“Pregnant women have difficulty sleeping” is far from an attention-grabbing headline. Of course, expectant mothers in their third trimester are likely to have trouble getting comfortable at bedtime due to their growing bellies, various aches and pains, or heartburn from late-night snacking. Once they fall asleep, they may not stay that way for long due to inevitable overnight bathroom trips and/or leg cramps. Yawn. What else is new?
Mothers who sleep poorly during pregnancy are at risk for PMADs
Before you hit snooze on caring about pregnancy insomnia, consider that 4 in 10 women may experience significant, even debilitating symptoms, like difficulty caring for other children or working a job due to daytime sleepiness, and mood struggles [1]. What’s more, chronic sleep deprivation during pregnancy sets mothers up poorly for the initial weeks and months of expected sleep deprivation during postpartum, making them particularly vulnerable to perinatal mood and anxiety disorders (PMADs) like postpartum anxiety, depression, OCD, PTSD, and psychosis [2]. This is especially the case for women with mental health struggles prior to conceiving [3].
And, as one would expect, the relationship between depression during pregnancy and sleep struggles goes both ways [4]. Insomnia and fatigue are симптомы of depression [5]. Struggling with mental health during pregnancy leads to trouble sleeping, and poor-quality sleep hurts mental health.
The relationship between depression during pregnancy and sleep struggles goes both ways. Insomnia and fatigue are symptoms of depression. Struggling with mental health during pregnancy leads to trouble sleeping, and poor-quality sleep hurts mental health.
Pregnancy insomnia puts babies at risk, too
Pregnancy insomnia doesn’t just impact expectant mothers. It may also raise the risk of preterm birth, according to исследование from 2017 [6]. Research (sources found здесь) also potentially links pregnancy insomnia to “effects on fetal brain development (potentially via fetal programming of disease), toddler cognition, risk for ADHD, and poorer social-emotional development from infancy through early childhood (potentially via impacts on parenting behaviors)” [2].
For many women, pregnancy insomnia starts long before the third trimester… and it carries on into postpartum
Pregnancy insomnia often starts early on, in the second or even first trimester. Worse, pregnancy insomnia may not just go away on its own. A Исследование 2015 года found that among mothers who experience pregnancy insomnia at eight months pregnant, 4 in 10 still had trouble sleeping two years after giving birth. That’s worth sitting up and taking notice [7].
How do we treat pregnancy insomnia?
The bad news first? Even well-trusted mainstream medical sources (and the top Google search results for ‘pregnancy insomnia’) fail to mention the evidence-based treatment options. While they may be falling asleep at the metaphorical wheel, the good news is that pregnancy insomnia is treatable, and expectant mothers have multiple effective options.
Cognitive behavioral therapy
Согласно 2026 research review, cognitive behavioral therapy for insomnia (CBT-I) can be helpful for pregnant women just as for the general population with insomnia [2]. CBT-I has five specific components: “sleep hygiene education, stimulus control to associate the bed with sleep, time in bed restriction to consolidate sleep, relaxation, and cognitive therapy to counter unhelpful beliefs about sleep.”
“Sleep hygiene education” encompasses things like avoiding screens and other blue light sources in the hour or so before bed (in исследование, avoiding blue light and using only ‘warm’ light in the evening is called ‘dim light therapy’), and winding down with specific rituals (though the ritual need not be elaborate) [8]. ‘Associating the bed with sleep’ means limiting activities and time spent in bed to resting or sex. No sitting and working on a laptop in or on the bed, no doomscrolling on social media before getting up in the morning.
CBT-I may be delivered face-to-face or virtually, even through digital apps like Sleepio [2].
Mindfulness-based techniques
Research also supports the effectiveness of mindfulness-based techniques for treating “nocturnal cognitive arousal,” which many moms will refer to with more informal terms like “I can’t get my brain to shut off at night.” Specifically, mindfulness-based stress reduction (MBSR) “teaches nonjudgmental awareness of sensations, thoughts, and emotions and is shown to increase acceptance, reduce rumination, and improve sleep…” [2].
Rather than getting drawn into worry tornadoes or rumination spirals, MBSR aims to allow individuals to notice their thoughts without getting “sucked in” and reacting accordingly.
Of note, while MBSR has research backing for feasibility and effectiveness, further research is needed to evaluate how long the benefits last after treatment ends.
Light therapy
While it may sound like a fringe alternative treatment option for the pharmaceutical-averse, light therapy, aka light exposure therapy, may have the most direct effect on insomnia compared to CBT–I or mindfulness-based approaches [9]. This is because exposure to light directly impacts the internal clock governing circadian rhythm, the body’s sleep and wake cycle.
