregnancy figure comes from 10 studies with 8,798 participants, pooled into one estimate. The confidence interval is the range the true figure is likely to sit in, so it is best read as a range, not one exact number: wide enough to say insomnia is common in late pregnancy, not precise enough to promise the same rate in every group of women.

The analysis covers the third trimester only, so it gives no rate for the first or second. It is also a count of how many women had insomnia, not a test of what helps. In the same way, the NHS list of causes and the CDC sleep hours describe adults in general. They are a fair starting point in pregnancy, and your own midwife or doctor can fill in what applies to you.

Snoring and sleep apnea in pregnancy and in menopause: is it insomnia or something else?

Snoring and sleep apnea are a different question from insomnia, and it is worth keeping them apart. Insomnia is about getting to sleep and staying asleep. If you or someone who shares your room has noticed loud snoring or pauses in your breathing, that is something to mention by name at your next appointment, so it can be looked at directly instead of being filed under a bad night's sleep.

This holds at every stage. If you are pregnant, your OB-GYN or midwife is the person to tell. If you are reading because of sleep apnea in menopause, the same step applies with your doctor, and it is worth asking for the snoring to be looked at separately from night sweats or early waking, which have their own treatments.

What helps most at the appointment is a week of simple sleep notes: when you went to bed, roughly when you fell asleep, when you woke and how you felt the next day. Add anything a partner has noticed, such as snoring, and anything you noticed yourself, such as waking suddenly or feeling unrefreshed after what looked like a full night. You do not need to arrive with the answer. Your part is to describe what is happening, and theirs is to work out what is behind it.

Many women hold back from raising snoring because it feels minor or a little embarrassing. It is neither. It is a useful detail, it takes one sentence to say, and it can change which kind of help you are offered.

Next steps

Start with what feels most doable. Pick one everyday cause that sounds like your nights, whether that is caffeine, a warm or noisy room or a mind that will not settle, and try changing it for a week while you keep your sleep notes. Take those notes to your OB-GYN or midwife (in the UK, your midwife or GP), ask whether CBT is an option for you, and check any sleep aid or supplement with them before you take it. If your sleep is steadily getting worse, or low mood or anxiety is growing alongside it, bring the conversation forward. Some women find a cooler room is enough and others want more support, so take what fits you and your pregnancy; this is not one size fits all.