Sleep in the Postpartum Period: What to Expect and Signs That It’s Time to Seek Help

By Elizabeth Culnan, PhD, DBSM

Sleep can be so hard to come by during the postpartum period. Most people are aware of this prior to having their baby, but it’s one thing to be told to expect some sleepless nights, and another thing to actually be in the thick of it. Whether you’re pregnant, planning a pregnancy soon, are newly postpartum, or are supporting someone who is pregnant or postpartum, read on to find out what you may expect when it comes to sleep – and when to seek out professional help.

The early postpartum weeks

Compared to the last weeks of pregnancy, women typically experience a decrease in the total amount of sleep they get each night, in addition to more awakenings at night and more time awake in the middle of the night during those first postpartum weeks (Signal et al., 2007). Sleep disruption at night may also lead to more daytime napping in an effort to catch sleep when you can. Sleep is more disrupted during the first week postpartum compared to the later weeks, although, of course, sleep is still far from back to baseline at this point (Lillis et al., 2025). For example, by the thirteenth week postpartum, the total amount of sleep mothers got was similar to the amount they were getting before they got pregnant. However, the longest uninterrupted stretch of sleep postpartum women were getting was still significantly shorter than before they got pregnant.

Why is this?

The most common reasons new parents face sleep disruption are their new baby’s sleeping and feeding patterns (Thomas and Foreman, 2005). During those first weeks, many babies seem to have their days and nights reversed. Babies also have sleep and wake periods that alternate over the 24-hour cycle. This is in part because newborn babies have not yet developed their own circadian rhythms. Circadian rhythms are like an internal body clock that helps signal when to sleep at night and helps with wakefulness during the day. There is, of course, individual variation in this, but babies begin to develop their circadian rhythms for sleep closer to the three-month mark (Joseph et al., 2015). Over the first three months, your baby will begin sleeping for longer stretches, which will hopefully help you get more and more sleep.

What can I do during these early weeks?

If you have a partner or a support system that can help with night wakings or feedings, try enlisting them for help. In addition to helping to decrease sleepiness and fatigue, our ability to sleep is highly related to mood, so having a plan in place can possibly serve as a preventative measure for postpartum depression or anxiety.

Some partners intentionally schedule their evenings based on who is more of a night owl and who is more of a morning person. For example, the early bird may go to sleep earlier in the evening and then attend to night wakings that occur during the middle of the night or early morning, while the night owl might remain awake attending to wakings until the middle of the night. Also, adding in what’s called a dream feed for your baby can help. A dream feed is where you give your baby one last feeding before you go to bed, while trying to wake them up only enough to feed.

Another coping strategy is to validate that this is a really challenging time, while reminding yourself that there is a light at the end of the tunnel – your baby’s sleep will improve over time, which will make it easier for you to also begin getting more sleep.

Three to six months Postpartum

At this point, you can expect your baby’s sleep to begin to have more of a typical day-night pattern. Although they will still likely be waking to feed, the number of times most babies wake during the night decreases throughout this period, and the longest uninterrupted stretch of sleep continues to increase (Galland, Taylor, Elder, & Herbison, 2012). This means that you, as a parent, will likely begin to feel like you’re able to sleep for much longer stretches overnight.

Many children also become capable of falling asleep independently at this age. More specifically, after a calming bedtime routine, they can be placed in their crib drowsy but awake and can fall asleep on their own from there. Learning this skill at bedtime can also help to decrease how often babies need help to get back to sleep during middle-of-the-night wakings. During the day, most babies also begin having consistent naps.

What can I do to help myself and my baby?

Try to have a consistent, relaxing bedtime routine both for yourself and for your baby. You can also try putting your baby down drowsy but awake to help encourage them to learn to fall asleep independently. The more consistency you can have with your bedtimes and wake times, the better.

When should I seek out help?

If you’re having trouble with insomnia (difficulty falling or staying asleep, despite your baby being able to get quickly back to sleep), you may benefit from seeking help from a therapist, psychologist, or other professional who treats insomnia. Many parents describe feeling extremely fatigued and sleepy, but battling worry and dread that their baby might wake up at any minute, which gets in the way of falling asleep. Other parents experience insomnia that is connected to postpartum depression or anxiety. For example, some parents describe having a racing mind, worrying about how they’re doing as a parent, fretting about their baby’s safety, or feeling the need to check on their baby to see that they are still breathing during the night. These experiences are common as a new parent – but treatment can help!

References

Galland, B. C., Taylor, B. J., Elder, D. E., & Herbison, P. (2012). Normal sleep patterns in infants and children: a systematic review of observational studies. Sleep medicine reviews, 16(3), 213-222.

Joseph, D., Chong, N. W., Shanks, M. E., Rosato, E., Taub, N. A., Petersen, S. A., … & Wailoo, M. (2015). Getting rhythm: how do babies do it?. Archives of Disease in Childhood-Fetal and Neonatal Edition, 100(1), F50-F54.

Lillis T., Hansen, D., & Van Dongen, H. (2025). Profound postpartum sleep discontinuity in first-time mothers [Poster presentation]. SLEEP, 48(S1), A398.

Signal, T. L., Gander, P. H., Sangalli, M. R., Travier, N., Firestone, R. T., & Tuohy, J. F. (2007). Sleep duration and quality in healthy nulliparous and multiparous women across pregnancy and post‐partum. Australian and New Zealand Journal of Obstetrics and Gynaecology, 47(1), 16-22.

Stremler, R., Hodnett, E., Lee, K., MacMillan, S., Mill, C., Ongcangco, L., et al. (2006). A behavioral-educational intervention to promote maternal and infant sleep: A pilot randomized, controlled trial. Sleep, 29,1609-1615.

Thomas, K. A., & Foreman, S. W. (2005). Infant sleep and feeding pattern: Effects on maternal sleep. Journal of Midwifery & Women’s Health, 50(5), 399-404.

About the Author

Elizabeth “Liz” Culnan, PhD, DBSM

Elizabeth “Liz” Culnan, PhD, DBSM, is a Licensed Clinical Health Psychologist who is board-certified in Behavioral Sleep Medicine. She is also the founder of Mindful Health Psychology. She provides therapy for people living in Colorado, Illinois, and the 40+ states included in PSYPACT. Liz specializes in the treatment of sleep disorders and perinatal mental health concerns. She is passionate about combining these specializations to help people through the stressors, the difficulty sleeping, and major life transitions accompanying pregnancy, infertility, and the postpartum period. Her own experiences as a mom have cemented her commitment to and belief in this work.