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Sleep and Post-Partum Anxiety

9/17/2025 | Dr. Laura

woman carrying baby
Photo by Jenna Norman on Unsplash

Sleep and Post-Partum Anxiety

Post-partum, or the fourth trimester, is an extremely challenging time for new parents. However, it tends to be the most challenging for moms as they balance little sleep, hormonal changes, physical recovery, and new responsibilities.12

It’s normal to feel overwhelmed, and with social media, too easy to feel like you’re failing at a role you’ve only just started. Whether it’s your first baby or your third, postpartum can feel like a never ending storm. In order to protect you from this storm, your brain tends to be more sensitive to things that might be a danger to you and your baby.3 Social threats like social exclusion or rejection (e.g., people not answering your texts, you don’t have time to return a phone call), or isolation (e.g., time periods where you’re alone) can be interpreted by your brain as threats.4 This can be in addition to health worries like whether you’re recovering well, or is your baby sleeping/eating/peeing/pooping enough. Whether these are things you’ve experienced before, or they are new to you, it might feel like your brain is on high-alert all the time.

Research has found that how well you sleep during pregnancy - and after the baby has arrived - has a very strong relation to the intensity of postpartum anxiety and depression.5 Lack of sleep results in an increase in word searching, forgetfulness, brain fog, lower tolerance to stress, and a more difficult time coping with stressors that you may have been able to handle before.6 What’s more, an increase in stress also worsens our ability to sleep (e.g., takes forever to fall asleep, waking up throughout the night, not being able to fall back to sleep once waking up at night).7

Luckily, psychotherapy can help with both post-partum anxiety and sleep.8 Cognitive behavioral therapy for insomnia (CBT-I) is the gold standard for improving sleep. CBT is also a fantastic therapy for anxiety as well, helping your brain change in the way that it processes and reacts to the dangers you are seeing around you each day.9 Acceptance commitment therapy (ACT) is another therapy that assists with easing post-partum anxiety.10 Here at HHAWC, we have extensive training in CBT-I, CBT, and ACT therapies. Please don’t hesitate to reach out to us with any questions you might have, especially if you are experiencing any of the above. We are here to help!

Disclaimer: These posts are for informational purposes only and are not a substitute for professional mental health care. Viewing or interacting with this post does not constitute a therapeutic relationship.

Footnotes

  1. Paladine, Heather L et al. “Postpartum Care: An Approach to the Fourth Trimester.” American family physician vol. 100,8 (2019): 485-491. ↩

  2. Wu, Xueqin, and Rong Jin. “Effects of postpartum hormonal changes on the immune system and their role in recovery.” Acta biochimica Polonica vol. 72 14241. 11 Jun. 2025, doi:10.3389/abp.2025.14241 ↩

  3. Nakić Radoš, Sandra et al. “Anxiety During Pregnancy and Postpartum: Course, Predictors and Comorbidity with Postpartum Depression.” Acta clinica Croatica vol. 57,1 (2018): 39-51. doi:10.20471/acc.2017.56.04.05 ↩

  4. Crawford, Bonni et al. “Brain structure correlates of expected social threat and reward.” Scientific reports vol. 10,1 18010. 22 Oct. 2020, doi:10.1038/s41598-020-74334-z ↩

  5. Okun, Michele L et al. “Poor sleep quality increases symptoms of depression and anxiety in postpartum women.” Journal of behavioral medicine vol. 41,5 (2018): 703-710. doi:10.1007/s10865-018-9950-7 ↩

  6. Chen, Pinqiu et al. “The Devastating Effects of Sleep Deprivation on Memory: Lessons from Rodent Models.” Clocks & sleep vol. 5,2 276-294. 15 May. 2023, doi:10.3390/clockssleep5020022 ↩

  7. Nollet, Mathieu et al. “Sleep deprivation and stress: a reciprocal relationship.” Interface focus vol. 10,3 (2020): 20190092. doi:10.1098/rsfs.2019.0092 ↩

  8. Grigoriadis, Sophie, and Paula Ravitz. “An approach to interpersonal psychotherapy for postpartum depression: focusing on interpersonal changes.” Canadian family physician Medecin de famille canadien vol. 53,9 (2007): 1469-75. ↩

  9. Surkan, Pamela J et al. “Anxiety-focused cognitive behavioral therapy delivered by non-specialists to prevent postnatal depression: a randomized, phase 3 trial.” Nature medicine vol. 30,3 (2024): 675-682. doi:10.1038/s41591-024-02809-x ↩

  10. Burklund, Lisa J et al. “Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder.” Psychiatry research. Neuroimaging vol. 261 (2017): 52-64. doi:10.1016/j.pscychresns.2016.12.012 ↩

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