Colin Snow
Sleep disturbances are a common occurrence during pregnancy, with nearly 80% of women experiencing some form of disrupted sleep. This can be attributed to various factors, including hormonal changes, physical discomfort, and pregnancy-specific conditions. While some sleep aids may be unsafe for pregnant individuals, certain options are generally considered safe and can provide much-needed relief. It is important to consult with a healthcare provider to weigh the risks and benefits before taking any sleep aid during pregnancy. This paragraph introduces the topic of safe sleep aids during pregnancy, highlighting the prevalence of sleep disturbances, potential causes, and the importance of consulting medical professionals.
Safe to take during pregnancy for sleep
| Characteristics | Values |
|---|---|
| Melatonin supplements | Probably safe but limited research |
| Unisom | Safe according to Layan Alrahmani, M.D. |
| Doxylamine | Safe according to Layan Alrahmani, M.D. |
| Advil PM | Safe according to Layan Alrahmani, M.D. |
| Aleve PM | Safe according to Layan Alrahmani, M.D. |
| Excedrin PM | Safe according to Layan Alrahmani, M.D. |
| Sominex | Safe according to Layan Alrahmani, M.D. |
| Diphenhydramine | Safe in recommended doses according to Layan Alrahmani, M.D. |
| Benadryl | Generally considered safe |
| Tylenol PM | Safe in moderation according to Baskovic |
| Antihistamines | Safe and used to treat morning sickness |
| Yoga | Recommended as a natural alternative |
| Massage | Recommended as a natural alternative |
| Herbal tea | Recommended as a natural alternative |
| Aromatherapy | Recommended as a natural alternative |
| Acupuncture | Safe according to Ross |
| Baths | Safe according to Ross |
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What You'll Learn
Melatonin supplements
Melatonin is a hormone that is naturally produced by the human body and helps people fall asleep and wake up at the appropriate times. It is also sold over the counter as a dietary supplement and is a popular natural remedy for sleep problems. Melatonin supplements are one of the most common sleep aids used during pregnancy.
The safety of melatonin supplements during pregnancy is still uncertain. There is a lack of randomized, controlled trials examining the efficacy and safety of melatonin supplements as a treatment for sleep disorders during pregnancy. However, clinical trials that have used melatonin during pregnancy for other clinical conditions have not shown major safety concerns or adverse events. Some studies suggest that melatonin supplementation may have a beneficial effect on fertilization rates and embryo quality, likely due to a reduction in oxidative damage. Melatonin levels tend to naturally increase with each trimester during pregnancy, and the placenta also produces melatonin, which is thought to be important for a normal, healthy pregnancy.
However, the dose of melatonin in most over-the-counter preparations is higher than what the body normally produces, and there is limited research on the impact of high levels of hormones on the developing fetus. As such, healthcare professionals may recommend melatonin to pregnant women in certain instances, such as for older women trying to become pregnant or for pregnant women with preeclampsia. In pregnant women without a documented health issue associated with low melatonin levels, supplementation might not be advisable.
If you are considering taking melatonin supplements during pregnancy, it is important to consult with a healthcare provider to weigh the potential benefits and risks for your specific situation.
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Antihistamines
However, the use of H1-antihistamines during pregnancy has been controversial due to possible teratogenic effects. While some studies have shown no increase in teratogenic risk in humans, others have reported isolated cases of antihistamines causing congenital malformations. The Food and Drug Administration (FDA) has not categorized any antihistamines as safe during pregnancy based on controlled animal or human studies. As a result, careful risk-benefit assessments should be conducted before prescribing antihistamines to pregnant individuals.
It is important to note that the safety of many sleep aids for pregnant people and their fetuses has yet to be verified due to limited research. Pregnant individuals should always consult with a healthcare provider before starting any new medication or supplement. While some sleep aids may be necessary for pregnant people experiencing sleep difficulties, experts generally recommend addressing sleep problems without medication or supplements. Improving sleep hygiene, such as avoiding caffeine, having consistent bedtimes, and avoiding screens before bed, can help relieve sleep disorders.
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Natural remedies
Sleep disturbances during pregnancy are common, and insomnia may be caused by hormonal, physiologic, metabolic, and psychological changes. Regular sleep medication is not advised during pregnancy, but there are natural remedies that can help.
Acupuncture
Acupuncture is a traditional form of Chinese medicine that involves inserting thin needles into strategic points in the body. It is generally considered safe during pregnancy and can help treat various symptoms such as nausea, fatigue, heartburn, and lower back pain. It is recommended to seek treatment from someone trained in prenatal care, as certain pressure points should be avoided during pregnancy.
Aromatherapy
Aromatherapy involves inhaling essential oils or applying them to the skin for restorative purposes. It is considered relatively safe during pregnancy, but it is recommended to consult with a healthcare provider to determine which essential oils are beneficial and which should be avoided.
