The majority of new mothers struggle with postpartum insomnia, which is often due to new responsibilities, hormonal changes, and/or postpartum depression.
Disrupted sleep during pregnancy and postpartum can increase inflammation and potentially lead to mood changes, weight gain, and elevated blood sugar.
The research behind treatments for postpartum insomnia is scarce, but limited evidence points to cognitive behavioral therapy as a top treatment for sleepless moms.
Other insomnia treatments that are safe for both mom and baby include exercise, meditation, relaxation techniques, and probiotics.
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source]. Aside from poor sleep, some other symptoms of postpartum depression include [4 Trusted SourcePubMedGo to source]:
Changes in eating patterns
Difficulties with concentration and thinking
Feelings of worthlessness
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 Trusted SourcePubMedGo to source]. 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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source]. 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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
Some major signs that loss of sleep during pregnancy and after childbirth may be causing inflammation include [5 Trusted SourcePubMedGo to source]:
Changes in mood, anxiety, and depression
Changes in appetite
Difficulty losing weight and/or weight gain post-pregnancy
Gestational diabetes or high blood sugar
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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
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).
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 Trusted SourcePubMedGo to source].
Sleep hygiene: Addresses abnormal sleep schedules (like a late bedtime), sleep behavior, and sleep disruptions, such as alcohol or electronics use.
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.
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 Trusted SourcePubMedGo to source], 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 Trusted SourcePubMedGo to source].
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.
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.
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 Trusted SourcePubMedGo to source]. Exercise can also help combat inflammation [21 Trusted SourcePubMedGo to source, 22 Trusted SourcePubMedGo to source], 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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source].
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 Trusted SourcePubMedGo to source]. One study that looked into music therapy for insomnia found that listening to music may significantly improve sleep quality and duration [35 Trusted SourcePubMedGo to source].
Other therapies that promote relaxation and may be beneficial for treating postpartum insomnia include:
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.
The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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