Can Insomnia Be an Early Sign of Pregnancy?

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.

sleep changes during pregnancy
Illustration by Brianna Gilmartin, Verywell

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 healthcare provider 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.

Doctor Discussion Guide Woman
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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.
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  3. Reichner CA. Insomnia and sleep deficiency in pregnancyObstet Med. 2015;8(4):168-171. doi:10.1177/1753495X15600572

  4. Mai E, Buysse DJ. Insomnia: Prevalence, impact, pathogenesis, differential diagnosis, and evaluationSleep Med Clin. 2008;3(2):167-174. doi:10.1016/j.jsmc.2008.02.001

  5. Manber R, Bei B, Simpson N, et al. Cognitive behavioral therapy for prenatal insomnia: A randomized controlled trialObstet Gynecol. 2019;133(5):911-919. doi:10.1097/AOG.0000000000003216

Additional Reading
  • Kryger, MH et alPrinciples and Practice of Sleep MedicineExpertConsult, 6th edition, 2017.