Pregnancy and sleep: How hormonal changes and sleep deprivation impact maternal health

Pregnancy is a journey filled with joy, anticipation, and undeniable physical and emotional changes. But if there's one thing many expecting mothers struggle with silently, it's sleep. And it’s not just about tossing and turning—sleep deprivation during pregnancy can have serious consequences for both the mother and the baby.

Why sleep during pregnancy is not just a luxury
“Sleep is as vital as nutrition and prenatal care,” says Dr. Kavita Shirkande. During pregnancy, your body goes into overdrive to support the growing baby. Hormonal shifts, physical discomfort, and emotional changes all demand that you rest and recover—yet many pregnant women find it increasingly difficult to get a full night’s sleep.

Dr. Shirkande explains that sleep isn’t just essential for maternal well-being; it plays a critical role in fetal development too. “Adequate sleep helps avoid complications like hypertension, gestational diabetes, mood swings, and even postpartum depression in mothers,” she says. “For the baby, proper maternal sleep supports healthy growth, reduces the risk of low birth weight and premature labor, and supports cognitive development.”

What happens when you don’t sleep enough during pregnancy?
Dr. Bijal Mistry Kasar warns that sleep deprivation can be more damaging than most people realize. Pregnant women sleeping less than 6 hours a night are at increased risk of:

• Gestational Diabetes Mellitus (GDM)
• Hypertension
• Preterm labor
• Prolonged labor
• Depression and anxiety

And the list doesn’t end there. “Insomnia in pregnancy has been linked with higher maternal mortality and morbidity,” says Dr. Kasar. Even short-term sleep loss can trigger mood swings, memory issues, headaches, body aches, and overall fatigue. Long-term deprivation, on the other hand, increases the risk of developing type 2 diabetes, cardiac issues, and chronic mental health disorders like depression and anxiety.

The hormonal connection: Estrogen, Progesterone & Cortisol
One of the key reasons sleep becomes so elusive during and after pregnancy is hormones.

Both doctors highlight how hormonal fluctuations affect sleep. “There’s a sharp drop in estrogen and progesterone levels post-delivery, which disrupts the body’s natural sleep pattern,” says Dr. Shirkande. These hormonal changes, coupled with the physical fatigue of childbirth and the demands of caring for a newborn, create a perfect storm for chronic sleep deprivation.

Dr. Kasar adds another layer: “Pregnancy, postpartum, menopause, and PCOS all involve some degree of hormonal imbalance. These fluctuations affect levels of estrogen, progesterone, and cortisol—hormones that play a crucial role in regulating sleep.” This condition, often referred to as hormonal insomnia, can persist for weeks or even months if not addressed properly.

Estrogen and melatonin—two hormones closely tied to sleep regulation—are essential for achieving restful REM (rapid eye movement) sleep. When these hormones dip, as they often do during pregnancy and postpartum, sleep becomes fragmented and less restorative.

Postpartum period: A new set of sleep challenges
Just when you think you've made it through the sleepless nights of pregnancy, the postpartum period introduces new hurdles. Between feeding sessions, diaper changes, and the constant worry that comes with new motherhood, sleep can feel like a distant dream.

Dr. Shirkande points out that the postpartum period brings significant biological changes: “Increased frequency of urination, pressure on the lungs, leg cramps, acid reflux—all these affect sleep.” Add to that the emotional rollercoaster caused by fluctuating hormones and the stress of caring for a newborn, and you’ve got a major sleep crisis on your hands.

This isn’t just about fatigue. Chronic sleep deprivation in new mothers can lead to postpartum depression, reduced milk supply, impaired decision-making, and even hinder the body’s ability to heal after childbirth.

So, what can be done?
The good news? There are ways to manage and improve sleep during pregnancy and beyond:

1. Prioritize sleep hygiene
Create a calming nighttime routine. Avoid screens an hour before bed, keep your room cool and dark, and try relaxation techniques like deep breathing, prenatal yoga, or meditation.

2. Nap smartly
Daytime naps can help compensate for lost nighttime sleep—but limit them to 30-45 minutes to avoid disturbing your night cycle.

3. Stay active
Light to moderate physical activity during the day can promote better sleep at night. Just avoid exercising too close to bedtime.

4. Seek support
New mothers often hesitate to ask for help, but sharing responsibilities—especially nighttime duties—can be a game changer for your mental and physical health.

5. Speak to your doctor
If you’re experiencing persistent insomnia, anxiety, or symptoms of depression, don’t brush it off. Professional support, whether it’s therapy, nutritional advice, or medical intervention, can make a huge difference.

Both Dr. Kasar and Dr. Shirkande emphasize that poor sleep isn’t just a symptom—it’s a signal. It reflects deeper physiological and hormonal changes that need to be addressed for overall maternal and fetal health. Ignoring these signs can have long-term repercussions, including chronic diseases and emotional imbalances.

Pregnancy is a time to nurture yourself as much as your growing baby. While sleepless nights may seem inevitable, understanding the root causes and taking steps to protect your sleep can make this journey healthier and more joyful.

Sleep isn’t a luxury during pregnancy—it’s a necessity. From regulating hormones to supporting fetal development and preventing complications, quality rest is one of the most powerful tools in an expecting mother’s health arsenal. So, the next time you feel guilty about sneaking in a nap, remember: you’re not being lazy—you’re investing in the well-being of two people.