Insomnia During Pregnancy, Treated Without Medication
Work with a licensed sleep psychologist. Covered by insurance. Delivered virtually.
Virtual CBT-I with a licensed clinical psychologist, across 39 states and Washington, D.C. RISE bills major insurance plans directly; network status, benefits and out-of-pocket costs are verified with your plan before treatment begins.
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Pregnancy insomnia is trouble falling or staying asleep that starts or worsens during pregnancy, most often in the first and third trimesters. It is treatable without medication: Cognitive Behavioral Therapy for Insomnia (CBT-I) is the structured, non-drug treatment the American Academy of Sleep Medicine recommends as first-line care for chronic insomnia, and it fits pregnancy because it involves no medication at all.
What is pregnancy insomnia and how common is it?
Difficulty falling or staying asleep during pregnancy, most often reported in the first and third trimesters. Pregnancy insomnia has physical drivers that ordinary insomnia does not: nausea, reflux, hip and back pain, restless legs, and the frequent waking that comes with a growing uterus pressing on the bladder. Those sit on top of the anxiety and rumination that keep any insomnia going. At the RISE Sleep Clinic, CBT-I for pregnancy is delivered over video by a licensed clinical psychologist and adapted around the discomfort that changes trimester to trimester. It does not replace your obstetric care: anything needing a prescriber or an OB assessment goes back to them.
What are the signs and symptoms of pregnancy insomnia?
Waking repeatedly through the night
Frequent waking is near-universal in the third trimester: bladder pressure, position changes, heartburn. Insomnia is what happens when getting back to sleep becomes the harder problem than the waking itself.
Lying awake anxious about the birth or the baby
Rumination at 3am about labor, delivery, finances, or returning to work. The thoughts are reasonable. The problem is that the bed becomes the place they happen.
Restless legs at night
Restless legs syndrome is more common in pregnancy than outside it, and it is a physical driver rather than a behavioral one. Raise it with your obstetric provider: it is sometimes linked to iron status.
Daytime exhaustion that sleep doesn't fix
Sleeping longer without sleeping better. Fragmented sleep leaves people tired in a way that extra hours in bed tend to make worse rather than better.
If this sounds familiar
Pregnancy insomnia is treatable. CBT-I is the non-drug treatment the American Academy of Sleep Medicine recommends as first-line care for chronic insomnia.
Check Insurance & Get StartedPrevalence statements reflect the range reported across obstetric sleep literature, where estimates vary widely by trimester and by how insomnia is defined. Deliberately stated as a range rather than a single figure. Specialist counts are from the American Board of Sleep Medicine's public directory (my.absm.org), counted 2026-09-03 with scripts/count-absm-directory.mjs against the snapshot committed at data/sources/absm-snapshot-2026-09-03.html. It is a certification roster rather than an availability roster, so it overstates how many clinicians are reachable.
Why pregnancy insomnia is hard to get treated
Pregnancy insomnia sits in a gap between two specialties. Obstetric care is built around the pregnancy, sleep medicine around sleep disorders. Insomnia in pregnancy belongs to both and is owned by neither, so most people are told it is normal and to wait it out.
- The default answer is that it is normal: It is normal, in the sense that most pregnant people experience it. That is not the same as untreatable, and the distinction matters when insomnia runs for months rather than weeks. Chronic insomnia does not reliably resolve at delivery. For some people it carries into the newborn period, where sleep is already scarce.
- The medication route is mostly closed: Most prescription sleep medication is not first-line in pregnancy, and decisions about anything taken during pregnancy belong to your obstetric provider. That narrows the options, which is why a non-drug treatment matters more here than in the general population, not less.
- The specialists are scarce and slow to reach: The American Board of Sleep Medicine's public directory of certified behavioral sleep medicine specialists lists 203 practice locations across 38 states and the District of Columbia. Twelve states have none at all. Reaching one usually means a referral, a wait, and a drive, during a period that already has a full calendar of obstetric appointments.
- The window is short and it keeps moving: A trimester is roughly thirteen weeks and a course of CBT-I runs six to ten. Anything that adds a two-month wait to the front of that spends the window it was meant to treat.
Virtual care answers all four. Sessions are weekly over video, they fit around obstetric appointments rather than competing with them, and treatment can start in days rather than after a referral chain. It does not replace obstetric care: your clinician sends anything needing an OB assessment or a prescriber straight back to them.
