Postpartum Insomnia

What Causes Postpartum Insomnia?

The days, weeks, and months following childbirth are a time of intense transition physically, mentally, and emotionally. The changes that occur during this time can affect sleep and contribute to postpartum insomnia.

Patterns That Carry Over From Pregnancy

Sleep difficulties are common during pregnancy, especially during the third trimester, when discomfort, heartburn, the need to urinate frequently, and sleep disorders often interfere with sleep. As a result, problematic behaviors and thought patterns regarding sleep Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source may emerge during pregnancy and persist in the postpartum period. 

For example, poor sleep may lead to a habit of taking long afternoon naps, which in turn, make it difficult to fall asleep at night. Similarly, sleep deprivation may cause anxiety about sleep that makes it harder to fall back asleep after a nighttime waking. These patterns may lead to the continuation of insomnia from pregnancy or its development during the postpartum period. Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source

Sleep disruptions

New babies typically need to be fed and diapered every two to three hours, which means that their caregivers experience significant sleep disruptions. Sleeping in short increments and on an irregular schedule can disrupt a person’s circadian rhythms, the 24-hour patterns that govern the sleep-wake cycle. Desynchronized circadian rhythms Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source can cause a person to feel sleepy when they want to be awake and awake when they want to sleep.

“Low estrogen levels postpartum can mirror menopausal levels and cause hot flashes and night sweats, which can disrupt sleep quantity and quality.”

Alyssa Dweck, MD, FACOG

Gynecologist, Women’s Heath Expert

Hormonal Changes 

People experience dramatic fluctuations in their hormones Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source after giving birth—including decreased levels of progesterone and estrogen. Progesterone facilitates relaxation and sleepiness, while estrogen reduces the amount of time it takes to fall asleep and the number of times a person wakes up in the night. So, drops in these hormones may precipitate sleep problems Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source following childbirth.

Pain

Pain and insomnia appear to have a bidirectional relationship during the postpartum period. Many individuals experience pain related to childbirth, breastfeeding, and caregiving, Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source and that pain can make it harder to sleep. But insomnia also appears to increase a person’s chances of experiencing bodily pain Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source in the two years following childbirth, especially when paired with symptoms of depression.

Mental Health Struggles

People who experience sleep problems in the postpartum period have an increased risk Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source of developing depression and anxiety—and, conversely, postpartum mood disorders can aggravate insomnia symptoms. This can create a self-perpetuating cycle. Individuals who have traumatic pregnancies or births Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source may also experience sleep problems related to post traumatic stress disorder.

“Anxiety about newborn’s wellbeing, especially if there are medical issues of concern, relationship changes, or financial stress can contribute to sleep loss.”

Alyssa Dweck, MD, FACOG

Gynecologist, Women’s Heath Expert

Symptoms of Postpartum Insomnia

Individuals with postpartum insomnia Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source often:

• Wake frequently in the night
• Feel that their sleep is unrefreshing
• Experience daytime tiredness
• Feel irritable

That said, many of these symptoms can also be the result of ordinary sleep disruptions that come with caring for an infant. A person is likely to have postpartum insomnia—and not simply fragmented or insufficient sleep—if they have trouble sleeping even when they’re given the opportunity to sleep without interruption. Insomnia is also the likely culprit if a person experiences sleep difficulties even if they’ve resolved any physical discomfort and created a good environment for sleep.

People who experience long-term postpartum insomnia may develop depression or anxiety and may experience chronic pain—so the presence of these disorders may point to underlying insomnia.

Treating Postpartum Insomnia

Left untreated, insomnia can negatively impact the health and wellbeing of individuals in the postpartum period, along with the children in their care. Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. View Source The good news is that postpartum insomnia can improve and even resolve with treatment. If you have postpartum insomnia, seek support from a doctor or therapist who can help craft a treatment plan. There are a couple of approaches they might recommend.

Cognitive Behavioral Therapy for Insomnia

One of the most effective treatments for insomnia is cognitive behavioral therapy for insomnia (CBT-I). Usually overseen by a therapist, this approach can help you address thoughts and behaviors that interfere with sleep and cultivate mindsets and practices that promote healthy sleep. If you experience insomnia during pregnancy, consider engaging in CBT-I before giving birth. Research suggests this may reduce the likelihood Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source that you will experience postpartum insomnia, anxiety, and depression.

Light Therapy

Light therapy can help you realign your circadian rhythms and establish a healthy sleep-wake cycle via exposure to bright light at strategic times of day. Often, this is accomplished through the use of a device called a light box. This therapy may be particularly useful if you also are also experiencing postpartum depression. Trusted Source National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source

Improving Postpartum Sleep

There are several steps you can take at home to reduce the impact of and even prevent the sleep difficulties that accompany early parenthood.

• Sleep when you can: Especially in the first few months after birth, try to sleep when your baby sleeps, even during naps. If you’re able to, go to bed early several times a week.
• Ask for help: If possible, get a partner or family member to help in the night or to watch the baby while you nap during the day.
• Go for a morning walk: Exposure to sunlight and exercise might help you feel more alert in the morning, and it may help you sleep better at night.
• Avoid caffeine and alcohol late in the day: While an afternoon cup of coffee may sound tempting, and a beer or glass of wine in the evening may help you relax, both caffeine and alcohol are known to interfere with sleep.
• Seek emotional support: The postpartum period comes with many challenges. Talking to a counselor or joining a support group may help you feel less alone and better equipped to navigate this season of life—and these measures may also benefit your sleep by reducing stress.

Still have questions? Ask our community!

Join our Sleep Care Community — a trusted hub of sleep health professionals, product specialists, and people just like you. Whether you need expert sleep advice for your insomnia or you’re searching for the perfect mattress, we’ve got you covered. Get personalized guidance from the experts who know sleep best.