Resolve Postpartum Insomnia and Get Back to Sleep

Natural Ways to Get More Sleep After a New Baby

• What Causes Postpartum Insomnia?|
• Consequences of Postpartum Sleep Loss|
• Natural Treatments for Postpartum Insomnia|
• Getting Help for Postpartum Insomnia|

Have you had a hard time getting some shut-eye since childbirth? Research shows that you’re not alone, as 67% of women experience postpartum insomnia [1].

A massive influx of responsibilities, postpartum depression, and hormonal fluctuations can all disrupt your sleep-wake cycle during the postpartum period. Unfortunately, sleep deprivation among new moms can increase inflammation, causing low mood, anxiety, and difficulty losing weight.

But there’s good news if you find yourself tossing and turning after having a baby, as there are several effective treatments for postpartum insomnia that are safe for both you and the little one. 

While behavioral therapies have the most research supporting their use in postpartum insomnia compared to other treatments, probiotic supplements, exercise, and meditation may also be beneficial. Read on to figure out what may be causing your postpartum sleep loss and for help on how to get back to sleep fast. 

What Causes Postpartum Insomnia?

Postpartum sleep disturbances can be attributed to a number of factors, with some being fairly obvious, like a change in sleep patterns during the first year of childcare or the dreaded teething phase. 

Children’s fragmented sleep schedules, nighttime feedings, and a shift in home responsibilities can all throw off your circadian rhythm and lead to decreased sleep time and quality. Even the financial burden of a new addition to the family can keep some women (and their partners) awake at night [2].

Even more, if you already struggled with chronic insomnia prior to a new baby, you may be at a higher risk for developing postpartum insomnia [2].

Could It Be Postpartum Depression?

There can be a deeper reason why you’re not getting enough sleep at night after giving birth. Postpartum depression is linked to insomnia, and its effects can be seen as early as the third trimester (known as perinatal depression) [3]. Aside from poor sleep, some other symptoms of postpartum depression include [4]:

• Changes in eating patterns
• Difficulties with concentration and thinking
• Feelings of worthlessness
• Anxious thoughts
• Psychosis and delusions (rare)

Unfortunately, changes in sleep due to postpartum depression can increase inflammation, which further influences mood and anxiety levels, creating a vicious cycle [5]. However, help is on the way, as there are several things you can do to get your sleep cycle back on track.

If you believe you may have postpartum depression that is contributing to your insomnia, it’s important that you speak with your healthcare provider as soon as possible. While many women with depressive symptoms may see benefit from natural treatments, some may require more help, like prescription antidepressants and regular therapy.

How Hormones Play a Role in Insomnia

Hormonal changes can also influence sleep both during pregnancy and postpartum. Estrogen and progesterone are naturally occurring hormones that regulate the menstrual cycle and help maintain pregnancy. Their levels significantly increase during pregnancy, and fluctuations in these hormones are believed to contribute to perinatal insomnia and may even lead to restless leg syndrome (RLS) [2].

Progesterone tends to have an overall relaxing and calming effect on the body, which can be beneficial during pregnancy, as higher levels of progesterone are linked to better sleep [2]. However, its levels sharply decline after childbirth and can add to postnatal sleep problems among new mothers.

Changes in estrogen and progesterone levels are also believed to contribute to vasomotor symptoms, like night sweats, which can further interrupt your sleep [6]. 

Melatonin is a major hormone that regulates the sleep-wake cycle and helps you fall asleep at night. It’s secreted after dark and is inhibited by light — if you’ve ever wondered why electronic use before bed is a bad idea, this is partially why. 

Research shows that postpartum women have altered levels of melatonin, which disrupts the circadian rhythm and can cause difficulties with falling and staying asleep [7].

The Consequence of Postpartum Insomnia

Increased inflammation appears to be a significant repercussion of postpartum sleep problems. Inflammation levels are generally higher during pregnancy and are worsened by postpartum sleep deprivation [5].

Some major signs that loss of sleep during pregnancy and after childbirth may be causing inflammation include [5]:

• Changes in mood, anxiety, and depression
• Changes in appetite
• Difficulty losing weight and/or weight gain post-pregnancy
• Gestational diabetes or high blood sugar
• Preterm labor

You may especially be at higher risk for insomnia-induced inflammation (and any of the above conditions) if you’re of non-Caucasian descent, as research shows that African American women have a higher inflammatory response during pregnancy [5].

Now that you know some of the culprits behind postpartum insomnia, what can you actually do about it? 

Unfortunately, many prescription and natural sleep aids (including melatonin) may be unsafe for postpartum use, as they’re easily passed through breastmilk and can disrupt the baby’s natural circadian rhythm or cause other side effects [8].

However, there are several potential treatments for postpartum insomnia that are safe for both you and your little one. Let’s dig in.

The Best Natural Treatments for Postpartum Insomnia

Getting naps throughout the day and practicing good sleep hygiene are a great place to start to help improve postpartum insomnia [8], but may not be enough for everyone.

While the research on approved treatments for postpartum insomnia is scarce, there are some emerging sleep therapies for pregnancy, making them a favorable option for use during the postpartum period. 

