Postpartum Insomnia: Symptoms, Causes, and What to Do About It

Postpartum insomnia is a relatively common problem for new mothers. Insomnia refers to trouble falling asleep, staying asleep, or both.

Adjusting to life with a newborn while experiencing physiological changes can make sleep feel impossible in the postpartum period. Postpartum insomnia is fairly common for new mothers and you may have sleep problems even before your baby is born.

This article will describe the symptoms and causes of postpartum insomnia, as well as its relation to postpartum depression, and prevention tips for improving sleep. 

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Symptoms of Postpartum Insomnia

The main symptoms of postpartum insomnia are difficulty falling asleep and/or staying asleep. Insomnia can also cause you to lie awake in bed, sleep for only short periods, or wake up too early. These sleep disturbances then lead to several other symptoms and complications, including: 

  • Anxiety: Women with postpartum insomnia are more likely to experience anxiety and depression in the postpartum period. Anxiety itself can lead to disturbed sleep, so this can become a cycle of insomnia. 
  • Fatigue: Without adequate sleep, people with insomnia feel fatigued throughout the day. It’s also common to have trouble concentrating or thinking clearly.
  • Irritability: When you aren’t sleeping, it is natural to feel more irritable than normal. Insomnia can lead to daytime headaches, which could add to the feeling of irritability as well. 
  • Mood swings: It is common for new mothers to feel like they are having frequent mood swings. This is likely a combination of hormonal changes and lack of sleep. 
  • Sadness: Insomnia can lead to feelings of sadness throughout the day. It is very common for new mothers to feel sad or cry in the postpartum period. If you are concerned that you may be experiencing postpartum depression, talk with your healthcare provider right away.

Causes of Postpartum Insomnia

Many mothers experience postpartum insomnia for a variety of reasons. Newborns have not developed their circadian rhythms (natural sleep-wake cycle) after birth, which means that they wake up frequently throughout the night. Mothers also experience physical changes themselves that make sleep difficult. 

Iron Deficiency

A lack of iron in the blood, known as anemia, is a risk factor for insomnia. Pregnant women are at an increased risk of anemia, especially right before birth. Women who experienced heavy bleeding during childbirth may be anemic in the postpartum period. Having a low iron level after birth then raises your risk of postpartum insomnia.

Hormonal Changes

New mothers experience drastic hormonal changes following labor and delivery. After a baby is born, a mother’s progesterone level falls. Progesterone has sleep-inducing properties, and this decline makes it harder to sleep. Most women also experience changes in their melatonin levels and circadian rhythms. 

Physical Postpartum Changes

For most new mothers, the postpartum period is physically uncomfortable, especially on the days after childbirth. Discomfort can be caused by a sore perineum (area between your anus and genitals), episiotomy or laceration stitches (repair to where the perineum may have been cut or torn), engorged breasts, incision from a Cesarean delivery (C-section), and other physical changes. If you notice that you are so uncomfortable that you cannot sleep, talk with your healthcare provider. 

Anxiety/Postpartum Mood Disorders

Postpartum insomnia has been linked with postpartum mood disorders like depression or anxiety. About 12%–18% of new mothers experience a postpartum mood disorder, and insomnia is one of the earliest signs. 

Altered Circadian Rhythm

When your normal sleep pattern is interrupted, it is natural for your body’s circadian rhythm to change. This can make falling asleep difficult, even when you are exhausted. 

Changes to Sleep Schedule

When you have a newborn at home, you do not have the luxury of deciding when to go to bed and when to wake up. Having an ever-changing sleep schedule can be confusing for your body and makes it difficult to fall asleep and stay asleep. 

Timely Feeding

Newborn babies need to eat frequently throughout the night. If you are breastfeeding, that means that you are involved in each of those nighttime feedings. This significantly impacts your ability to sleep.

Emotional Processing

Having a child is a major life transition and can bring up several emotions. Having feelings of anxiety or depression can lead to trouble falling asleep, putting new mothers at risk of insomnia. 

Are Postpartum Insomnia and Postpartum Depression Linked?

There is a connection between postpartum insomnia and postpartum depression. Insomnia is one of the first signs of postpartum depression and needs to be addressed right away. In addition, feelings of depression and anxiety can lead to disrupted sleep, raising the risk of insomnia. 

Tips for Treating and Preventing Postpartum Insomnia

Many new mothers assume that insomnia is just part of the postpartum period, but there are small steps that you can take to improve your sleep. 

Talk with your healthcare provider before trying medication for sleep. Many prescription sleep medications are not safe for pregnant women and women who are breastfeeding. 

Sleep When Baby Sleeps

This old piece of advice is a classic for a reason. New mothers require as much rest as possible, especially when they are not sleeping well at night. When your baby sleeps during the day, take advantage of that time to rest yourself. 

