Postpartum Insomnia: Why You Can’t Sleep After Giving Birth

Quick answer: Postpartum insomnia is trouble falling or staying asleep after childbirth, even when your baby is asleep, and you have time to rest. Hormonal changes, pain, anxiety, and disrupted sleep patterns may contribute. Contact a healthcare professional if it persists, worsens, or affects your mood or daily functioning.

Interrupted sleep is expected when you are caring for a newborn. Your baby may wake several times during the night for feeding, changing, or comfort, leaving you with very little uninterrupted sleep.

But what if your baby is asleep and you are still wide awake?

You may feel physically exhausted but unable to settle. You might fall asleep briefly, wake an hour later, and struggle to drift off again. For some people, worrying about missing their chance to sleep makes the problem even worse.

This may be a sign of postpartum insomnia rather than sleep loss caused only by newborn care.

What is postpartum insomnia?

Postpartum insomnia describes ongoing difficulty falling asleep, staying asleep, or returning to sleep after giving birth, even when you have a reasonable chance to rest.

Researchers differentiate insomnia from sleep disruption during the perinatal period caused by newborn care, where sleep is shortened or interrupted due to the baby's needs. Although both can lead to exhaustion and may occur simultaneously, they are not the same issue [1]. 

Insomnia can also affect how you feel and function during the day. You may notice low energy, irritability, difficulty concentrating, or growing anxiety about whether you will sleep that night.

Is postpartum insomnia normal after giving birth?

Sleep disruption is expected during the newborn stage. Being unable to sleep when you have a chance to rest is different and should not automatically be dismissed as part of having a baby.

A helpful question is:

When my baby is settled, and someone else is available to help, can I fall asleep?

If the answer is consistently no, insomnia may be contributing to your sleep problems.

You may experience both at the same time. Newborn care may leave you with less time to sleep, while insomnia can make it difficult to sleep during the rest periods you do get.

What are the symptoms of postpartum insomnia?

Postpartum insomnia may involve one or more of the following:

• Taking a long time to fall asleep

• Waking repeatedly when your baby does not need you

• Waking earlier than intended and being unable to return to sleep

• Feeling alert or restless when you want to sleep

• Getting sleep that does not leave you feeling refreshed

• Worrying about sleep throughout the day

• Watching the clock or calculating how little sleep remains

• Feeling tense or anxious as bedtime approaches

Lack of sleep can also affect how you feel during the day. You may experience:

• Fatigue or low energy

• Irritability

• Difficulty concentrating

• Forgetfulness

• Headaches

• Reduced patience

• Low mood

• Feeling overwhelmed by ordinary tasks

Fatigue by itself does not necessarily mean you have insomnia. Many new parents feel tired because their sleep is interrupted. The more specific sign of postpartum insomnia is difficulty sleeping even when you have a chance to rest.

What causes postpartum insomnia?

Several changes after childbirth can affect sleep at the same time. The combination will not be the same for everyone.

Physical and hormonal recovery

Estrogen and progesterone levels fall sharply after childbirth. Your body is also adjusting to fluid changes, feeding, healing, and the physical demands of caring for a newborn.

Postpartum hormone changes may contribute to sweating and changes in body temperature. Night sweats can wake you or make it difficult to get comfortable again [2].

Pain may also interfere with sleep after either a vaginal or cesarean birth. Perineal soreness, incision pain, uterine cramping, headaches, breast discomfort, and muscle aches can all make it harder to settle.

Pain that prevents you from caring for yourself or your baby should be discussed with your healthcare professional.

Anxiety and heightened alertness

After giving birth, you may find yourself listening for every sound your baby makes. You might wake to check whether your baby is breathing, wake at small movements that would not have disturbed you before, or feel unable to switch off even when someone else is caring for your baby.

Some degree of alertness is understandable when caring for a newborn. It can interfere with sleep when your mind remains on watch even while someone else has taken over.

