Insomnia and Tiredness in Pregnancy: Sleeping Better, Trimester by Trimester

It is 3 a.m. You have been up twice to go to the loo, the baby is doing somersaults, and now your mind is spinning through the hospital bag list and maternity leave. Pregnancy insomnia is no whim: according to a guide from Washington State’s health care authority in the United States, 75% of pregnant women have sleep problems, and 38% have insomnia in the medical sense.

These broken nights have different causes depending on the stage of pregnancy, and some respond well to treatment. Here is what happens trimester by trimester, two often overlooked conditions, restless legs and sleep apnoea, and what really helps you sleep better while pregnant.

Why do we sleep so badly in pregnancy?

Because several discomforts add up. The Quebec guide Mieux vivre avec notre enfant lists hormonal changes, waking to pass urine, backache, heartburn, cramps, difficulty finding a comfortable position and anxiety. Low iron and not drinking enough add to the tiredness.

Sleep problems are more common in the third trimester, when the bump weighs the most. But many mums-to-be are also exhausted in the very first weeks, when nothing shows yet.

Trimester by trimester: what changes

The little ailments that wake you, from reflux to heavy legs, are detailed in our article on the minor ailments of pregnancy, and solutions for night-time acidity are in the one on heartburn in pregnancy.

Restless legs: it is not in your head

Restless legs syndrome brings, in the evening and at night, an irresistible urge to move your legs, with unpleasant sensations (crawling, tingling, pulling). It gets worse at rest and eases when you move. According to the Washington State guidelines, it affects about 20% of pregnant women who have sleep problems.

The UK’s NHS links it in particular to iron: a deficiency can favour it, and correcting it may improve it. Good news, the symptoms usually disappear after birth. In the meantime:

• have your iron level checked, and your folate, and take a supplement only if it is prescribed (see our article on anaemia in pregnancy);
• move during the day, but avoid intense exercise in the evening;
• try a lukewarm bath or a leg massage before bed;
• avoid caffeine after midday, mint tea included;
• when the discomfort comes, walk, stretch, or occupy your mind with some reading.

Talk to your doctor if the symptoms keep you from sleeping or wear down your mood. No medication without their advice.

Snoring and sleep apnoea: when to worry?

Many women start snoring during pregnancy, and it is not necessarily worrying. But frequent snoring is also the most common sign of sleep apnoea, those pauses in breathing that chop up the night without you realising.

According to the Washington State guidelines, apnoea affects about 15% of pregnant women who have sleep problems. It is more common with excess weight, and associated with pregnancy high blood pressure and gestational diabetes. Tell your doctor about loud snoring almost every night, pauses in breathing noticed by your partner, or daytime sleepiness to the point of falling asleep sitting up. They can refer you for a sleep test. The signs of pre-eclampsia, worth knowing late in pregnancy, are gathered in our article on high blood pressure and pre-eclampsia.

Position and pillow: a good starting point

From 28 weeks, the rule is simple: go to sleep on your side, left or right, at night and for naps, the NHS reminds us, because going to sleep on your back is associated with a higher risk of stillbirth. Waking up on your back is not a problem: just turn over.

A pregnancy pillow between the knees and under the bump eases your back and hips and helps you hold the position. How to set it up, depending on its shape, is detailed in our guide to sleeping well while pregnant: positions and pillow, and all the models are in our pregnancy and nursing pillows section.

From the shop

Pregnancy pillows for more comfortable nights

A pillow won't cure insomnia, but it eases your back and hips and helps you stay on your side. Here are several sizes and prices; all of them double up for breastfeeding afterwards.

• −35 %DoomooSofty nursing pillow, Flower Yellow – Doomoo403 DHinstead of 620 DHView product
• −19 %DoomooSofty nursing and maternity pillow, Ruby Stripes – Doomoo501 DHinstead of 620 DHView product
• −9 %DoomooSofty nursing and maternity pillow, Tetra Jersey Green – Doomoo564 DHinstead of 620 DHView product
• −9 %DoomooComfy Big nursing and maternity pillow, Tetra Brick – Doomoo619 DHinstead of 680 DHView product
• −9 %DoomooBuddy nursing and pregnancy pillow, Tetra Jersey Green – Doomoo810 DHinstead of 890 DHView product
• −9 %DoomooTwisty 2-in-1 pregnancy pillow, Pearl Grey, pearl grey cover – Doomoo901 DHinstead of 990 DHView product
• The whole aisle · Pregnancy and nursing pillows20 products online, delivered anywhere in Morocco.Open the aisle

Products sold by La Maison du Bébé, publisher of this magazine. Prices as of 12 October 2026; please check the product page.

What really helps you sleep better while pregnant

Sleep hygiene tips are useful, but the Washington State guidelines are frank: on their own, they are not enough to treat insomnia that lasts. The reference treatment is cognitive behavioural therapy for insomnia (CBT-I), generally in 6 to 8 sessions, with a psychologist or a trained doctor. It combines several tools: understanding your sleep, calming racing thoughts, keeping the bed for sleep only, relaxing. Treating insomnia during pregnancy might also help prevent postpartum depression.

Day to day, these habits lay the foundations:

• regular times, for going to bed and getting up, even after a bad night;
• caffeine limited to under 200 milligrams a day according to the NHS and American guidelines, and none at all late in the day;
• a light dinner, not too late, and less to drink just before bed, drinking well during the day;
• regular physical activity during the day, such as walking;
• a dark, quiet, cool bedroom, no screens before sleep, with a simple alarm clock rather than your phone;
• a short, not-too-late nap if you need one: the NHS advises avoiding late-day naps that delay falling asleep, while the Quebec guide suggests them to recover.

Sleeping pills, herbal teas, supplements: caution first

Do not take any sleeping pill, any “sleep” supplement, or any herbal tea or essential oil without the advice of your doctor or pharmacist. The Quebec guide reminds us that natural products are not risk-free in pregnancy and should be treated like medicines. American guidelines reserve sleep medication for severe insomnia, when other methods have failed and the benefits outweigh the risks.

Finally, insomnia that comes with sadness, hopelessness or loss of interest in what you used to enjoy may point to depression, warns the NHS. It can be treated, during and after pregnancy: our article on baby blues and postpartum depression helps you tell the difference.