How is pregnancy insomnia treated?
CBT-I in pregnancy uses the same components as CBT-I anywhere else, adapted for a body that is changing month to month. The component that needs the most care is sleep restriction, which narrows time in bed to rebuild sleep pressure. Your clinician adjusts or holds it depending on your trimester, your daytime sleepiness, and what your obstetric provider advises. It is not applied by default.
What CBT-I techniques are used for pregnancy insomnia?
Stimulus control
rebuilding the association between the bed and sleep
Sleep scheduling
adjusted by trimester rather than applied uniformly
Cognitive restructuring
working on the 3am spiral about birth, health, and money
Relaxation training
wind-down routines that work around physical discomfort
Environment and positioning
practical changes, coordinated with your obstetric care
First-line care
The American Academy of Sleep Medicine recommends CBT-I as first-line treatment for chronic insomnia
Time-limited
A structured course of weekly sessions, not an ongoing prescription
No medication
CBT-I involves no medication. Prescribing stays with your existing clinician
How you get matched to the right treatment
There is one intake, not a menu. You complete a structured sleep and clinical assessment, a licensed RISE clinician reviews your symptoms, history, screening results and insurance, and they match you to the format that fits: one-to-one CBT-I with a sleep psychologist, or prescription digital CBT-I, which delivers the same protocol through an app in about five to ten minutes a day. You do not pick the format and neither does a referring clinician. RISE evaluates and matches.
Both are CBT-I: two ways of delivering one protocol. The match turns on trade-offs, mostly cost, how quickly a clinician is available, whether a weekly appointment fits your schedule, how much support you want, and what else is going on medically. Live video is available in either, and you can step up from the digital program to sessions with a psychologist if that turns out to be what you need.
RISE bills major insurance plans directly; network status, benefits and out-of-pocket costs are verified with your plan before treatment begins.
RISE clinicians are licensed clinical psychologists. They do not prescribe medication. Starting, adjusting, tapering or stopping any sleep medication stays with your prescribing clinician unless that is specifically coordinated with them.
“I wish more people knew about this. I can finally sleep better without a cocktail of medications every night.”
The sleep psychologists
All of our clinicians are licensed in the states we cover, board-certified in behavioral sleep medicine or licensed psychologists with specialized training in CBT-I.
Dr. Jane Dyonzak
Ph.D., FAASM
Licensed Clinical Psychologist and Fellow of the American Academy of Sleep Medicine with 20+ years specializing in sleep and behavioral medicine. Dr. Dyonzak has served as a consultant to sleep disorders centers and principal investigator for clinical trials on sleep medications and devices.
Dr. Lauren Neaman
Psy.D., A-CBT
Licensed Clinical Psychologist and Diplomate of the Academy of Cognitive and Behavioral Therapies. Dr. Neaman completed advanced training through the University of Pennsylvania's Behavioral Sleep Medicine program and specializes in insomnia, anxiety disorders, and circadian rhythm issues.
Dr. Benjamin Pfeifer
Ph.D.
Founding clinician at RISE Sleep Clinic specializing in treating adults with insomnia and sleep disorders. Dr. Pfeifer completed his Ph.D. at The Ohio State University and holds PSYPACT authorization for telehealth practice. His background includes work with veterans at VA Ann Arbor Healthcare System.
Dr. Daniella Marchetti
Ph.D., DBSM
Licensed Clinical Health Psychologist and Diplomate in Behavioral Sleep Medicine. Dr. Marchetti specializes in insomnia treatment, CPAP adherence, nightmare therapy, and circadian rhythm disorders. She earned her doctorate from the University of Miami and completed her fellowship at the Miami VA Medical Center.
Frequently Asked Questions
Do I need a sleep doctor, my OB, or a sleep therapist for pregnancy insomnia?
Is CBT-I safe during pregnancy?
Can I take something to sleep while pregnant?
Which trimester is this most useful in?
Will this still help after the baby arrives?
Ready to treat pregnancy insomnia?
Take the assessment. We verify your coverage before treatment starts.
Check Insurance & Get StartedMedically reviewed by Dr. Chester Wu, MD — Double Board-Certified in Psychiatry and Sleep Medicine. Last reviewed 2026-09-06.
A physician reviews the clinical content on this page; the treatment itself is delivered by licensed psychologists. Those are deliberately two roles and two people.