Three distinct stages mark the postpartum period.
The first stage involves intense changes that happen quickly within the first six to twelve hours after giving birth. The second phase, during which the body undergoes significant changes less rapidly than in the first stage, lasts two to six weeks. Finally, the third stage (termed the delayed postpartum period), where changes are less abrupt, can last up to six months.
The changes associated with the postpartum period, specifically the first and second stages, can cause significant distress for a new mom.
Women in the postpartum period may experience backaches, headaches, sore breasts, fatigue, heartburn, constipation, vaginal dryness, and other undesirable symptoms. Each woman experiences the postpartum period differently; however, one of the most common complaints is sleep problems.
One team of researchers found that approximately 50 to 73% of women experience sleep pattern changes during pregnancy and postpartum. An estimated 17 to 30% experience symptoms of insomnia in particular.¹
Insomnia is a sleep disorder characterized by difficulties falling asleep, staying asleep, or having good quality, restful sleep. If you experience insomnia after giving birth and didn’t struggle with sleep before pregnancy, your sleeping issues may be linked to the physical changes associated with childbirth.
Your baby's arrival is a significant event in your life, and you must mentally and physically prepare yourself for the challenges ahead. As soon as your newborn arrives, you'll likely want to sleep. However, you may only be able to get quality rest once you learn how to deal with the changes happening within (and outside) your body.
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Insomnia is difficulty initiating, maintaining, or achieving good quality sleep. Anyone can experience sleep issues, such as insomnia. When insomnia occurs after giving birth, it’s called postpartum insomnia. About 60 % of mothers experience sleep problems in the months following childbirth. The issue affects new and experienced mothers equally.² ³
Women with postpartum insomnia may struggle to fall or stay asleep, and they commonly wake in the morning feeling unrefreshed. Postpartum insomnia seems to resolve as the postpartum period progresses. In their assessment of 37 healthy women (using the Insomnia Severity Index (ISI)) at two and six months postpartum, one team of researchers found that average sleep quality scores were better at six months than at two.⁴
However, improvement is rarely linear, and sleep issues can return or worsen at any point in response to stress or other factors, such as sleeplessness caused by pain medications.
According to the National Sleep Foundation, the average person needs between seven and eight hours of sleep each night. Undoubtedly, it's normal to experience disrupted sleep patterns during pregnancy and after childbirth.⁵
As a new mother, you may suffer from exhaustion and poor sleep quality due to hormonal changes, increased stress levels, and other physiological changes. While breastfeeding, you may struggle with falling asleep and staying asleep.
Sleep is necessary for a person’s health and well-being, and new moms are no exception. Lack of sleep negatively impacts mood and energy levels, causing stress and exhaustion. If you’re sleeping poorly, you may be less productive at home and work. In addition, evidence shows that sleep plays a crucial role in postpartum health and affects postpartum processes, including bonding with your baby.⁴
Postpartum insomnia is not recognized as a medical condition but as a symptom of other disorders, including depression, anxiety, and substance abuse. Insomnia lasting three months or less is considered short-term insomnia, while the International Classification of Sleep Disorders (ICSD) considers insomnia to be chronic if it lasts longer than three months.
Along with difficulty falling asleep, symptoms of insomnia may include vivid dreams, nightmares, and other disturbing thoughts and feelings.
Postpartum insomnia can lead to excessive daytime sleepiness, which causes cognitive impairments, memory loss, poor decision-making, and an increased risk of accidents. Other symptoms include low energy levels, frequent waking at night, fatigue during daytime hours, and difficulty concentrating.
Research shows that pregnant women who experience severe stress due to high anxiety, depression, and trauma are more likely to develop postpartum insomnia than others. When you have difficulty sleeping, you may feel irritable and depressed, experience weight gain, or suffer from headaches, muscle pain, and digestive problems. These symptoms can last for months or even years after delivery.⁶
Many mothers worry about their children waking up too much during the night. Sleeping problems might stem from stress or anxiety around new motherhood. Factors that may contribute to postpartum insomnia include:
Lack of restorative sleep before the baby's arrival
Stressors in life
Insomnia can result from hormonal changes occurring after childbirth. Lack of sleep causes increased cortisol (stress hormones) in the body, which leads to increased blood pressure and difficulty relaxing. Higher cortisol levels indicate the body cannot produce enough estrogen and progesterone hormones, which are necessary for regulating your sleep cycle.
Progesterone comes from cholesterol in the ovaries, adrenal glands, placenta, and brain. It plays a role in regulating moods, sexual desire, emotions, and memory. Low levels of these hormones can cause insomnia, nightmares, vivid dreams, exhaustion, irritability, and trouble falling asleep at night.
In addition to insomnia, many new moms experience anxiety postpartum. When you feel anxious, your body releases adrenaline into your bloodstream, stimulating your brain to secrete excess amounts of norepinephrine, a neurotransmitter that increases wakefulness.
A significant contributing factor to the onset of anxiety is the sudden change in hormones. Another symptom of stress is breast tenderness or pain. When these conditions occur together, it may be difficult to fall asleep at night.
