Postpartum Insomnia

All new parents know that sleep is precious. Newborns need to eat frequently, which can make it challenging for parents to rest in between feeds. Older infants can go through periods of disrupted sleep, too, whether due to teething, a growth spurt or regression. And when your baby isn't sleeping well at night, neither are you.

For some parents, falling back to sleep after a midnight feed is as easy as returning to bed and shutting their eyes. But insomnia can make much-needed rest feel impossible for others.

Here's what new parents need to know about postpartum insomnia, including what causes insomnia after childbirth and how to manage your symptoms.

What is postpartum insomnia?

You may have heard of insomnia during pregnancy, or perhaps you suffered from it yourself. Thanks to vivid dreams, pre-birth anxieties and physical changes (frequent bathroom trips, heartburn and round ligament pain, to name just a few), insomnia is estimated to affect more than 75 percent of moms-to-be during the third trimester.

Insomnia can also occur after baby's birth. Falling back to sleep after nighttime interruptions can be difficult for some new parents. In some cases, insomnia can linger even after your baby is sleeping soundly through the night.

Frequent sleep struggles are considered short-term insomnia if they occur for fewer than three months, or chronic insomnia if continue at least three times a week for three months or longer.

What causes postpartum insomnia?

Poor sleep is closely linked to changes in routine and in your body — both of which are happening during the postpartum period. 

Possible causes of insomnia after childbirth can include:

• Stress
• Demanding newborn schedule
• Hormonal changes that affect a new mom's circadian rhythm
• Physical postpartum changes, such as breast engorgement or night sweats
• Postpartum depression (PPD) or postpartum anxiety
• Changes to your baby's sleep routine, such as teething or a regression
• General life changes as you adjust to parenthood

Is there a link between insomnia, postpartum depression and postpartum anxiety?

Research suggests that people with postpartum depression and postpartum anxiety are more likely to suffer from poor sleep. What's more, insomnia can increase the risk of developing anxiety and depression.

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Some symptoms of postpartum anxiety and postpartum depression can keep you up at night, including:

• Intense feelings of anxiety
• Social isolation
• Excessive concerns about your baby’s health
• Obsessive negative thoughts about you or your baby

If this sounds like something you’re experiencing — particularly if your symptoms continue for more than a few weeks and feel more intense than the "baby blues" — talk to your doctor or health care provider.

Your practitioner can recommend medications and strategies to help treat your symptoms, such as talk therapy or antidepressants. If you're breastfeeding, you may still be able to take certain kinds of antidepressants.

How can you manage and prevent postpartum insomnia?

If you’re exhausted and sleep deprivation is becoming a normal part of your routine, try these strategies:

• Consider your eating habits. Avoid caffeine and chocolate, both of which can keep you awake, especially if you indulge in the late afternoon or early evening. A big meal before bed may have the same effect.
• Hit the gym. Once your practitioner has given you the green light, ease back into a workout routine. Exercise may help you de-stress and even ward off postpartum depression, and getting your heart rate up during the day might make sleep easier to come by at night.
• Create a routine. A consistent bedtime routine helps babies develop good sleep habits, but a routine can be beneficial for parents, too. Slowing down signals to your body that it's time to rest. Dim the lights, put on comfy pajamas, listen to soft music, meditate, read a book, try restorative yoga and avoid screens a few hours before bed.
• Practice good sleep hygiene. Once you head to bed, keep your bedroom dark and quiet (a sound machine is a good investment for both you and baby). Keep your cellphone and other devices away from your bed, since the light can disturb your circadian rhythm and make falling asleep more difficult.
• Keep nighttime care brief. When your little one wakes up at night — whether for a feeding, diaper change or reassurance — do your best to keep the visit short. Feed, burp and change your baby, then immediately put him back to bed. Keep the room quiet and dark to prevent him from fully waking up.
• Ask your pediatrician about sleep training. If your baby is between 4 and 6 months old and still struggling to sleep (and preventing you from doing the same), you may want to consider sleep training. 
  

How can you treat postpartum insomnia?

Sleep disruptions are often part of being a new parent, but when they become chronic and insomnia prevents you from getting the rest you need to function, it's essential to seek help.

If your insomnia persists for more than a month, talk to your doctor. She might recommend that you consult a sleep behavioral psychologist to help you work through the challenges that are keeping you from getting the rest you need.

Your doctor may also recommend an over-the-counter or prescription sleep aid. If you're breastfeeding, make sure you ask for one that is safe for nursing moms. Some doctors advise against using melatonin while breastfeeding, for example.