Worrying about sleep can also keep insomnia going. Checking the time, counting the hours until morning, and trying to force yourself to sleep can increase frustration and alertness.

An unpredictable sleep schedule

Feedings, diaper changes, pumping, and irregular naps can make your sleep schedule difficult to predict. Bright light and screen use during the night may increase alertness and make it harder to return to sleep.

Your circadian rhythm uses light and darkness to help regulate when you feel awake or sleepy. Keeping nighttime light low may make it easier to settle again after caring for your baby.

Postpartum depression or anxiety

Sleep problems can occur alongside postpartum anxiety or depression. Anxiety may cause racing thoughts, panic, physical tension, or constant worry. Depression may cause low mood, hopelessness, reduced interest, or changes in sleep and energy.

Sleep problems alone do not mean you have a mood disorder, but persistent changes in both sleep and mood deserve medical attention.

Postpartum thyroiditis

Sometimes insomnia has a medical cause that can resemble ordinary postpartum stress.

Postpartum thyroiditis is inflammation of the thyroid that can occur during the first year after childbirth. It affects an estimated 5% to 10% of postpartum women [3].

Its overactive phase often begins one to four months after delivery and may cause:

• Insomnia

• Anxiety or irritability

• A fast or pounding heartbeat

• Heat intolerance

• Unexplained weight loss

• Shakiness

• Fatigue

A later underactive phase may cause low mood, constipation, dry skin, weight gain, and severe fatigue.

Tell your healthcare professional if insomnia occurs with heart palpitations, sensitivity to temperature, or unexplained weight changes. A blood test can help determine whether your thyroid is involved.

Other sleep or health conditions

Insomnia may also be affected by a condition that existed before pregnancy or developed during it.

Your healthcare professional may consider:

• Sleep apnea, especially if you snore or wake up gasping

• Restless legs syndrome

• Acid reflux or GERD

• Medication side effects

• Anemia

• Chronic pain

Tell your healthcare professional about any prescription medicines, over-the-counter medicines, vitamins, and supplements you take.

How long does postpartum insomnia last?

There is no single timeline. Some parents notice that their sleep gradually improves as pain decreases, physical recovery progresses, and their baby begins sleeping for longer periods. Others continue to struggle for months, particularly when anxiety, depression, pain, or worry about sleep are also present.

Research shows that insomnia symptoms can continue beyond the early newborn stage for some mothers [4]. This is why it is more useful to look at how your sleep is changing than to rely on a specific deadline.

Consider these questions:

• Is it becoming easier to sleep when I have time to rest?

• Is my sleep improving as my baby’s sleep becomes more predictable?

• Am I becoming increasingly anxious about bedtime?

• Is sleep loss affecting my mood, concentration, or ability to function?

Insomnia that occurs at least three nights a week for three months or longer is considered chronic. You do not need to reach that point before seeking support.

What can help with postpartum insomnia?

What helps with postpartum insomnia depends on what is contributing to it. Good sleep hygiene may support recovery, but persistent symptoms may require CBT-I or treatment for an underlying condition.

Protect time to rest

When possible, ask a partner, family member, or another support person to cover part of the nighttime care.

Depending on your feeding plan, that person may be able to handle diaper changes, burping, settling, bottle-feeding, or bringing the baby to you only when needed. The goal is to create a period when you are not responsible for listening for every movement.

Use available breaks for sleep or quiet rest without pressuring yourself to fall asleep immediately. The advice to “sleep when the baby sleeps” can feel frustrating when insomnia is the problem.

Reduce nighttime stimulation

During nighttime feedings or pumping:

• Keep the room dim

• Avoid checking the time repeatedly

• Turn down your phone brightness or keep the phone away

• Keep conversations and activities quiet

• Return to bed once care is complete

A cool, dark, and quiet bedroom may also help, particularly if postpartum night sweats are waking you.

Be mindful of your caffeine intake

Caffeine may feel necessary after a difficult night, but using it later in the day can make it harder to fall asleep.

