What causes insomnia during pregnancy?

Updated: Aug 20, 2019
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Insomnia is most prevalent in the first and third trimesters and affects a substantial minority of pregnant women. Causes include urinary frequency, low back pain, nocturnal cramps, fetal movements, and restless legs syndrome (RLS) or periodic limb movements of sleep.

Urinary frequency often occurs early in pregnancy and may result in repeated bouts of nocturia.

Low back pain is a common symptom among pregnant women. The weight of the enlarging uterus stresses the spine and changes lumbar posture. Sleeping position may have to be changed to one that minimizes backache. Specially shaped pillows have been recommended and offer some benefit. Water exercises, physical therapy, and acupuncture may also reduce discomfort, improve function, and lessen insomnia.

Nocturnal cramps occur more frequently during pregnancy than in other stages of life. The cause of these painful, sleep-disrupting attacks usually cannot be determined. Several trials of vitamin and mineral supplements have been published, but little benefit from such treatments is documented. The available data give greatest support to the use of magnesium salts to decrease cramps.

Fetal movements become increasingly prominent as pregnancy progresses, and they may contribute to nocturnal arousals in certain patients.

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