Furthermore, there are several research-backed treatments that are effective for alleviating insomnia in the general population, and are safe to try during the postnatal period (even if you’re breastfeeding). 

Behavioral Therapy

Changes in behavior surrounding sleep appear to have the most benefit for treating postpartum and perinatal insomnia. Cognitive behavioral therapy for insomnia (CBT-i) may be more effective at treating insomnia than prescription sleep aids and is preferred during pregnancy [5].

CBT-i addresses sleep-related behaviors and primarily consists of three main components [5, 9]:

1. Sleep hygiene: Addresses abnormal sleep schedules (like a late bedtime), sleep behavior, and sleep disruptions, such as alcohol or electronics use.
2. Stimulus control: Associates the bed with sleep and decreases its association with wakefulness. It consists of several components, such as leaving the bed and not checking the time when you can’t sleep at night.
3. Mild sleep restriction: Initially restricts the amount of time spent in bed to reduce nighttime awakenings, then slowly increases the duration while maintaining sleep quality. This step may not be ideal for pregnant women or during the postpartum period where nighttime awakenings are frequent.

One study explored the effects of sleep-behavioral training (delivered by a healthcare provider) on maternal well-being and infant sleep during the postpartum period. This training consisted of lectures, role playing, written materials, and confronting common sleep disturbances (like sleep-related partner conflicts). The researchers found that the training improved infant sleep disturbances and maternal depression [10], making CBT-i a promising therapy for postpartum insomnia.

Smartphone apps now allow digital access to CBT-i, also known as dCBT-i. While dCBT-i may help improve insomnia remission rates in pregnancy and prevent postpartum depression and anxiety, it doesn’t appear to affect the severity of insomnia during pregnancy [11].

However, as postpartum depression and mood changes are linked to sleep disturbances, and digital CBT is more accessible than in-person behavioral training, it’s not a bad place to start if you’re looking for help with postpartum insomnia.

Probiotics

These beneficial bacteria are just one of many supplements that can help with insomnia, and several studies show that those who took probiotics had improvements in sleep quality [12, 13, 14]. Probiotics may also improve sleep issues in those with depression [15], making it a hard-hitting treatment for women who have insomnia related to postpartum depression. You may even get an added benefit of better mood, as several studies show improvements in anxiety and depression with probiotic use [16, 17, 18, 19, 20]. 

While these studies didn’t specifically look at probiotic use in postpartum depression, they appear to have significant benefits on sleep overall. Even better, they’re safe to take while breastfeeding, making them a viable option for most moms. 

Physical Activity

Exercise is well-known to have beneficial effects on sleep and is safe after childbirth, making it an effective therapy for postpartum insomnia. A 2017 systematic review showed that regular exercise helps adults sleep better, overall [21]. Exercise can also help combat inflammation [21, 22], making it an even better option for postpartum women who tend to suffer from higher inflammation levels.

Another study found that those who participated in high-intensity interval training (HIIT) reported significant improvements in sleep quality and moderate improvements in sleep efficiency (the amount of time in bed actually spent sleeping) [23].

However, it may be best to stick to exercising earlier in the day, as vigorous physical activity performed within an hour before bedtime can reduce total sleep time, make it take longer to fall asleep, and impair sleep efficiency [24].

Meditation and Relaxation Techniques

Calming your mind may also be extremely helpful for postpartum insomnia, as research shows those who practiced mindfulness meditation had reduced nighttime awakenings and took less time to fall asleep [25]. These findings are backed by several studies that found it to improve overall sleep quality and effectively treat insomnia [25, 26, 27, 28, 29].

Exercises that incorporate meditative movements, such as yoga, tai chi, and qigong, also improved sleep quality in those with a wide array of health conditions, though none looked directly at postpartum women [29, 30, 31, 32, 33]. These exercises also have the added benefit of improving depression and may be especially helpful for new moms dealing with low mood or other mental health issues [30].

Relaxation techniques, such as guided imagery, music, muscle relaxation, and deep breathing are commonly used in CBT-i and may have lasting benefits in treating perinatal insomnia [34]. One study that looked into music therapy for insomnia found that listening to music may significantly improve sleep quality and duration [35].

Other therapies that promote relaxation and may be beneficial for treating postpartum insomnia include:

• Taking a warm bath [36]
• Getting a professional back massage [37]
• Drinking chamomile tea [38]
• Receiving acupuncture therapy [34, 39]

These techniques are natural, safe, and a great option for first-time moms who are struggling with getting enough sleep and want to wake up feeling more energized. 

Help for Postpartum Insomnia Is on the Way

Many women who have recently had a baby struggle with postpartum insomnia, so you’re certainly not alone. Changes in home responsibilities and daily schedules among new parents, hormonal fluctuations, and even postpartum depression can all lead to sleepless nights.

Fortunately, there are several safe and natural options that can help you get your ZZZs. Cognitive behavioral therapy, exercise, mindfulness, and relaxation techniques can all promote sleep in postpartum women, and are completely safe to try while breastfeeding. 

If you’re having trouble sleeping at night and would like some help, you can schedule an appointment with our functional medicine center. You can also check out my book, Healthy Gut, Healthy You, to learn all about how gut health can impact your sleep. 

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