Gina Johnson
Sleep disruption is a common issue during pregnancy, with many expecting mothers experiencing insomnia or other sleep disorders. While sleep aids can provide much-needed relief, it is important to understand which options are safe for pregnant women. The majority of medications have not been adequately tested on pregnant women, making it difficult to determine their safety during pregnancy. As such, pregnant women should always consult with a healthcare provider before starting any new medication or supplement. While some natural sleep aids, such as melatonin, have been recommended by doctors as safe and effective, others, such as benzodiazepines, have been associated with an increased risk of miscarriage and newborn health issues.
Can pregnant women take sleeping pills?
| Characteristics | Values |
|---|---|
| Difficulty sleeping during pregnancy | Very common |
| Sleep aids | Melatonin supplements, medication, herbal sleep aids, therapy, exercise, naps, pregnancy pillows |
| Melatonin supplements | Recommended by some providers, cross the placenta, limited research |
| Prescription sleep medication | Benzodiazepines, nonbenzodiazepines, sedating tricyclic antidepressants |
| Prescription sleep medication risks | Increased risk of miscarriage, cleft lip, cleft palate, congenital malformation, low birth weight, preterm delivery, C-sections, infant breathing and muscle tone problems |
| Prescription sleep medication risk period | Risk of malformation is confined to the first trimester |
| Prescription sleep medication safety | Fewer than 1% of medicines approved since 1980 have enough information to determine safety during pregnancy |
| Prescription sleep medication alternatives | Antihistamines, antidepressants |
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What You'll Learn
Melatonin supplements
Sleep problems are common during pregnancy, especially in the later trimesters. Research suggests that 46% to 78% of pregnant women experience sleep disorders, with nearly 80% of women experiencing insomnia by the third trimester.
Melatonin is a naturally occurring hormone produced by the brain that promotes sleep. Melatonin levels tend to increase with each trimester during pregnancy. Melatonin supplements are often marketed as sleep aids, so pregnant women with sleep problems may be curious about them as a potential remedy.
There is limited research on the safety of melatonin supplements for healthy pregnant women. Most studies on melatonin and pregnancy are animal studies, which have shown that melatonin supplementation can decrease the risk of pre-eclampsia, preterm birth, and intrauterine growth retardation (IUGR). However, in a study of pregnant rats, melatonin supplementation negatively impacted litter size and the growth and mortality rates of the pups. It is unclear if these results can be generalized to humans.
Some preliminary human studies suggest that melatonin supplementation may have a beneficial effect on fertilization rates and embryo quality, possibly due to a reduction in oxidative damage. Clinical trials that have used melatonin during pregnancy for other clinical conditions have not indicated major safety concerns. However, the lack of randomized controlled trials means that the efficacy and safety of melatonin for treating sleep disorders during pregnancy are still uncertain.
If you are pregnant and experiencing sleep problems, it is important to consult your doctor before taking any medication or supplement, including melatonin. Your doctor can consider your health history, medications, and supplements to determine the best course of action. They may suggest non-medication alternatives or strategies such as cognitive behavioral therapy for insomnia (CBT-I), regular exercise, napping early in the day, or limiting caffeine and evening meals to improve sleep.
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Prescription sleep medication
Sleep disturbances are common during pregnancy, and for many women, these disruptions may be severe. While prescription sleep medication is available, it is important to exercise caution as some medications may carry risks for the developing fetus.
Pregnant women should always consult their healthcare provider before starting any new medication or supplement. The human body naturally produces melatonin, a hormone that regulates sleep and wake cycles. Melatonin supplements are often recommended by healthcare providers to help pregnant women fall asleep more easily. While some providers recommend melatonin during pregnancy, others advise against it due to limited research on its effects during this sensitive period. However, a review of 15 studies concluded that melatonin use during pregnancy and breastfeeding is likely safe.
Sedating tricyclic antidepressants, such as amitriptyline or nortriptyline, have not been associated with an increased risk of congenital malformations. Benzodiazepines, including Ativan (lorazepam) and Klonopin (clonazepam), may also be considered. However, there is some controversy regarding their use during pregnancy. While initial reports suggested a potential link to an increased risk of cleft lip and palate, more recent studies have not found an association. Additionally, one nationwide study found an increased risk of miscarriage associated with benzodiazepine use. Furthermore, there are reports of withdrawal and toxicity symptoms in newborns whose mothers took benzodiazepines during pregnancy.
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Herbal sleep aids
Sleep medicines are generally advised against during pregnancy. However, there are herbal remedies that can help with sleep.
Pregnant people may wish to avoid certain herbal teas marketed as sleep aids. For example, one study found that drinking chamomile in the final months of pregnancy increased the risk of preterm birth and decreased the size of newborns. However, these findings need to be confirmed by further research. Not enough is known about other herbs, such as valerian and lavender, to determine whether they are safe to take during pregnancy.
Some doctors recommend lavender and lemon balm teas as safe choices to help with insomnia during pregnancy. Sherry Ross, MD, a women's health expert, says that "aromatherapy is probably safe during pregnancy, but it's important to know that it's a bit controversial since medical studies have not been conducted. It's best to discuss essential oils with your ob-gyn before using them."
