Insomnia and problems sleeping during pregnancy

What is insomnia?

Insomnia may manifest itself as:

• Difficulty falling asleep

• Waking up frequently during the night

• Difficulty returning to sleep

• Unrefreshing sleep

What causes insomnia during pregnancy?

Interrupted sleep is, as many mothers will attest, not uncommon in all stages of pregnancy – think of it as a taste of things to come. Causes of insomnia include:

• Back pain

• Heartburn

• Getting up to urinate frequently during the night

• Frequent and vivid dreams

• Discomfort due to the increased size of your belly, especially after 33 weeks

• Anxiety

• Anticipation of the arrival of your baby

• Hormonal changes

How common is insomnia throughout pregnancy?

Insomnia affects around 75% of expectant mums, especially in the third trimester, when sleeping becomes more uncomfortable due to the size of your bump.

It can seem incredibly frustrating that, at a time when you need sleep the most, you can't get it. It's not uncommon to struggle with drifting off to sleep despite being very tired. Try to think of it as good practice for what lies ahead once your baby arrives – at least it won't be such a shock to the system!

What you can do to prevent insomnia during pregnancy

Don't worry

Easier said than done, we know, but sometimes just letting go of the worry is all it takes to help you sleep. Remember: insomnia can't hurt you or your baby. If you have persistent worries that are keeping you awake, talk about them with your partner, a friend or doctor and try to sort them out during daylight hours – or try writing them down.

Review your diet

Eat well and get lots of Vitamin B – if you don't have enough, it can contribute to insomnia. You should also avoid caffeine and chocolate, especially in the late afternoon or evening, since they can keep you awake, and try to drink lots of water earlier throughout the day, so there's less chance of waking up in the night needing a wee. If you can eat a relaxed, early dinner without rich or spicy food, you might find that helps too. Take your time eating and don't eat too close to bedtime – this will help keep heartburn at bay, and give your body enough time to digest your food.

Make a bedtime routine

Getting into a routine can help train your body to recognise when it's time for bed. Try to go to sleep and get up at around the same time every day, and before bed cut down on screen time – it can lead to overstimulation which means you'll have more difficulty drifting off. Try reading a book or listen to soothing music, or perhaps a warm bath, warm milk or a massage to relax you.

If you're uncomfortable, you won't sleep either, so check the room temperature – opening a window might help if you're stuffy. Make sure the mattress and pillows give you solid support – a body pillow may help with that. If sound or light bothers you, invest in some earplugs and an eye mask. If your partner's snoring keeps you awake, consider sleeping in another room for the time being.

Finally – save your bed for sleep! In other words, try to avoid doing 'daytime' activities in bed, i.e. writing emails and doing admin.

Other things you can try

Get some daily exercise, but not too close to bedtime. Low-impact activity like walking, swimming or pregnancy yoga can help combat insomnia.

Have sex – if you feel up to it! The endorphins released can help relax you and make it easier to sleep.

If you're not sleeping, get up. If you're not asleep after 20 to 30 minutes of trying, get up and then try to go to sleep again after pottering around. You may just be tired enough by that point to get the rest you need.

Don't be afraid to nap. If you're not sleeping at night but find you're ready for a kip in the day, and able to take one, it's okay. It's better you get the sleep than miss out.

Don't count the hours.

Though most people do best on eight hours of sleep, some do fine on less and some need more. So instead of aiming for a particular number of sleep hours ask yourself how you're feeling on the hours you're sleeping during pregnancy. If you're not chronically tired, you may actually be getting enough rest.

Alternative therapies which may help with insomnia:

• Lavender, chamomile or ylang-ylang essential oils may help. Put the drops on a tissue, not your pillow, so you can use fresh oil each time – or add them to your evening bath.

• Bach Flower Remedies, such as Rescue Remedy, may ease general stress, and any tension that's keeping you awake. There's no good evidence that these are effective, but many women find them helpful, but they do have a very small alcohol content. It's only a few drops, but if you're avoiding alcohol completely, you may wish to give them a miss.

• Massage, aromatherapy, and reflexology can help you to relax – even asking your partner for a shoulder rub is a good start.

• If backache or other physical problems are keeping you awake, osteopathy, physiotherapy or a chiropractor may ease them.

If your insomnia is very bad

If you are really struggling with insomnia, speak to your doctor – there might be something they can suggest that will help. Occasionally insomnia can be a symptom of depression, so if you are experiencing it alongside other symptoms such as low mood, loss of appetite and interest in general life or constant anxiety, please do contact your doctor.

Talk to your midwife, too. She's there to support you emotionally as well as physically throughout your pregnancy, and you can discuss the possibility of a counselling referral.

If you're approaching the end of your pregnancy and your insomnia is still bad, you may wish to start your maternity leave early, so you can try to relax (easier said than done) and get some sleep before the baby arrives.