Pregnancy Insomnia: Can’t Sleep at Night? Here’s What Helps

It is 2am. Your bump is propped on one pillow, another is jammed between your knees, and you have already been to the loo twice. The baby picked this exact moment to start kicking. Your body is heavy and tired, but your brain is wide awake, counting the hours until the alarm. If pregnancy insomnia means you can’t sleep at night, you are not doing anything wrong. It is one of the most common parts of pregnancy, and there is a lot you can do about it.

Here is the short answer. Go to sleep on your side with a pillow under your bump and one between your knees. Keep caffeine to the morning, stop eating about 3 hours before bed, and sip rather than gulp in the evening. If you wake and cannot drift off again, breathe slowly and gently for 5 minutes, and get up for something quiet and dim if 20 minutes pass. And if your baby is moving less than usual or the pattern changes, call your midwife or maternity unit straight away, even in the middle of the night.

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Why you can’t sleep at night when you’re pregnant

You are far from alone. Cleveland Clinic says about 1 in 4 women have insomnia in the first trimester, and up to 80% report insomnia symptoms by the end of the third. Many have never had a sleep problem before.

The reasons change as the months go by:

• Early on, hormones. Cleveland Clinic says rising estrogen and progesterone affect your breathing and the phases of your sleep cycle. Add nausea, which does not always wait for the morning, and nights get choppy fast.
• Later, your body. The growing baby presses on your back, joints and bladder. Finding a comfortable position takes ages, and then you need to pee.
• The rest of the list. Leg cramps, heartburn, a faster heart rate, feeling short of breath, a stuffy nose, and a baby who is busiest when you lie still.
• Your mind. Worry about the birth, money, work or being a parent can keep you alert. Then you start worrying about the sleep you are losing, which keeps you up even more.

That last loop is the one most people miss. The discomfort wakes you. The worry keeps you awake. You can work on both.

Set up your bed for a bump

Position is the first fix, and in the third trimester it is also a safety point. The NHS says the safest way to go to sleep is on your side, left or right, because research suggests that after 28 weeks falling asleep on your back can double the risk of stillbirth. The same page says not to worry if you wake up on your back. Just turn onto your side and go back to sleep.

Left or right? You may have read that the left side is the only safe one. Tommy’s, the UK pregnancy charity, says that claim is not backed by good evidence, and that either side is fine. That matters at 3am, because it means you can switch sides when one hip starts to ache.

A setup that works for a lot of people:

1. A pillow under your bump, so it is not pulling on your lower back.
2. A pillow between your knees, so your top leg does not twist your hips.
3. A pillow behind your back. Tommy’s suggests this to make rolling onto your back less likely.

You do not need to buy anything special. Tommy’s says regular pillows and pregnancy pillows work equally well. If your back or hips still hurt, our guide on how to sleep with lower back pain has more pillow ideas. If the pain shoots down one leg, see how to sleep with sciatica.

Third trimester: can’t sleep because the baby keeps moving

You lie down, finally comfortable, and the kicking starts. This is so common that the NHS week 29 guide mentions it directly: babies seem to have a habit of being really active just as you want to go to sleep, because they keep their own sleep and wake patterns.

What helps here is less about stopping the movement and more about not fighting it:

• Let it be normal, not a problem. Kicks at bedtime are something the NHS expects. Many people find it easier to drift off once they stop waiting for the kicks to end.
• Give your mind something slower to follow. Rest a hand on your bump and breathe slowly (the breathing below). Some find that following the rhythm of their own breath makes the kicks feel less like an alarm.
• Change sides. Turning over can shift how the movement feels, and it gives a sore hip a break.

One thing never to sleep through: a change. The NHS says to call your midwife or maternity unit immediately if your baby is moving less than usual, if you cannot feel them moving anymore, or if their usual pattern changes. Do not wait until the next day, even if it is the middle of the night. There is no set number of kicks to count; what matters is knowing your baby’s usual pattern. And the NHS says not to use a home doppler to check for yourself.

What to eat and drink so the night goes easier

Small changes during the day make a real difference after dark.

Caffeine. The NHS says to have no more than 200mg of caffeine a day while pregnant. For sleep, timing matters too: Cleveland Clinic suggests avoiding caffeine for 8 hours before bed. Remember that tea, cola, energy drinks and chocolate count.

Heartburn. If burning in your chest wakes you, the NHS heartburn advice for pregnancy is to eat small meals often instead of three big ones, not to eat within 3 hours of going to bed, and to prop up your head and shoulders when you lie down. Sleeping on your left side can also help. More on that in heartburn keeping me awake at night. Ask your midwife or GP before taking anything for it.

Night-time peeing. You cannot stop it in pregnancy, and you should not stop drinking. Cleveland Clinic suggests no more than a glass of water in the two hours before bed, taken in small sips. The Sleep Foundation suggests a night light instead of the overhead light for bathroom trips, so you do not wake up fully. If you then lie there wide awake, our guide on what to do when you can’t sleep after waking up to pee walks you through it.

Legs. Cramps and restless legs are both common. If a calf locks into a hard knot, see how to stop leg cramps at night. If your legs feel crawly and you have to move them, read restless legs at night in pregnancy. Cleveland Clinic notes restless legs can be linked to low folate, so mention it to your midwife.

