Ashwin Lewis
Sleep is often elusive during pregnancy, and insomnia is common, especially in the third trimester. While some sleep aids may be safe to use during pregnancy, it's important to remember that research on their safety for pregnant people and fetuses is limited. Experts generally recommend addressing sleep difficulties without medication or supplements, and non-pharmacological interventions are likely the safest option. However, if these measures fail to alleviate sleep problems, certain sleep aids may be considered. Pregnant people should consult their doctors to discuss the potential effects of any medication on their baby and ensure it doesn't interact with other medications.
| Characteristics | Values |
|---|---|
| Safety of taking sleep medicine while pregnant | There is limited research on the safety of sleep medicines during pregnancy. Some medicines are considered safe, but it is important to consult a doctor before taking any medication. |
| Recommended sleep aids | Doxylamine (Unisom), Diphenhydramine (Benadryl), Melatonin |
| Sleep aids to avoid | Benzodiazepines, Barbiturates, Herbal teas (Chamomile) |
| Risks of sleep deprivation during pregnancy | Pregnancy-related diabetes, high blood pressure, depression, premature birth, difficult labor, cesarean section |
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What You'll Learn
Insomnia during pregnancy
Insomnia is a common problem during pregnancy, especially in the third trimester. It can be caused by a variety of factors, such as hormonal changes, discomfort, anxiety, and the need to urinate frequently. Lack of sleep during pregnancy can impact the health and safety of both the mother and the baby. Poor sleep has been linked to an increased risk of developing pregnancy-related diabetes, high blood pressure, and depression. It may also increase the likelihood of premature birth, difficult labor, or the need for a cesarean section.
Pregnant women should be cautious when considering sleep aids and always consult their healthcare provider before taking any medication or supplement. While some over-the-counter medications, such as Unisom and Benadryl, are generally recognized as safe by the FDA for occasional use during pregnancy, there are limited studies on the long-term effects of these drugs on pregnant women and their babies. Unisom, for example, is intended to treat temporary sleeplessness and should not be relied upon as a long-term solution.
Some sleep aids, such as benzodiazepines, have been associated with an increased risk of miscarriage, birth defects, and neonatal withdrawal symptoms. Therefore, they are not recommended for pregnant women. Herbal teas like chamomile, which is marketed as a natural sleep aid, should also be avoided during pregnancy as it has been linked to an increased risk of preterm birth and smaller newborn size.
Non-pharmacological interventions are generally recommended as the safest approach to treating insomnia during pregnancy. These include lifestyle modifications such as exercise (with a physician's approval), changing sleeping positions, and using a pregnancy pillow for comfort. However, in cases where non-pharmacological measures fail to alleviate sleep problems, certain sleep aids may be considered in consultation with a healthcare provider. Melatonin, for example, has been suggested by some experts as a possible option for pregnant women who struggle with sleep, but more research is needed to confirm its safety and effectiveness during pregnancy.
Pregnant women should always prioritize their safety and that of their baby when considering any medication or supplement. It is important to remember that the research on sleeping pills during pregnancy is limited, and the potential risks may outweigh the benefits. Consulting a healthcare provider can help weigh the risks and benefits of different treatment options and ensure the best possible care for both mother and child.
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Melatonin as a sleep aid
Melatonin is a hormone produced by the brain that regulates normal sleep-wake cycles. It is also sold over the counter as a dietary supplement and is a popular natural remedy for sleep problems. Melatonin supplements are often marketed as sleep aids, so pregnant women with sleep problems may be curious to try them.
Pregnant women commonly experience sleep disorders, with research suggesting that 46% to 78% of pregnant women experience sleep issues. By the third trimester, nearly 80% of women experience insomnia. However, the safety of taking melatonin supplements during pregnancy is not yet fully understood. Melatonin is not classified as a drug or hormone, and its production is not monitored by the Food and Drug Administration (FDA). The typical dose of melatonin (1 to 3 mg) can elevate blood melatonin levels up to 20 times the normal amount, and there is limited research on the impact of these high levels of hormones on the developing fetus.
Some studies suggest that melatonin plays a role in fetal development and is important for a normal, healthy pregnancy. Animal studies have shown that melatonin can reduce oxidative stress and act as a free radical scavenger. Additionally, melatonin receptors are present in the developing fetus from the earliest stages, and it has been shown to have neuroprotective properties and play a role in training circadian rhythms. However, an animal study of pregnant rats found that melatonin supplementation negatively impacted litter size and the growth and mortality rates of the pups, but it is unclear if these results can be generalized to humans.
While some healthcare professionals may recommend melatonin to pregnant women, especially those with certain health conditions, it is generally advised to use medications with a better-characterized reproductive safety profile. Pregnant women experiencing sleep problems may benefit from cognitive-behavioral therapy for insomnia (CBT-I) and improved sleep hygiene instead of melatonin supplementation. If you are pregnant and considering taking melatonin, it is important to consult with your doctor to weigh the potential risks and benefits.
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Herbal teas and remedies
While herbal teas and remedies may be natural, they are not necessarily safe to consume during pregnancy. There is limited research on the safety of herbal remedies for pregnant people and foetuses. It is always a good idea to consult a doctor or pharmacist before consuming any herbal teas or remedies while pregnant, especially if you are taking prescription medicine.
