Relvay makes a pregnancy pillow. We also tell you below when you should not buy one.
The short answer
Poor sleep is very common in pregnancy, and it is worth raising when the usual tips have not helped or your days are suffering. Bring a one-week sleep diary and say how it affects your days, not only your nights.
- Track: bedtime, wake-ups, why, and how the next day went.
- Ask before: any sleep medicine, supplement or herbal tea.
- Urgent: thoughts of harming yourself.
Why can't you sleep during pregnancy?
Usually several things at once: hormones, needing to pee, heartburn, aches, a growing bump, and a busy mind. Pregnancy, Birth and Baby says sleep issues affect around 1 in every 2 pregnancies.
3:05 a.m.
I was 22 weeks and I had done everything. No screens after nine. Warm shower. Pillow between my knees. Decaf only. I still lay there from three until the alarm, listing everything I had not done for the baby yet.
At work I read the same email four times. I cried in the car over a parking ticket. At my appointment the midwife asked how I was, and I said fine, because I did not know how to say I am awake all night without it sounding like a complaint.
"Help I can't sleep, tried all the tricks not working, I'm due December"
YouTube comment on a pregnancy sleep videoSaying "I'm not sleeping" is not complaining. It is giving your care team information they need.
When should you talk to your midwife or OB-GYN about sleep?
Raise it when you still have trouble sleeping after trying the usual tips, or when it is affecting your mood, your safety or how you get through the day. You do not need to wait until it is severe.
- The usual tips have not helped after a couple of weeks.
- You feel low, anxious or flat most days, or have lost interest in things.
- You are nodding off while driving, at work or in conversation.
- Pain, heartburn, a racing mind or restless legs keep you awake.
- You snore loudly, or someone has noticed pauses in your breathing.
- You are thinking about trying a sleep aid, supplement or herbal remedy.
If repeated waking is the main issue, our guide waking repeatedly at night while pregnant goes deeper on night patterns.
What should a one-week sleep diary include?
Five things per day: when you got into bed, roughly how long it took to fall asleep, how many times you woke and why, when you got up, and how the next day went. A week of this beats any amount of describing.
| Column | What to write | Example |
|---|---|---|
| In bed | Time you lay down to sleep | 10:45 p.m. |
| Fell asleep | Your rough guess | About 40 minutes |
| Woke up | How many times, and the reason if you know it | 3 times: pee, heartburn, hips |
| Up for the day | Time you got up | 6:30 a.m. |
| Next day | Energy, mood, any nodding off, from 1 to 5 | 2, nearly dozed at my desk |
Keep it on paper or in your phone notes, and fill it in when you get up rather than in the night. Guesses are fine. You are looking for a pattern, not precision.
What should you ask, based on how your days are going?
Start with how your days are going, because that shapes what help makes sense. Pick the row that sounds like you and bring that question.
| If your days look like this | Say this | Ask this |
|---|---|---|
| Tired, but managing | I'm sleeping badly but getting through the day. | Is there anything about my pregnancy I should change, or is this expected for now? |
| Struggling to function | I'm making mistakes at work and nearly dozing off. | What can we look at first, and is it safe for me to drive? |
| Low or anxious mood | I'm lying awake worrying and feeling low most days. | Could this be more than sleep, and who can I talk to? |
| Pain or physical symptoms | Hips, heartburn or restless legs wake me. | Can we deal with the symptom that wakes me? |
| Snoring or gasping | My partner hears me snore or stop breathing. | Should my breathing at night be checked? |
Penny brought her diary to her 24 week visit and read out one line: next day, 2 out of 5, nearly fell asleep at my desk. The conversation changed. Her midwife asked about her mood, then about her hips, and they made a plan for both.
What kind of help can your care team offer?
That depends on what is keeping you awake, which is why the diary matters. Pregnancy, Birth and Baby describes cognitive behavioral therapy as a first choice for insomnia in pregnancy, and many sleep medicines are not considered suitable.
- Help with the symptom that wakes you, such as heartburn, pain or needing to pee.
- Support for low mood or anxiety, if that is part of it.
- A referral for therapy that focuses on sleep habits and thoughts.
- A check of your breathing at night, if snoring or pauses are noticed.
Do not start any sleep medicine, supplement or herbal remedy on your own, including ones you used before pregnancy. Ask your midwife, OB-GYN or pharmacist first.
Comfort still counts. If hips or your back wake you, our guide do you need a pregnancy pillow? shows how to set up regular pillows first.
When is sleep loss urgent?
If you have thoughts of harming yourself or feel you cannot keep yourself safe, get help now. In the US, call or text 988, or call 911.
- Thoughts of harming yourself or not wanting to be here.
- Feeling extremely distressed, panicky or out of control.
- Not sleeping at all for several nights in a row.
- Feeling confused or seeing or hearing things others do not.
None of this means you have failed at pregnancy. It means you need more support than tips can give, and asking for it is the right move.
Frequently asked questions
Is it normal to not be able to sleep during pregnancy?
Yes, it is very common. Pregnancy, Birth and Baby says sleep issues affect around 1 in every 2 pregnancies. Common does not mean you have to put up with it, so mention it if it is affecting your days.
When should I tell my doctor I can't sleep while pregnant?
When the usual tips have not helped, or when it affects your mood, your safety or how you function. A one-week sleep diary makes that conversation easier.
Can I take a sleep aid while pregnant?
Do not start any sleep medicine, supplement or herbal remedy without asking your midwife, OB-GYN or pharmacist first. Many sleep medicines are not considered suitable in pregnancy.
Does pregnancy insomnia mean something is wrong?
Usually it reflects the many changes of pregnancy. It can also be linked to low mood, anxiety, pain or breathing at night, which is why telling your care team helps.
What can I do tonight while I wait for my appointment?
Keep to a regular bedtime, limit caffeine to mornings, deal with worries earlier in the evening, and set up pillows so lying on your side is comfortable. Start your sleep diary tomorrow morning.
If aches are part of what keeps you awake, our pregnancy pillow buying checklist helps you decide whether regular pillows are enough first.
Penny's story is a composite based on public posts and reviews from pregnant sleepers. Names and details are changed.
