Herbie Murray
Sleep disturbances are common during pregnancy, with 77% of pregnant individuals experiencing some degree of sleep disturbance, which can range from mild to severe. While sleep aids can provide much-needed relief, it is important to consider the safety of these medications for both the pregnant person and the fetus. The majority of sleep aids have not been extensively studied in pregnant populations, and the limited data available makes it difficult to determine their safety during pregnancy. As a result, healthcare providers may opt not to recommend any sleep aids during pregnancy, and pregnant individuals are generally advised to avoid medications, including sleep medicines. However, sleep deprivation during pregnancy can have negative consequences, and some individuals and their doctors may decide that the benefits of certain sleep aids outweigh the risks.
Can I take a sleeping pill while pregnant?
| Characteristics | Values |
|---|---|
| Difficulty sleeping during pregnancy | Very common, affecting 77% of pregnant individuals, with issues peaking in the third trimester |
| Causes of insomnia during pregnancy | Nausea, backaches, heartburn, frequent urination, restless leg syndrome, sleep apnea, anxiety, and depression |
| Prescription sleep medication | Generally advised against during pregnancy due to limited research on safety for pregnant people and fetuses, and potential risks such as miscarriage and low birth weight |
| Over-the-counter sleep aids | May be recommended by healthcare providers, including antihistamines such as doxylamine (Unisom) and diphenhydramine (Benadryl), which are considered safe during pregnancy |
| Melatonin supplements | Opinions vary; some healthcare providers recommend against it due to lack of research and crossing the placenta, while others suggest it for pregnant women with sleep difficulties |
| Herbal remedies | Include ginseng, honey, and nutmeg |
| Lifestyle measures | Limiting caffeine and screen time, taking warm baths, listening to relaxing music, destressing, using pregnancy pillows, and maintaining a regular bedtime routine |
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What You'll Learn
Melatonin supplements
Sleep disturbances are common during pregnancy, and many women wonder if it is safe to take over-the-counter or prescription sleep medication, melatonin supplements, or herbal sleep aids. Melatonin is a naturally occurring hormone produced by the brain that promotes sleep. Melatonin supplements are often marketed as sleep aids, so pregnant women with sleep problems may consider them as a potential remedy.
While melatonin levels tend to naturally increase with each trimester during pregnancy, there is limited research on the safety of melatonin supplements for pregnant people and their fetuses. The Food and Drug Administration (FDA) requires manufacturers to provide information on the safety of medications during pregnancy, but the majority of medications approved since 1980 lack sufficient data to determine their safety during pregnancy. This is because it is difficult to safely test medications on pregnant women.
Some healthcare providers recommend against taking melatonin supplements during pregnancy because it crosses the placenta, and there isn't extensive research on its use in pregnancy. On the other hand, some providers recommend melatonin supplements for older women trying to become pregnant, for pregnant women with preeclampsia, or for women with endometriosis. Additionally, a review of 15 studies concluded that using melatonin during pregnancy and breastfeeding is likely safe, but more research on effectiveness and safety is needed.
If you are pregnant and experiencing insomnia, it is important to consult with a healthcare provider before starting any new medication or supplement. Cognitive behavioral therapy for insomnia (CBT-I) and improved sleep hygiene might be recommended as a first-line treatment. Other strategies to improve sleep while pregnant include sleeping on your left side, keeping the bedroom dark and quiet, establishing a regular bedtime routine, and eating and drinking mindfully.
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Antihistamines
Sleep disturbances are common during pregnancy, and many women experience insomnia or other sleep disorders. While some women may require pharmacological intervention, the safety of many sleep aids for pregnant people and their foetuses is unverified due to limited research. Therefore, healthcare providers generally recommend addressing sleep difficulties without medication or supplements.
Oral antihistamines such as cetirizine (Zyrtec), chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), fexofenadine (Allegra), and loratadine (Claritin) seem to be safe during pregnancy. Doxylamine, the active ingredient in Unisom, is also considered safe and is probably the safest option among sleep medications during pregnancy. Diphenhydramine is another antihistamine that can be taken in recommended doses during pregnancy, even for extended periods. These antihistamines are generally safe because they do not travel throughout the body and are not associated with an increased risk of birth defects or other adverse pregnancy outcomes.
However, it is important to be cautious about taking any medication during pregnancy, and some antihistamines should be avoided. Antihistamines combined with decongestants should be avoided during pregnancy, especially during the first trimester. One common decongestant, pseudoephedrine, has been linked to a small risk of abdominal wall birth defects when taken during the first three months of pregnancy. Therefore, it is crucial to consult a healthcare provider before taking any antihistamine or other medication during pregnancy to weigh the benefits against the risks and make an informed decision.
