Sleep Disorders Causes & Risk Factors Can Insomnia Be an Early Sign of Pregnancy? By Brandon Peters, MD facebook twitter Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial process Brandon Peters, MD Medically reviewed by Medically reviewed by Sanja Jelic, MD on September 12, 2020 Sanja Jelic, MD, is board-certified in sleep medicine, critical care medicine, pulmonary disease, and internal medicine. Learn about our Medical Review Board Sanja Jelic, MD on September 12, 2020 Print Women who are at an age and disposition in which it is possible to become pregnant may wonder about early signs or symptoms of pregnancy. Can insomnia be one of these early symptoms or physical signs of being pregnant? Difficulties falling or staying asleep commonly plague pregnant and non-pregnant women alike, so is it a reliable indicator of being with child? Learn how sleep may change with pregnancy and whether insomnia itself usefully predicts the onset of being pregnant. Illustration by Brianna Gilmartin, Verywell Learn About the Consequences of Lack of Sleep During Pregnancy How Sleep Changes Early in Pregnancy The first trimester of pregnancy includes many changes that affect a woman’s body. A handful of these changes can also undermine sleep in pregnancy, and some develop soon after conception. It is even possible for some of these early alterations to lead to symptoms characteristic of insomnia. Women in the first 12 weeks of pregnancy commonly experience fatigue and excessive daytime sleepiness. Sleepiness or drowsiness may lead to an increased desire to sleep during the day, dozing off when sedentary, or taking naps. This may lead to poor concentration, impaired job performance, and even a propensity toward accidents. Sleepiness affects up to 37.5% of pregnant women at 6 to 7 weeks and is due to increasing levels of the hormone progesterone. Progesterone often leads to increased sleep fragmentation, which may affect overall sleep quality. Moreover, morning sickness, increased urinary frequency, back pain, breast tenderness, increased appetite, and anxiety can all disrupt sleep as well. It is a reasonable conclusion that these difficulties would disrupt a woman’s ability to stay asleep, triggering awakenings that may contribute to insomnia if difficulty returning to sleep occurs. By week 10 of pregnancy, women spend more time sleeping, with a longer sleep duration overnight, and frequent naps throughout the day. This is partly due to the fact that sleep has become more disturbed by frequent awakenings, and the amount of deep sleep decreases. Many pregnant women complain that their sleep is of poor quality during this period. Fortunately, it tends to improve in the second trimester, before sleep again worsens with the physical discomfort of late pregnancy. Can Insomnia Be a Sign of Pregnancy? Even though insomnia is a common occurrence during pregnancy, is it a reliable early indicator of pregnancy? The short answer is probably "no." What is the argument against insomnia being an early sign of pregnancy? Consider these factors: It may not occur often or early enough to be a useful physical sign of being pregnant. Insomnia is the most common sleep disorder in general, affecting millions of people of both sexes and all ages. Although it may be an indicator of early sleep disruption in some pregnant women, it occurs so often in others that it is not a trustworthy sign specific to pregnancy. Consequently, insomnia should not be relied upon as a sign that a woman has become pregnant. Getting Help for Insomnia If you have insomnia, no matter the reason, you should seek help to sleep better. For temporary relief, the use of over-the-counter or prescription sleeping medications may be used, but these are not recommended to be used beyond a few weeks. For more persistent difficulties, other treatment options may be pursued. Cognitive-behavioral therapy for insomnia (CBTI) is an attractive option to fix the condition without needing to rely on sleeping pills, which may not be safe to use during pregnancy. This education program teaches you a set of skills that will help you to sleep better for the rest of your life, no matter the cause of insomnia. If trouble sleeping persists, seek evaluation by a board-certified sleep physician. If needed, a sleep study can be arranged to identify other causes of the disturbance, including the presence of sleep apnea. Contributions from stress, anxiety, pain, and other issues can be sorted out. Fortunately, if a sleep disorder is contributing to insomnia, effective treatment may quickly resolve the condition. And if you think you may be pregnant, you should simply take a home pregnancy test or see your doctor to be certain. You can use our Doctor Discussion Guide below to start a conversation with a healthcare professional about the right treatment approach for you. Insomnia Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Was this page helpful? Thanks for your feedback! Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Tsai SY, Lee PL, Lin JW, Lee CN. Persistent and new-onset daytime sleepiness in pregnant women: A prospective observational cohort study. Int J Nurs Stud. 2017;66:1-6. doi:10.1016/j.ijnurstu.2016.11.003 Kim B, Lee EM, Chung YS, Kim WS, Lee SA. The utility of three screening questionnaires for obstructive sleep apnea in a sleep clinic setting. Yonsei Med J. 2015;56(3):684-690. doi:10.3349/ymj.2015.56.3.684 Reichner CA. Insomnia and sleep deficiency in pregnancy. Obstet Med. 2015;8(4):168-171. doi:10.1177/1753495X15600572 Mai E, Buysse DJ. Insomnia: Prevalence, impact, pathogenesis, differential diagnosis, and evaluation. Sleep Med Clin. 2008;3(2):167-174. doi:10.1016/j.jsmc.2008.02.001 Manber R, Bei B, Simpson N, et al. Cognitive behavioral therapy for prenatal insomnia: A randomized controlled trial. Obstet Gynecol. 2019;133(5):911-919. doi:10.1097/AOG.0000000000003216 Additional Reading Kryger, MH et al. Principles and Practice of Sleep Medicine. ExpertConsult, 6th edition, 2017.