Almost every parent is familiar with the sleep deprivation that comes with having a newborn, but many moms-to-be are surprised by the lack of sleep that can occur before you even deliver. Many pregnant women report having issues getting rest (up to 78 percent in one study!), and we know that women who were severely short on sleep regularly (less than 6 hours a night) are actually at increased risk of having a longer labor or needing a C-section. Here are a few reasons why you might be struggling at night.

1. Wacky hormones. If it seems that hormones are almost always to blame for everything in pregnancy, it’s because it’s true. Sky-high progesterone levels (in early pregnancy especially) can leave you exhausted during the day. You might nap and then find it harder to sleep at night as a result. High levels of progesterone can also lead to relaxed muscles. This might sound good, but when that causes you to snore more or have worse gastroesophageal reflux, it can be a recipe for long nights lying awake or less restful sleep.

2. Frequent bathroom breaks. In the first trimester, progesterone is again to blame, and later on it’s because a big baby and uterus are pushing on your bladder. Getting up at night to pee even just once can wake you enough to keep you up for hours, or at least make it hard to get into a good deep sleep.

3. Weird dreams. Hormones again are often to blame for this. Pregnant women often report very vivid dreams that will often wake them up. 

4. Pain, pain, pain. Back pain, pelvic pain, leg cramps, restless legs, and more—these can all hurt your ability to fall (and stay) asleep.

5. Worrisome thoughts. Is the nursery ready? When should I return to work? Will I know how to care for a baby? Does it hurt to give birth? These thoughts and more always seem to pop up once your head hits the pillow and your mind has a chance to wander. Who can fall asleep when you’re this stressed out?!

6. Real medical problems. If you find you get so short of breath when you lie down to sleep that it makes it difficult to breathe or that you are frequently gasping for air, this could signal a problem with your heart or your lungs. Best to check in with your medical provider as soon as possible to rule this out.

While you might experience one or all of these phenomena, the good news is that there are some things you can do to improve your sleep.

  • Make sleep a priority, and get in bed at a reasonable hour at about the same time every night.
  • Nap if you need to during the day, but move naps earlier or shorten them if it’s keeping you from being tired at night.
  • Cut out the distractions: no TV or technology in the hours before bed or in your bedroom.
  • Cut back on the fluids after dinnertime and do your main hydrating earlier in the day.
  • Get as comfy as you can—sleep on your side, buy a good body pillow, or use a heating pad as needed.
  • Jot down your bothersome thoughts or worries and make a plan to tackle them. Dedicate time each day other than bedtime to think about things that concern you.
  • Consider relaxing habits before bed such as yoga, reading, meditation, or massage.
  • Talk with your doctor or midwife if any red flags exist or if you just can’t get sleep no matter what.

Reviewed by Dr. Jen Lincoln, April 2020


  • The vast majority of pregnant women report issues with sleeping at some point in their pregnancy.
  • Many reasons can lead to decreased sleep or poor sleep.
  • Limit technology and fluids before bedtime, and try relaxing habits like yoga and reading.


  1. National Sleep Foundation. Pregnancy and sleep.


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