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Benzodiazepines
Most benzodiazepines are categorized as "Category D" by the U.S. Food and Drug Administration (FDA) Pregnancy Categories, indicating positive evidence of fetal risk. However, the potential benefits of benzodiazepine use may outweigh these risks in certain cases. For example, a pregnant woman with severe anxiety or insomnia that significantly impacts her quality of life and functioning may consider using benzodiazepines after consulting with her doctor.
Studies have shown that taking benzodiazepines during pregnancy may be associated with an increased risk of birth defects, neonatal withdrawal symptoms, preterm labour, cesarean delivery, and low birth weight infants. Additionally, there are concerns about the potential for altered transmitter synthesis and function, leading to neurobehavioural problems in children exposed to benzodiazepines in utero. However, the data on these risks is inconsistent, and some studies have found no significant increase in malformations or adverse effects on neurobehavioural development and IQ.
It is important for pregnant women who are currently using benzodiazepines or considering taking them to understand the potential risks and weigh them against the benefits. Pregnant women should not abruptly stop taking benzodiazepines without consulting a doctor, as this can cause withdrawal symptoms. Instead, they should seek the help of addiction specialists to assist in quitting if they decide to discontinue use during pregnancy.
While there is limited understanding of the full effects of benzodiazepines on pregnant women and their babies, it is generally recommended to prioritize lifestyle modifications, supplements, and non-pharmacological treatments for sleep disturbances during pregnancy. Pregnant women should consult their healthcare providers to determine the best course of action for their specific circumstances.
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Zolpidem
If you are taking zolpidem and become pregnant, it is important to speak to your doctor. They can help you decide what to do and may switch you to a medicine that is more suitable for pregnancy. It is generally recommended to try non-drug methods and alternative medications to treat insomnia during pregnancy before considering zolpidem.
There is limited information about taking zolpidem while breastfeeding, but studies have shown that zolpidem passes into breast milk in small amounts. While no problems have been reported in babies, it is important to monitor them for symptoms such as sleepiness, trouble gaining weight, low muscle tone, or slow breathing. If you notice any of these symptoms, contact your healthcare provider.
There is no evidence that zolpidem affects fertility in men or women or increases the chance of birth defects if taken by the father. However, studies specifically examining these effects have not been conducted.
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Doxylamine
Sleep disturbances are common during pregnancy, and many women experience insomnia or other sleep disorders. While some women may require pharmacological intervention, the safety of many sleep aids for pregnant people and their foetuses has yet to be verified. Therefore, healthcare providers may opt not to recommend any sleep aids during pregnancy. However, as sleep deprivation during pregnancy can have adverse effects, some pregnant individuals and their doctors may decide that the benefits of certain sleep aids outweigh the risks.
If you are pregnant and struggling to sleep, it is essential to consult with your healthcare provider before taking any medication, including over-the-counter sleep aids. They can help address any underlying problems, such as restless leg syndrome, sleep apnea, or heartburn, and discuss the risks and benefits of any potential treatment options.
Additionally, there are non-pharmacological measures that can help alleviate sleep problems during pregnancy. These include sleeping on your left side, using a pregnancy pillow, maintaining a regular bedtime routine, and eating and drinking mindfully. Keeping the bedroom dark and quiet can also help promote better sleep.
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Frequently asked questions
Sleep disturbances are common during pregnancy, with 77% of pregnant individuals experiencing issues. While sleep aids provide much-needed relief, always consult a healthcare provider before starting any new medication or supplement. Prescription sleep medications are advised against during late pregnancy, but some over-the-counter antihistamines are considered safe. Doxylamine, such as Unisom, and diphenhydramine, such as Benadryl, have shown no increased risk of congenital abnormalities. Melatonin supplements are also used during pregnancy, but many healthcare providers recommend against them due to a lack of research.
Benzodiazepines, a common ingredient in sleeping pills, has been linked to an increased risk of miscarriage and toxicity symptoms in newborns. Prescription sleep medications may also cause breathing and muscle tone problems in infants.
There are many natural alternatives to sleeping pills during pregnancy, including limiting caffeine intake, reducing liquid consumption in the evening, and maintaining a regular bedtime routine. Keeping the bedroom dark and quiet, and using pregnancy pillows to get comfortable can also help.
