New research presented at the ANESTHESIOLOGY® 2025 Annual Meeting suggests that women who deliver by cesarean section are at higher risk of experiencing severe pain that interferes with sleep and daily functioning, as well as a higher risk of developing sleep disorders.

How Cesarean Deliveries and Sleep Disorders are Related

“Sleep is often overlooked in postpartum recovery, but it is central to a mother’s physical and mental health,” said Moe Takenoshita, M.B.B.Ch., lead author of the study and postdoctoral fellow in the Department of Anesthesia at Stanford University Center for Academic Medicine in Palo Alto, California. “Cesarean deliveries, in particular, appear to increase the risk of severe pain and sleep disturbances, which can lead to postpartum depression, thinking and memory problems, and fatigue, as well as interfere with bonding with their babies and relationships with family and friends.”

The research team used both qualitative and quantitative methods. In the qualitative part, they interviewed 41 mothers about their pain and sleep experiences after giving birth. Of these, 24 had given birth vaginally, 11 had had a planned cesarean section, and six had had an unplanned cesarean section. More than two-thirds of those who had a cesarean section (73% of planned and 67% of unplanned) reported severe pain that affected their sleep and daily activities, compared to only 8% of mothers who had vaginal deliveries. The quantitative analysis was based on a national insurance database of more than 1.5 million mothers who had given birth between 2008 and 2021. The results showed that mothers who had a cesarean section were 16% more likely to receive a new diagnosis of a sleep disorder (such as insomnia, sleep deprivation, or obstructive sleep apnea) within one month to one year after delivery than those who had a vaginal delivery.

How to Promote Better Sleep

Dr. Takenoshita advised new mothers, especially those recovering from a cesarean section, to take steps to effectively manage pain, as untreated pain can further disrupt sleep. Other strategies for better sleep include light physical activity when possible, sleeping when the baby sleeps, avoiding caffeine and alcohol in the late afternoon, and relaxing before bedtime through activities such as bathing or deep breathing. “Those planning a cesarean section should be aware that this procedure is associated with more severe pain after delivery and a higher risk of sleep disturbances. Anyone who has sleep problems during pregnancy or after delivery should discuss their concerns with their doctor, who can assess the problem, make recommendations, and refer them to a specialist if necessary,” said Dr. Takenoshita.