Sleepwalking, night terrors and sleep paralysis in pregnancy

By trimester

Weeks 1–13

1st trimester

Early pregnancy already brings more nighttime awakenings, from bathroom trips to nausea, and the same fragmented-sleep pattern researchers link to a higher overall rate of parasomnias during pregnancy can begin as soon as sleep quality changes. The research behind these prevalence figures compared pregnancy as a whole to the months before conception rather than isolating a first-trimester-only rate, so there is no dedicated early-pregnancy number to cite.

Weeks 14–27

2nd trimester

Sleep tends to fragment further in the second trimester as a growing belly makes some positions less comfortable, and comorbid issues like restless legs syndrome or snoring can add to the awakenings researchers associate with sleepwalking and night terror episodes. As with the first trimester, the underlying study did not break its findings out by trimester, so this reads as a period of continued rather than newly appearing risk.

Weeks 28–birth

3rd trimester

By the third trimester, positional discomfort, frequent urination, and a higher rate of sleep-disordered breathing combine to fragment sleep the most, which fits the pattern researchers describe as a driver of NREM parasomnia episodes. Sleep paralysis is the outlier: the research found it becomes significantly more common only after delivery, not during pregnancy itself, so a new episode of sleep paralysis in the third trimester falls outside the pattern the study identified.

What does the evidence show for parasomnias?

• In a study of 325 pregnant women (mean age 30.3), the overall share reporting any parasomnia rose from 20.5% in the three months before pregnancy to 24.8% during pregnancy, then fell back to 20.3% after delivery. 1
• Sleepwalking and night terrors both became significantly more frequent during pregnancy itself (sleepwalking, p = 0.02; night terrors, p < 0.001), while sleep paralysis followed a different pattern and instead increased significantly after delivery (p = 0.008). 1
• Researchers point to fragmented, frequently interrupted sleep, driven by nighttime bathroom trips and difficulty finding a comfortable position, along with comorbid conditions like sleep-disordered breathing and periodic limb movements, as factors that can set off NREM parasomnia episodes; addressing those underlying sleep problems was linked to fewer parasomnia episodes overall. 1
• Parasomnia is the general medical term for unusual behavior during sleep or during the transition into or out of sleep, a category that spans sleepwalking, talking, and eating during sleep alongside sleep paralysis and other partial-arousal events. 2
• Sleepwalking arises from an incomplete arousal out of deep, slow-wave non-REM sleep and carries a lifetime prevalence around 6.9% in the general population; more than 24 hours of sleep deprivation is a documented trigger in people already prone to episodes, and injuries from falls or from walking into furniture or windows are a recognized risk, which is why locking doors and windows and clearing a path near the bed are standard precautions. 3
• Night terrors happen during a sudden, incomplete arousal out of non-REM sleep, marked by a scream, a racing heart, or frantic movement with little response to comforting and typically no memory of the episode afterward, a pattern distinct from a nightmare, which unfolds during REM sleep and is usually recalled in vivid detail. Fever, sleep deprivation, and emotional stress are named as common triggers. 4
• Sleep paralysis occurs when waking awareness returns before the muscle atonia of REM sleep has released its hold, leaving a person briefly unable to move or speak, sometimes alongside a frightening hallucination of a presence in the room; general population prevalence is estimated around 7.6%, and isolated episodes have not been linked to any documented long-term health consequence, though the condition often coexists with narcolepsy, obstructive sleep apnea, or insomnia disorder. 5
• Sleep-related eating disorder involves involuntary eating during a partial arousal from sleep with amnesia for the episode afterward, a different pattern from consciously eating while fully awake overnight; the sedative sleep medications zolpidem and eszopiclone carry an FDA black-box warning specifically for triggering this and other complex sleep behaviors. 6

Four sleep parasomnias compared

When should I call my provider about parasomnias?

Call your provider if a sleepwalking or night terror episode leads to a fall, a burn, or any other injury, or if you notice signs of eating inedible or unsafe items during a sleep-related eating episode: these point to a safety risk that needs a specific plan, such as door and window locks or a medication review, rather than reassurance alone. Night terrors or sleepwalking that begin for the first time in adulthood are uncommon and are worth a medical evaluation, since adult-onset episodes can signal an underlying condition that benefits from a closer look. A new parasomnia that starts soon after beginning a sedative sleep medication such as zolpidem or eszopiclone should be reported to the prescriber, since these medications carry an FDA black-box warning for triggering involuntary eating, walking, or other complex behaviors during sleep. Frequent sleep paralysis can coexist with conditions like narcolepsy or obstructive sleep apnea, so recurrent episodes are worth raising at a prenatal visit rather than assuming they are a routine pregnancy symptom. Trust your read on your own body. If something feels off beyond the list above, please consult your healthcare provider rather than waiting it out.