Some herbal teas are considered unsafe during pregnancy, such as chamomile, which has been linked to higher rates of preterm labour and miscarriage. Other herbal teas to avoid include dandelion tea and rose hip tea, as there is insufficient information to determine their safety.
Some herbal teas that are considered safe during pregnancy include:
- Oatstraw tea
- Lavender tea
- Lemon balm tea
- Ginger tea
- Peppermint tea
- Raspberry leaf tea
In addition to herbal teas, there are other natural remedies that can help with sleep during pregnancy. One example is acupuncture, a traditional form of Chinese medicine that is generally safe during pregnancy. It involves inserting thin needles into specific points in the body and can help treat symptoms such as nausea, fatigue, heartburn, and lower back pain. However, it is important to seek treatment from a qualified practitioner trained in prenatal care to avoid certain pressure points during pregnancy.
Another natural remedy is taking a warm bath before bed, which has been shown to help regulate core body temperature and improve sleep. Pregnant individuals are also recommended to consume adequate amounts of magnesium, which helps build the baby's nervous system and may promote better sleep by easing muscle pain. However, it is important to consult a doctor before taking magnesium supplements to ensure they are safe for you and your baby.
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Benzodiazepines and birth defects
Benzodiazepines were once believed to cause birth defects, but recent research suggests this might not be the case. However, the safety of benzodiazepines during pregnancy remains uncertain due to limited and conflicting evidence from epidemiological studies.
Some studies have found a small but significant increase in the risk of overall malformations and heart defects associated with first-trimester benzodiazepine exposure, especially at higher daily doses. Other potential adverse outcomes associated with gestational exposure to benzodiazepines include increased odds of spontaneous abortion, induced abortion, preterm birth, low birth weight, low Apgar scores, and neonatal intensive care admission. However, it is important to note that the number of exposed pregnancies in these studies was small, and more research is needed to confirm these findings.
While insomnia and anxiety are common during pregnancy, and benzodiazepines are frequently prescribed to manage these conditions, it is crucial for pregnant individuals to carefully consider the potential risks and benefits of taking any sleep aids or medications. Healthcare providers may recommend addressing sleep difficulties through non-pharmacological measures or lifestyle modifications before resorting to medication. Pregnant individuals should consult their doctors to discuss the potential effects of any medication on their pregnancy and explore the safest options available.
Additionally, certain types of barbiturates have been linked to birth defects, and infants exposed to barbiturates in the womb may experience withdrawal symptoms after birth. Therefore, it is important for pregnant individuals to be cautious about taking any sleep aids or medications and to consult their healthcare providers to weigh the risks and benefits.
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Doxylamine and diphenhydramine
Sleep deprivation during pregnancy can have negative consequences, so it is important to address sleep difficulties. However, it is difficult to determine the safety of taking sleep medications during pregnancy, as studies often exclude pregnant people. Some healthcare providers opt not to recommend any sleep aids during pregnancy due to the limited research on their safety for pregnant people and fetuses.
Unisom, which contains doxylamine, is generally considered safe for pregnant women by the FDA. It is used to treat nausea and vomiting in pregnant women. Doxylamine is also available in combination with pyridoxine (vitamin B6) to treat nausea and vomiting during pregnancy. This combination is recognised as safe and effective by the FDA, but it is intended to treat temporary sleeplessness and is not a long-term solution. Doxylamine may cause drowsiness and it is important to avoid alcohol when taking this medication.
Diphenhydramine is the active ingredient in medications like Benadryl and is available over the counter. It is an antihistamine drug primarily used to relieve symptoms of allergic rhinitis and as a short-term treatment for insomnia. It is usually available in higher doses than doxylamine for the same uses. It is important to note that diphenhydramine can also cause drowsiness, and alcohol should be avoided when taking this medication.
While some studies have reported an association between the use of specific antihistamines in early pregnancy and certain birth defects, extensive studies of Bendectin, a medication containing doxylamine, found no evidence to support these concerns and established the relative safety of this medication. Similarly, research on the use of diphenhydramine during pregnancy did not support previously hypothesised associations between antihistamines and major congenital anomalies.
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Frequently asked questions
There is limited research on the safety of sleeping pills during pregnancy. Sleep deprivation during pregnancy can have negative consequences, so some doctors may determine that the benefits of certain sleep aids outweigh the risks. It is recommended that pregnant people address sleep difficulties without medication or supplements.
Benzodiazepines, such as Valium, Ativan and Xanax, have been linked to an increased risk of miscarriage and neonatal withdrawal. Certain types of barbiturates have also been linked to birth defects. Melatonin is not recommended by many healthcare providers as it crosses the placenta, and there is insufficient research on its use in pregnancy.
Experts caution against taking natural sleep aids during pregnancy due to a lack of research on their safety. Herbal teas such as chamomile have been linked to an increased risk of preterm birth and decreased newborn size. There is also not enough known about the safety of other herbs, such as valerian and lavender, during pregnancy.
Doxylamine, the active ingredient in Unisom, is considered safe during pregnancy by some healthcare providers. Diphenhydramine, found in Benadryl, is also considered safe to take during pregnancy, even for extended periods. However, it is important to consult with a doctor before taking any medication during pregnancy.