A небольшое исследование 2025 года found that, when combined with traditional cognitive behavioral therapy or antidepressant use, pregnant women with depression experienced more and longer-lasting improvement when they also had light therapy [5]. Participants in the intervention group held a bright light (10,000 lux) 15-20 inches away from the face, starting 30 minutes or less after waking up and lasting 30 minutes per day, every day for five weeks. Best of all, the benefits from light therapy persisted even six months after treatment stopped.
A 2022 исследование compared “light dark therapy,” which utilizes bright light exposure плюс specific measures to curb evening blue-light exposure, to CBT-I and to treatment-as-usual (traditional counseling or antidepressant use) [10]. Researchers found that both light dark therapy and CBT-I helped 4-12 months postpartum (not pregnant) women more than treatment-as-usual.
Итоги
Pregnancy insomnia is both common and treatable, and treat it healthcare professionals must, for the good of both mothers and babies. Cognitive behavioral therapy for insomnia (CBT-I), mindfulness-based stress reduction, and light therapy are all promising treatment options.
Ссылки
[1] Atzmon, O., Crowther, M. E., Quin, N., Cassera, L., Wellecke, C., Pinnington, D. M., & Bei, B. (2025). Cognitive Behavioral Therapy for Perinatal Insomnia: Exploring Adherence, Perceived Usefulness of Intervention Components, and their Associations with Sleep Outcomes. Behavioral Sleep Medicine, 23(5), 606–621. https://doi.org/10.1080/15402002.2025.2501704
[2] Felder, J.N., McClelland, B., Sorensen, C. и др. Behavioral Sleep Therapies During the Perinatal Period: A Scoping Review. Curr Sleep Medicine Rep 12, 5 (2026). https://doi.org/10.1007/s40675-026-00359-x
[3] Suri R, Stowe ZN, Cohen LS, Newport DJ, Burt VK, Aquino-Elias AR, Knight BT, Mintz J, Altshuler LL. Prospective Longitudinal Study of Predictors of Postpartum-Onset Depression in Women With a History of Major Depressive Disorder. J Clin Psychiatry. 2017 Sep/Oct;78(8):1110-1116. doi: 10.4088/JCP.15m10427. PMID: 28297589.
[4] Ladyman C, Sweeney B, Sharkey K, Bei B, Wright T, Mooney H, Huthwaite M, Cunningham C, Firestone R, Signal TL. A scoping review of non-pharmacological perinatal interventions impacting maternal sleep and maternal mental health. BMC Pregnancy Childbirth. 2022 Aug 23;22(1):659. doi: 10.1186/s12884-022-04844-3. PMID: 35999501; PMCID: PMC9395885.
[5] Bianciardi E, Sferra I, Castellani G, Pinci C, Marinucci E, Adulti I, Quinto RM, Niolu C. Light therapy as an add-on to standard care for perinatal depression: a 7-month follow-up randomized controlled study. Riv Psichiatr 2025;60(5):188-195. doi 10.1708/4583.45900
[6] Felder, Jennifer N. PhD; Baer, Rebecca J. MPH; Rand, Larry MD; Jelliffe-Pawlowski, Laura L. PhD; Prather, Aric A. PhD. Sleep Disorder Diagnosis During Pregnancy and Risk of Preterm Birth. Obstetrics & Gynecology 130(3):p 573-581, September 2017. | DOI: 10.1097/AOG.0000000000002132
Ссылки Продолжение
[7] Sivertsen, B., Hysing, M., Dørheim, S.K. и др. Trajectories of maternal sleep problems before and after childbirth: a longitudinal population-based study. BMC Беременность Роды 15, 129 (2015). https://doi.org/10.1186/s12884-015-0577-1
[8] Yoon J, Heo SJ, Lee H, Sul EG, Han T, Kwon YJ. Assessing the Feasibility and Efficacy of Pre-Sleep Dim Light Therapy for Adults with Insomnia: A Pilot Study. Medicina (Kaunas). 2024 Apr 14;60(4):632. doi: 10.3390/medicina60040632. PMID: 38674278; PMCID: PMC11052339.
[9] LeGates TA, Fernandez DC, Hattar S. Light as a central modulator of circadian rhythms, sleep and affect. Nat Rev Neurosci. 2014 Jul;15(7):443-54. doi: 10.1038/nrn3743. Epub 2014 Jun 11. PMID: 24917305; PMCID: PMC4254760.
[10] Verma S, Quin N, Astbury L, et al. Treating postpartum insomnia: a three arm randomised controlled trial of cognitive behavioural therapy and light dark therapy. Psychological Medicine. 2023;53(12):5459-5469. doi:10.1017/S0033291722002616
