Insomnia during early pregnancy is common, and it often occurs long before there is any bump to blame it on. Studies of pregnant women consistently find that sleep problems begin in the first trimester and affect a large share of patients, even those who slept easily before conceiving. The frustrating part is that early pregnancy is also when exhaustion is at its worst, so you can feel wiped out all day and still lie awake at night.
Here is what drives the insomnia, and what actually helps.
Progesterone Is Working Against You in Two Directions
Progesterone rises sharply after conception, and it has a sedating effect. That is why so many women describe first trimester fatigue as unlike any tiredness they have felt before.
This same hormone also fragments your sleep. It raises your core body temperature slightly, which can leave you feeling overheated at night, and it changes the structure of your sleep cycles so you wake more easily. Add in daytime napping to cope with fatigue, and your body’s sense of when it should be asleep gets scrambled fast.
The Bathroom Trips Start Earlier Than You Think
Many patients assume nighttime urination is a third trimester problem caused by the baby pressing on the bladder. It usually starts much sooner. Your blood volume begins increasing in the first weeks of pregnancy, and your kidneys filter more fluid as a result. Your uterus is also growing and sitting directly against your bladder well before it is visible from the outside.
Do not respond by cutting back on fluids overall, since staying hydrated matters for you and your pregnancy. Instead, shift more of your water intake to the morning and afternoon, and taper it in the two to three hours before bed.