Diana Quinn, a naturopathic physician, recommends drinking herbal tea an hour before bed to help you wind down. One of her favorites for sleep is oatstraw, which can be readily found in tea form at grocery stores.
Pregnant women should always consult with a healthcare provider before starting any new medication or supplement.
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Antidepressants
Sleep disturbance and insomnia are common during pregnancy, with up to 80% of pregnant women experiencing insomnia. While the bulk of evidence suggests that antidepressants do not cause birth defects, most experts advise against using these medications to treat sleep problems during pregnancy. This is because there is a lack of research on how antidepressants may affect pregnant people and their fetuses.
Sedating tricyclic antidepressants, such as amitriptyline or nortriptyline, have not been associated with an increased risk of congenital malformation. Benzodiazepines, including Ativan (lorazepam) and Klonopin (clonazepam), may also be useful in treating insomnia in pregnant women. However, there is some controversy regarding the use of benzodiazepines during pregnancy due to a potential, but very low, risk of cleft lip and cleft palate in the first trimester.
It is important to note that the safety of many sleep aids for pregnant women and their fetuses has not been verified due to the exclusion of pregnant people from studies assessing medication safety. Therefore, it is recommended that pregnant women experiencing sleep difficulties first try lifestyle adjustments and natural sleep aids, such as improving sleep hygiene through activities like drinking tea, taking a warm shower, meditating, or light reading before bed. Establishing a regular bedtime routine, avoiding caffeine later in the day, and eating and drinking mindfully can also promote better sleep.
If these interventions do not work, it is important to consult a healthcare provider to discuss safe sleep aids for occasional use during pregnancy.
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Non-medication alternatives
While pregnancy is an exciting time, it often comes with physical changes that can make it difficult to sleep. Sleep disturbances and disorders are common during pregnancy, and for a significant number of women, sleep disruption may be quite severe.
Pregnant women should always consult with a healthcare provider before starting any new medication or supplement. Doctors may recommend medication to help pregnant women with severe sleep disorders or other medical conditions that cause sleeping problems. However, prescription sleep medications should be avoided during late pregnancy as they may cause breathing and muscle tone problems in infants.
Exercise earlier
Regular exercise can help with sleep, but exercising too close to bedtime may make it hard to wind down for sleep.
Take naps early in the day
Napping may be a convenient way to recover from missed sleep, but naps should be taken early in the day so they don't interfere with bedtime.
Try cognitive behavioral therapy for insomnia (CBT-I)
This type of therapy aims to improve sleep by changing mental and behavioral habits without the need for medication.
Sleep on your left side
Left-side sleeping enhances blood flow and prevents the uterus from placing too much weight on the liver. Using a pressure-relieving mattress topper and placing pillows under the lower back, between the legs, or under the midsection may help with comfort.
Keep the bedroom dark and quiet
Use a dim nightlight instead of bright overhead lights during nighttime bathroom visits. This may make it easier to fall back asleep.
Establish a regular bedtime routine
Maintain similar sleep and wake times and carry out a relaxing, consistent bedtime routine so your body knows it is time to sleep.
Eat and drink mindfully
Avoid heavy meals, spicy foods, and excessive liquids before bedtime to reduce the risk of heartburn, indigestion, and frequent urination during the night. Limit caffeine intake during the day and avoid it in the afternoon and evening. If nausea keeps you up at night, a light, bland snack might help.
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Frequently asked questions
There is limited data on the safety of prescription sleeping pills during pregnancy. Benzodiazepines, for example, have been associated with an increased risk of miscarriage and toxicity symptoms in newborns. However, some alternatives such as sedating tricyclic antidepressants have not been linked to an increased risk of congenital malformations. It is always best to consult a healthcare provider before taking any medication or supplement during pregnancy.
Safe alternatives to prescription sleeping pills for pregnant women include antihistamines, such as doxylamine (Unisom) and diphenhydramine (Benadryl), and melatonin supplements. Melatonin is a naturally occurring hormone that helps regulate sleep and has been found to be effective and safe for pregnant women.
There are several non-medication strategies to improve sleep during pregnancy. These include limiting caffeine intake, avoiding heavy meals and spicy foods before bedtime, exercising earlier in the day, and trying different sleeping positions with a pregnancy pillow. Additionally, cognitive behavioural therapy for insomnia (CBT-i) can help improve sleep by changing mental and behavioural habits.
Yes, sleep disturbances during pregnancy can be a symptom of underlying conditions such as restless leg syndrome, sleep apnea, depression, or anxiety. It is important to consult a healthcare provider to receive an accurate diagnosis and appropriate treatment.
Sleep deprivation during pregnancy can increase the risk of complications such as high blood pressure, preeclampsia, gestational diabetes, preterm birth, longer labour, and cesarean section birth. Therefore, it is important to address sleep issues during pregnancy and not simply "put up" with sleep deprivation.