When you wake at 3am and can’t fall back asleep

For many pregnant people, falling asleep is not the hard part. Getting back to sleep after the bathroom trip is. This is the sequence I would try tonight:

1. Check your position. Back on your side, bump supported, pillow between your knees. Settle in once instead of shuffling every minute.
2. Keep the lights low and the phone down. Cleveland Clinic warns that the screen tells your brain to wake up. Checking the time starts the countdown math in your head.
3. Breathe slowly for 5 minutes. The NHS breathing exercise is gentle and works lying down: breathe in through your nose for a count of up to 5, let it flow out through your mouth for a count of up to 5, without forcing it, for at least 5 minutes. If you feel light-headed, go back to normal breathing.
4. Give the worry a place to go. If your mind starts a to-do list, write it on a notepad by the bed and close it. Cleveland Clinic suggests a journal for exactly this, so you can bring the worries to your next appointment.
5. Get up after about 20 minutes. The American Academy of Sleep Medicine advises getting out of bed if you do not fall asleep after 20 minutes and doing something quiet in low light, with no electronics. Fold some baby clothes. Read a dull page. Go back when your eyes feel heavy.

That last step feels backwards. But lying there braced and frustrated teaches your brain that bed is a place for being awake. Short, calm breaks protect the bed for sleep. There is a fuller version in how to fall back asleep in the middle of the night.

When the worry is what keeps you up

Lying awake, you might start worrying that the lost sleep is hurting the baby. The NHS is reassuring here: feeling tired will not harm you or your baby, even if it makes life harder. Hold onto that line at 3am. Many people find that dropping the goal of sleeping, and simply resting, is what finally lets sleep come. If this loop sounds familiar, how to stop worrying about not sleeping tonight is written for exactly that.

The NHS also says that strange dreams or nightmares about the baby and the birth are normal in pregnancy, and that talking about them with your partner or midwife can help.

Naps and daytime habits

• Keep naps short and early. Cleveland Clinic says naps of no more than 30 minutes can help you catch up, but long or late-afternoon naps can keep you up at night. The NHS advises against napping in the afternoon or evening.
• Move a bit every day. The NHS suggests activity like a lunchtime walk or swimming, or an antenatal yoga or pilates class (tell the instructor you are pregnant). Earlier in the day is better for sleep.
• Get up at a similar time each morning. A steady wake time helps your body know when night is. Cleveland Clinic recommends a regular sleep schedule, weekends included.
• Accept help. The NHS suggests putting your feet up during the day and saying yes when family or colleagues offer to help.

Sleeping pills, melatonin and supplements

Please do not take anything for sleep, including melatonin, herbal remedies or over-the-counter sleep aids, without talking to your midwife, doctor or pharmacist first. The Sleep Foundation explains that your own melatonin crosses the placenta and helps set up the baby’s sleep-wake cycle, and that experts generally recommend pregnant people avoid sleep medications and check with a doctor before starting any sleep supplement. Cleveland Clinic adds that many sleep medicines have not been tested for safety in pregnancy, so your provider has to weigh it up with you. That is a conversation for them, not for a website.

The treatment that has been tested in pregnancy

If your nights have been bad for weeks, there is a proper, drug-free treatment with evidence behind it: cognitive behavioural therapy for insomnia, or CBT-I. In a randomised trial of 194 pregnant women with insomnia, published in Obstetrics & Gynecology in 2019, 64% of those given CBT-I no longer had insomnia by the end, compared with 52% in the comparison group, and they got there faster. CBT-I works on the habits and thoughts that keep insomnia going. The Sleep Foundation notes it can also be done by phone or online. Ask your midwife or doctor whether it is available to you.

When to talk to your midwife or doctor

Pregnancy insomnia is common, but you do not have to just put up with it. Cleveland Clinic says to tell your healthcare provider if lack of sleep is affecting how you function during the day. Also speak to them if:

• You snore loudly, gasp or stop breathing in your sleep. Sleep apnoea can get worse in pregnancy and needs its own treatment.
• Your legs feel so restless you cannot lie still.
• Heartburn keeps you up even after you change what and when you eat.
• You feel low, hopeless or anxious most of the time, or you have lost interest in things you used to enjoy. The NHS says sleeplessness with these symptoms can be a sign of depression, and its page on mental health in pregnancy says depression and anxiety can start for the first time in pregnancy and that talking therapies like CBT can help. Tell your midwife or GP honestly how you feel. If you are in crisis or think you might harm yourself, get urgent help right away through your emergency number.

And always, without waiting: call your maternity unit if your baby’s movements slow down or change.

Will it get better?

Cleveland Clinic says the body changes that keep you up at night return to normal soon after the birth. They are honest that the newborn weeks bring their own broken nights. If you find you cannot sleep even when your baby finally does, this guide is for later: postpartum, can’t sleep even when baby sleeps. The skills you practise now, settling your body and letting go of the clock, will help then too.

Tonight, keep it simple

On your side, pillow under the bump, pillow between the knees. Caffeine done by lunchtime, dinner finished 3 hours before bed. If you wake, turn back onto your side, breathe slowly for 5 minutes, and get up after 20 minutes instead of lying there doing the math. You do not need a perfect night. You need your body to remember how to power down, so tomorrow you feel more like yourself and less like you are running on fumes.

Want a calm, guided way to switch off tonight? Get the free 5-minute sleep reset →

This article is general information, not medical advice. Your midwife or doctor knows your pregnancy best, so please check with them before changing anything, and before taking any medicine or supplement.