Perinatal Understanding of Mindful Awareness for Sleep (PUMAS)

Insomnia During Pregnancy: What is it?

Although sleep difficulties have long been considered a normal feature of pregnancy, recent estimates show that over half of women develop clinical insomnia during pregnancy. Insomnia involves difficulty falling asleep and/or staying asleep that leads to daytime fatigue, difficulty thinking, and worsened mood during the day. Untreated insomnia increases risk for several perinatal complications, such as maternal depression, pre-term birth, and reduced quality of life. Unfortunately, traditional treatment options for prenatal insomnia include sleep hygiene and over-the-counter sleep aids, but their effectiveness is not supported by research. Recently, insomnia therapy has gained support for improving sleep during pregnancy.

How can Henry Ford help?

Here at Henry Ford Health’s Perinatal Sleep Health Institute, we developed a mindfulness program for sleep in pregnancy: ‘Perinatal Understanding of Mindful Awareness for Sleep’ (PUMAS). PUMAS combines mindfulness exercises (e.g., meditation) and behavioral sleep strategies to deliver an insomnia program designed specifically to address the unique challenges to sleep in pregnancy. PUMAS involves six 1-hour sessions during which patients meet with a therapist to learn mindfulness skills and behavioral sleep strategies to regulate their sleep cycles, reduce stress, and create a healthier mindset at night. To ease access for busy moms, PUMAS is delivered virtually over video calls with the provider. PUMAS has been shown to alleviate insomnia and depression, calm busy minds at night, and strengthen mom’s bond to their baby.

Clinicians Interested in PUMAS

We are excited to share that PUMAS is currently being rolled out in Henry Ford Health’s Perinatal Sleep Clinic, Michigan Medicine’s Women and Infants Mental Health Clinic, the University of North Carolina’s Perinatal Outpatient Clinic, and several other locations.

If you are a behavioral health or sleep provider interested in learning more about the PUMAS program, then please contact Dr. David Kalmbach below (creator of PUMAS). The PUMAS manual is also free to download below. Additional materials, including email templates, meditation recordings, and therapy handouts, are freely available from Dr. Kalmbach.

Download Henry Ford PUMAS Manual

Contact Us

If you are pregnant, having difficulty sleeping, and are interested in learning more about the PUMAS program, then please email

David Kalmbach, PhD
Co-Director, Perinatal Sleep Health Institute at Henry Ford Health
Assistant Professor, Obstetrics, Gynecology, and Reproductive Biology at Michigan State University


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