Try keeping coffee, tea, energy drinks, and other caffeinated products to the earlier part of your day. Your healthcare professional can also advise you about caffeine intake while breastfeeding.

Keep a brief sleep record

For one or two weeks, write down:

• When you tried to sleep

• How long you think it took to fall asleep

• How often you woke for your baby

• How often you woke without a clear reason

• Medications and supplements

• Caffeine use

• Mood or anxiety changes

• Physical symptoms such as pain, sweating, or a racing heartbeat

This can help your healthcare professional determine whether your sleep problems are mainly related to newborn care, insomnia, a medical condition, or several factors at once.

Ask about CBT-I

Cognitive behavioral therapy for insomnia, or CBT-I, is a structured treatment that helps address the thoughts and behaviors that keep insomnia going.

It can help with:

• Anxiety about not sleeping

• Clock-watching

• Spending long periods awake in bed

• Irregular sleep timing

• Thoughts that increase pressure around sleep

Clinical trials have found that CBT-I can reduce postpartum insomnia symptoms [5]. Because newborn care can interrupt sleep at unpredictable times, CBT-I may need to be adapted to your recovery and caregiving responsibilities.

Ask your healthcare professional about a referral to a sleep specialist, a therapist trained in CBT-I, or an evidence-based digital CBT-I program.

Address other conditions affecting your sleep

Sleep may improve when the underlying problem is addressed. Treatment could involve:

• Better pain control

• Care for postpartum anxiety or depression

• Treatment for reflux

• Thyroid testing and treatment

• Evaluation for sleep apnea or restless legs syndrome

• Changing a medicine that affects sleep

Tell your healthcare professional about all your symptoms rather than discussing sleep in isolation.

Can you take sleep medication while breastfeeding?

Medication safety during breastfeeding depends on the specific medicine, dose, timing, your baby’s age, and whether your baby was born prematurely.

Some prescription sleep medications and over-the-counter sleep aids may be considered in certain situations, while others may not be appropriate. A healthcare professional or pharmacist can help weigh the possible benefits and risks.

Research on melatonin supplements during breastfeeding remains limited. The LactMed database states that there are no direct safety data on maternal melatonin use while breastfeeding. It also notes that short-term use at usual doses is unlikely to affect most breastfed infants, although some experts recommend avoiding it because of the limited evidence, particularly when nursing a preterm newborn [6].

Ask your healthcare professional or pharmacist before taking any sleep medicine or supplement.

Also Read: Is Melatonin Safe Long-Term? A Sleep Physician Explains

How is postpartum insomnia connected to mental health?

Sleep and mental health are closely connected. Persistent insomnia may increase emotional distress and make it harder to cope with recovery and newborn care. Postpartum depression and anxiety can also make it more difficult to fall asleep or return to sleep.

Sleep problems alone do not mean you have a mood disorder. However, changes in sleep that occur alongside changes in your mood, thoughts, or ability to function should be discussed with a healthcare professional.

When should you seek help?

Contact a healthcare professional promptly if:

• You are regularly unable to sleep when you have a chance to rest

• Your sleep is getting worse instead of better

• Sleep loss is affecting your ability to function

• You are struggling to care for yourself or your baby

• You feel persistently anxious, panicked, depressed, or hopeless

• You have intrusive or frightening thoughts that are causing distress

• You are experiencing ongoing pain or other physical symptoms

• You have loud snoring, gasping, or choking during sleep

• You have a racing heartbeat, heat intolerance, or unexplained weight changes

You do not need to wait until the problem has lasted three months or until your next routine postpartum appointment.

Get emergency help immediately if you experience:

• Confusion or severe disorientation

• Hallucinations

• Paranoia

• Beliefs that are not based in reality

• Severe agitation or rapidly changing behavior

• Unusually high energy despite getting little or no sleep

• Thoughts of harming yourself or your baby

• Feeling unable to keep yourself or your baby safe

These may be signs of postpartum psychosis or another serious mental health emergency. Postpartum psychosis can begin suddenly, often within the first few weeks after delivery, and requires immediate medical care.