Iron is necessary for many of the body’s essential processes. It is involved in oxygen transport, energy production, DNA synthesis, and the maintenance of healthy skin. Women who aren’t pregnant require about 18mg of iron daily to maintain normal hemoglobin levels (the protein that carries oxygen through the blood).
Most people get enough iron from their diet; however, some have trouble absorbing this mineral and may benefit from supplementation. Lack of dietary iron can cause fatigue, irritability, lack of concentration, and difficulty sleeping.
To have a healthy pregnancy, you should rest and avoid stress. Poor sleeping habits during pregnancy can get even worse after giving birth. Coming back from a high sleep debt can be challenging, so try to rest well before your baby is born.
Women with postpartum depression are more likely to experience postpartum sleep issues and vice versa. As many as one in seven new moms experience postpartum depression, which commonly causes anxiety, guilt, sadness, mood swings, difficulty concentrating, and, as noted, sleeping troubles.
Many mothers report sleeping problems related to romantic relationships. This problem is caused by a complex series of physical and emotional changes that take place during the transition into motherhood.
Physical trauma during childbirth is a risk factor for postpartum insomnia and depression. Labor and delivery are both taxing on the body and are associated with significantly elevated levels of cortisol and adrenaline.
High levels of cortisol and adrenaline from pain can interfere with sleep cycles, leading to insomnia.
Some women develop sleep disorders in their first pregnancy; however, there’s evidence sleep may worsen with subsequent pregnancies. While no cure currently exists for postpartum insomnia, you may find relief from medications, counseling, and lifestyle changes.⁷
Studies show that women who receive supportive counseling soon after delivery are less likely to suffer from postpartum depression and insomnia than those who don't get help. Talk therapy, including cognitive behavior therapy (CBT), has proven effective in treating postpartum insomnia. CBT helps you identify negative thought patterns and behaviors that contribute to depressive symptoms and teaches you how to cope with these feelings more effectively.
B vitamins are essential for many processes in the body and help your brain function optimally. They include folic acid, niacin, pantothenic acid, biotin, and choline. These vitamins are water-soluble and can improve conditions like postpartum depression, which may help with postpartum sleep.
Melatonin is produced naturally within the body. Darkness stimulates its production, while daylight inhibits it. Stress and other drugs that affect the nervous system can also lower the melatonin level in the bloodstream. Supplementing this hormone may be helpful when you suffer from sleep disorders caused by a lack of exposure to natural light.
A nutritious diet rich in protein, vitamins, and minerals can help your body recover from giving birth so you feel better. Consume plenty of vegetables, fruits, whole grains, lean meats, fish, nuts, and seeds. Avoid sugary junk food and carbonated drinks to keep yourself hydrated.
Avoid caffeine. While its stimulating effects may help you feel less drowsy during the day, they may linger into the night and worsen your insomnia. You should also abstain from alcohol. Despite its depressive nature, there’s evidence alcohol use may lead to sleep disturbances and poor sleep quality.⁸
Try eating foods high in magnesium and calcium (such as bananas and milk, respectively). Magnesium relaxes muscles, while calcium helps the body produce melatonin.
Practice stress-relieving techniques, such as breath focus, meditation, or yoga, to help you relax before bed. Clear your space of stressors, which may include work materials, clutter, or other things that might keep you awake. Put your electronics away and resist the urge to check your phone within the 30 minutes leading up to bedtime. Even if you don't feel tired, try to get around eight hours of sleep every night.
Sleeping issues related to newborn sleeping habits and the excitement and worry that come with a new baby are normal. However, if you experience persistent sleeping issues or your sleep troubles make it difficult to function during the day, see your doctor.
If you have trouble sleeping and other signs of postpartum depression, you may be among the many new moms struggling with the condition. Postpartum depression is a challenging but common condition that’s treatable. If you suspect you might have it, don’t hesitate to seek help from a qualified healthcare professional.
Postpartum insomnia causes fatigue, decreased energy levels, and poor concentration, which can affect your ability to care for your baby (and yourself). To improve your sleep, it’s essential you understand what’s causing your sleep troubles. Once you know the underlying causes, you can identify strategies to enhance sleep quality.
If you think you might be experiencing postpartum insomnia, see your doctor, who’ll work with you to pin down the cause and find an effective solution. Treatment options for postpartum insomnia may include medications, therapy, and lifestyle changes.
If you’re struggling with issues related to postpartum insomnia, contact the professionals at HealthMatch. We’ll help you understand your condition, help you investigate treatment options, and give you access to leading specialists. Visit our website or email us at email@example.com.
What is insomnia? | NIH: National Heart, Lung, and Blood Institute
How much sleep do we really need? | Sleep Foundation
Tips to psychologically prepare for birth | Centre of Perinatal Excellence
The nutrition source: Iron | Harvard T.H. Chan
What is postpartum depression and anxiety? | American Psychological Association
Melatonin and insomnia (1996)
Get enough sleep | Office of Disease Prevention and Health Promotion