Practice Sleep Hygiene Techniques 

Simple sleep hygiene techniques can make a big difference when used consistently. Do your best to follow a loose routine when it comes to your own bedtime. Aim to go to sleep at the same time each night and wake up at the same time each morning. Each day will be different depending on your baby’s needs, so try to stay flexible. 

Make Your Bedroom a Sleep Haven

To help yourself unwind at night, make your bedroom as comfortable as possible. Try keeping your room cool at night to help you fall asleep. Invest in a quality mattress with pillows and blankets that feel good to you. 

Keep the Bedroom Dark

The darker your bedroom is, the easier it will be for your body to relax and fall asleep. Keep your shades or curtains closed. If you have any screens in your home, make sure they are turned off. Consider removing your phone, computer, or television from your room as well. 

Share Work With Your Partner

Caring for a newborn is beautiful and exhausting work. If you have a partner or loved one who is able to help, include them as much as possible. Ask for help with nighttime feedings, meal preparation, housecleaning, and any other tasks that need to get done so that you can rest. 

Reduce Anxiety and Stress

Stress and anxious thoughts can make falling asleep challenging. Finding ways to relieve stress can significantly improve insomnia symptoms. Research shows that cognitive behavioral therapy (CBT) is an effective treatment for postpartum insomnia.

In fact, starting CBT during pregnancy has been shown to help prevent postpartum depression and anxiety. Ask your healthcare provider for a referral to a therapist or psychologist who offers CBT.

Get Exercise

Daily physical activity is a proven way to improve your sleep. Going for a morning walk can help you to feel more awake during the day and sleep better at night. Just be sure to avoid exercising right before you go to bed, as this could interfere with your ability to fall asleep. 

Avoid Screen Time

Looking at the screen on your phone, computer, or television before bed makes insomnia worse. The light from your screens keeps your brain activated and makes falling asleep more difficult. Aim to avoid screen time for about two hours before your bedtime. 

Limit Caffeine and Alcohol

Certain substances like caffeine, alcohol, and nicotine interfere with restful sleep and make postpartum insomnia worse. Avoid these substances during the postpartum period and ask your healthcare provider when it is safe to add caffeine back into your diet if you’re missing it. 

Deep Breathing and Relaxation Techniques

Deep breathing exercises and relaxation techniques may be helpful when trying to fall asleep at night. A therapist who offers CBT can also teach you relaxation techniques. Research shows that CBT is as effective as sleep medication in treating insomnia. 

Sleeping After a Cesarean Section

Postpartum insomnia is common in women who require a C-section at birth. To improve sleep, try to sleep on your back to prevent discomfort from your incision. This position puts less strain on your abdomen. Lying back at a 45-degree angle may also feel more comfortable after a C-section, which makes it easier to breathe deeply as well. 

Talk with your healthcare provider about a pain management plan to avoid waking up in pain. If you live with your partner, ask them to assist with nighttime feedings so that you can rest and heal. 

Summary

Postpartum insomnia is a common problem for new mothers that involves trouble falling asleep, staying asleep, or both. Possible symptoms include anxiety, fatigue, irritability, mood swings, and sadness. Postpartum insomnia is caused by a variety of factors such as anemia, hormonal changes, physical changes, mood disorders, and changes to the sleep schedule. 

A Word From Verywell 

When you’re in the fog of postpartum insomnia, it can feel like you’re never going to sleep again. While there are many factors you can’t control when it comes to your sleep, try to take small steps to feel better. Any time your baby is sleeping, take the opportunity to rest. Ask for help as much as possible and remember to be kind to yourself. This phase of life is overwhelming for everyone. 

Frequently Asked Questions

  • How long does postpartum insomnia usually last?

    Postpartum insomnia may last for a few weeks to months. Research shows that most new mothers are sleeping about six hours at night and one hour during the day by the time their child is 2 months old. 

  • Is postpartum depression a normal symptom after pregnancy?

    While postpartum depression is not considered a normal symptom after pregnancy, it is relatively common. About 12%–18% of new mothers will experience postpartum depression. It’s important to talk with your healthcare provider right away if you are concerned about your mood. 

  • What is postpartum blues?

    The postpartum blues, sometimes referred to as the baby blues, are a common condition after childbirth. The baby blues often start within a few days of the birth of your baby and last for a few days and include the following symptoms:

    • Sadness, anxiety, or feeling overwhelmed
    • Mood swings
    • Crying spells
    • Trouble sleeping
    • Loss of appetite 
  • How much sleep should a new mom get?

    New moms need as much sleep as they can get. While most adults need seven to nine hours each night, this is usually not available to new parents. 

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