For free, confidential maternal mental health support in the United States, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA (1-833-852-6262). It is available 24 hours a day in English and Spanish, with interpreters available for additional languages.

For a mental health or suicidal crisis, call or text 988. If you or your baby is in immediate danger, call 911.

Frequently asked questions

Can postpartum insomnia happen when your baby is sleeping?

Yes. The main sign is being unable to fall asleep or stay asleep despite having time to rest. This distinguishes insomnia from waking only because your baby needs care.

Is postpartum insomnia caused by hormones?

Hormonal changes may contribute, especially when night sweats or changes in body temperature affect sleep. However, postpartum insomnia usually involves several factors, such as pain, anxiety, irregular sleep timing, newborn care, or a medical condition.

Can breastfeeding affect your sleep?

Breastfeeding does not automatically cause insomnia, but nighttime feedings, pumping, breast discomfort, and concerns about the baby may interrupt sleep. A partner or support person may still be able to help with diapering, settling, and other nighttime tasks.

Can postpartum anxiety make it difficult to sleep?

Yes. Postpartum anxiety may cause racing thoughts, physical tension, constant checking, panic, or difficulty relaxing. Anxiety about whether you will sleep can also keep the insomnia cycle going.

Can you take melatonin while breastfeeding?

There are no direct safety data on maternal melatonin use while breastfeeding. Ask your healthcare professional or pharmacist before taking melatonin or another sleep supplement, particularly if your baby is a newborn or was born prematurely.

Should you wait three months before contacting a doctor?

No. Three months is part of the definition of chronic insomnia, not a required waiting period. Seek help earlier if sleep problems are severe, worsening, affecting daily functioning, or occurring with physical or mental health symptoms.

The bottom line

Caring for a newborn often means interrupted sleep. But being unable to sleep when your baby is settled, and you have time to rest, may point to postpartum insomnia.

You do not have to wait for the problem to become chronic. Tell your healthcare professional how much sleep you are getting, what keeps you awake, and whether you have noticed changes in your mood, thoughts, pain, or physical health.

Identifying what is driving the insomnia can help you find treatment that fits your recovery, feeding plan, and family situation.

This article is for educational purposes and does not replace medical advice, diagnosis, or treatment.

About the author

Dr. Ruchir P. Patel, MD, FACP, is the Medical Director of the Insomnia and Sleep Institute of Arizona and the founder of Sip2Sleep. He is triple board-certified in sleep medicine, obesity medicine, and internal medicine. Dr. Patel is a multi-year Phoenix Magazine Top Doctor and holds the Inspire Excellence designation.

References

1. Quin, N., Lee, J. J., Pinnington, D. M., Newman, L., Manber, R., & Bei, B. (2022). Differentiating perinatal Insomnia Disorder and sleep disruption: a longitudinal study from pregnancy to 2 years postpartum. Sleep, 45(2), zsab293. https://doi.org/10.1093/sleep/zsab293 

2. Chauhan G, Tadi P. Physiology, Postpartum Changes. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555904/

3. Carlson K, Mikes BA. Postpartum Thyroiditis. [Updated 2025 Nov 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557646/

4. Sivertsen, B., Hysing, M., Dørheim, S. K., & Eberhard-Gran, M. (2015). Trajectories of maternal sleep problems before and after childbirth: a longitudinal population-based study. BMC pregnancy and childbirth, 15, 129. https://doi.org/10.1186/s12884-015-0577-1

5. Manber, R., Bei, B., Suh, S., Simpson, N., Rangel, E., Sit, A., & Lyell, D. J. (2023). Randomized controlled trial of cognitive behavioral therapy for perinatal insomnia: postpartum outcomes. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 19(8), 1411–1419. https://doi.org/10.5664/jcsm.10572

6. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Melatonin. [Updated 2026 Apr 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501863/