If insomnia was part of your pregnancy experience, then missing out on sleep during the postpartum period is nothing new. That said, sleepless nights — especially several in a row — are not good for your physical or mental health.
According to the
Postpartum insomnia can disrupt daily life and decrease overall health. It’s also linked to other mental and physical health conditions, so it’s important to monitor it closely and seek help if it’s not getting better.
According to Peter G. Polos, MD, PhD, FCCP, FAASM, sleep medicine specialist and Sleep Number sleep expert, insomnia is a type of sleep disorder where a person has difficulty falling or staying asleep, and the overall quality of their sleep is poor.
What’s more, Polos says difficulty with sleep often precedes the delivery of the child and can then persist postpartum.
Your body goes through numerous changes during pregnancy. And if this is your first postpartum experience, you might be surprised how much your body continues to change during the fourth trimester (aka the 12 weeks after giving birth).
Sleep disturbances are one of the most common issues after giving birth. For some people, these issues get better in a matter of weeks. But for others, postpartum insomnia can drag on for months.
Health and physical changes all contribute to acute insomnia during the postpartum period. These include things like:
- increased stressors
- caregiving for a new infant
- changes in hormone levels
- new or previously diagnosed mental health conditions, like anxiety or depression
Aside from mental health conditions like perinatal depression, there may be hormonal causes as well.
Lynae Brayboy, MD, FACOG, an OB-GYN, reproductive endocrinologist, and chief medical officer of the menstrual tracking app Clue, says medical conditions such as postpartum thyroiditis can occur and impair sleep.
“Approximately 10% of women have postpartum thyroiditis, but it is underdiagnosed because the symptoms are not specific and can overlap with typical postpartum symptoms,” she says.
Brayboy says postpartum thyroiditis is the inflammatory autoimmune destruction of the thyroid gland. The thyroid gland is a butterfly-shaped gland in the neck that makes thyroid hormone, which sets the metabolism, or how the entire body processes energy.
“During the first stage of postpartum thyroiditis, called thyrotoxicosis, there is too much thyroid hormone in the bloodstream, leading to symptoms such as a fast heart rate, anxiety, irritability, and fatigue, in addition to insomnia,” she says.
If you’re noticing signs and symptoms related to postpartum insomnia, Brayboy says you need to get evaluated by a clinician with expertise in women’s health in partnership with an OB-GYN.
Depending on the cause of insomnia, she says the treatment will vary, but do not attempt to self-medicate.
Review infant sleep patterns
One of the first steps in addressing postpartum insomnia is to consider infant sleep and eating patterns. It’s common to have uninterrupted sleep for several months after bringing a baby home.
Being open with your partner, doctor, and pediatrician about your concerns can help you establish realistic expectations during this period. It also helps you understand your sleep patterns and how to identify early signs of insomnia.
Cognitive behavioral therapy
According to a
A 2022 randomized controlled trial examined the combination of CBT and light dark therapy (LDT) as a way to treat postpartum insomnia. Results from the trial found that therapist-assisted CBT and LDT were safe and effective at reducing postpartum insomnia symptoms.
Lifestyle modifications
Lifestyle modifications, such as avoiding caffeine or heavy meals in the hours before bedtime and keeping screens out of the bedroom, are a great place to start when practicing good sleep hygiene.
In fact, Polos typically recommends people first make changes to the fixable factors in their environment that may be affecting their sleep. But with a newborn, Polos says that might not always be possible.
For example, it’s likely you won’t be able to follow a regular sleep routine or even get in the recommended 7 to 9 hours of sleep each night. One piece of advice, he says, is to take advantage of naps: Sleep when your baby is sleeping.
Or, if you’re finally able to go to bed and find yourself having trouble falling asleep, Polos recommends getting out of bed and going into a different room.
“It can help train your brain that your bed is meant for sleeping,” he says.
Over-the-counter and prescription medication
Melatonin is an over-the-counter (OTC) supplement that some people take to help with sleep. While it can promote sleep onset, Polos points out that melatonin is not a sleeping pill, and it’s not regulated by the Food and Drug Administration (FDA).
Because of this, Polos says you should consult a sleep specialist. They can provide guidance on dosage, timing, and any follow-ups that may be necessary. He also warns there’s insufficient data to fully evaluate the use of melatonin while breastfeeding.
Prescription medications, like antidepressants and sedatives, are available for short- and long-term insomnia. So are OTC sleep aids with antihistamines. But both of these come with risks.
Make sure to talk with your doctor about complications or side effects from sleep medication, as well as safety when breastfeeding.
If there’s one thing a new baby will teach you, it’s patience.
Unfortunately, there’s no one-size-fits-all answer to how long postpartum insomnia will last. Like most health-related issues, it varies from person to person.
According to the
“Many factors that contribute to postpartum insomnia resolve over time,” Polos says. For example:
- your newborn’s sleep schedule begins to stabilize
- your hormone levels begin to return to baseline
- the lifestyle adjustments to having a baby begin to take shape
However, if insomnia persists, Polos says it’s time to talk with an expert.
Sleep during every phase of life is essential.
“Women in the postpartum period who don’t get enough sleep have elevated levels of inflammatory chemicals called cytokines and the stress hormone cortisol, making their immune system vulnerable and therefore their overall health vulnerable,” Brayboy says.
What’s more, the lack of sleep may worsen behavioral, mental, and medical outcomes.
One 2016 research review found that postpartum insomnia may increase the likelihood of postpartum depression. Brayboy says if you or someone you know is not sleeping after a pregnancy, contact a doctor for an evaluation.
Most experts recommend seeking help for insomnia if you experience an inability to go to sleep, wake too early, or feel unrested at least 3 nights a week for 3 months — especially if your lack of sleep continues after your baby is sleeping more regularly.
However, if insomnia harms your health at any point as a new parent, it’s time to talk with your doctor. They can do a physical exam and discuss sleep habits, stress levels, and current medications.
Your doctor may also conduct other exams, take blood, or recommend a sleep study to rule out other medical problems.
Interrupted sleep and feeling tired is normal after giving birth. But if these issues persist after 3 months or you’re experiencing insomnia to the point of not being able to function, it’s time to talk with your doctor.
Postpartum insomnia can lead to other issues, especially if left untreated. Your doctor may recommend lifestyle changes, prescription or OTC medication, or CBT to see whether it helps with sleep.