Herbal Tea
Drinking herbal tea can help you relax and prepare for sleep. Oatstraw tea, in particular, is recommended by naturopathic physicians. However, it is important to avoid drinking too much tea to prevent frequent bathroom trips during the night.
Massage
Massages can alleviate muscle and joint pain, reduce stress, improve mood, and even lessen labor pain. Prenatal massages are designed to be safe and comfortable for both mother and baby, using soothing strokes and positions.
Warm Baths
Warm baths taken an hour or two before bedtime can help regulate body temperature and improve sleep. They also help reduce swelling, pain, and stress. However, it is important to keep the water temperature below 98 degrees Fahrenheit to avoid restricting blood flow to the baby.
It is always recommended to consult with a healthcare provider before starting any new natural remedies during pregnancy to ensure safety for both mother and baby.
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Over-the-counter medications
Sleep problems are common during pregnancy, with up to 90% of pregnant people experiencing sleep difficulties. While the research on sleeping pills during pregnancy is limited, some over-the-counter medications are generally considered safe. However, it is always advisable to consult a doctor before taking any medication during pregnancy.
Antihistamines
Antihistamines are commonly used to treat allergies and induce drowsiness. They are also used to alleviate morning sickness and indigestion during pregnancy. About 10 to 15% of pregnant people use antihistamines during pregnancy. Some antihistamines that are considered safe during pregnancy include doxylamine and diphenhydramine. Doxylamine is the active ingredient in Unisom, which is commonly used to treat insomnia and nausea during pregnancy. Diphenhydramine is found in over-the-counter medications such as Benadryl, Decapryn, Aldex, Advil PM, Aleve PM, Excedrin PM, and Sominex.
Melatonin
Melatonin is a hormone that regulates sleep and wake cycles. Melatonin supplements are available over the counter and are considered relatively safe during pregnancy. However, it is recommended to consult a healthcare provider before taking melatonin supplements.
Other Options
In addition to over-the-counter medications, there are other options to improve sleep during pregnancy without medication. These include:
- Limiting caffeine intake, especially in the afternoon and evening.
- Reducing fluid intake in the evening to minimise urination during the night.
- Avoiding heavy meals and spicy foods before bedtime to prevent heartburn and indigestion.
- Enrolling in classes about labour, delivery, baby care, or breastfeeding to reduce anxiety.
- Cognitive behavioural therapy (CBT) is a recommended treatment for insomnia during pregnancy.
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Prescription medications
Sleep problems are very common during pregnancy, with up to 80% of women reporting sleep problems during the first trimester and 66% to 97% in the third trimester. While sleep aids provide much-needed relief, it is important to know which options are safe.
Pregnant women are generally advised to avoid prescription medications, including sleep medicines, during pregnancy. Most drugs are not tested on pregnant women, and the effects on the unborn baby are unknown. However, some doctors may recommend medication to help with sleep during pregnancy if non-pharmacological treatments fail to alleviate sleep problems.
Prescription sleep medications should be avoided during late pregnancy as they may cause breathing and muscle tone problems in infants exposed to these medications. Sedative hypnotics, a class of prescription drugs known to relieve anxiety and induce sleep, are also associated with adverse effects on the pregnancy and baby, and it is best to avoid them unless absolutely necessary. This class of drugs includes benzodiazepine receptor agonists (BZRAs), which are some of the most commonly prescribed insomnia medications. Benzodiazepines, such as lorazepam and clonazepam, have been found to have adequate data to support their reproductive safety. However, other benzodiazepines, such as Valium, Ativan, and Xanax, come with risks of birth defects and neonatal withdrawal.
Trazodone is another prescription medication commonly used for insomnia. While data regarding its reproductive safety is limited, a recent study found that trazodone exposure was not associated with a significantly increased risk of pregnancy termination, pregnancy loss, or small gestational age infants. However, the number of trazodone exposures remains small, and more data is needed to fully understand the risks.
Doxylamine, an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – 50 mg), is another option that may be considered. Doxylamine is also one of the ingredients in the anti-nausea medication Diclegis, which could be particularly useful for women experiencing severe nausea and vomiting during pregnancy.
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Frequently asked questions
Natural alternatives like yoga, massage, and improving your sleep hygiene are recommended. Sleep hygiene includes avoiding caffeine, having a consistent bedtime, and avoiding screens before bed. Drinking herbal tea, taking warm baths, and aromatherapy are other natural ways to help you sleep.
Over-the-counter sleep aids such as Unisom, Benadryl, and Tylenol PM are generally considered safe for pregnancy. Unisom contains the antihistamine doxylamine, which is considered safe during pregnancy. Doxylamine, in combination with vitamin B6, is sometimes prescribed for morning sickness.
Melatonin is a hormone that naturally occurs in our bodies and helps promote sleep. While melatonin supplements are commonly used to treat sleep difficulties, there is limited research on their safety for pregnant people and fetuses. Some experts advise against taking them during pregnancy due to the lack of research.
Prescription sleep medications such as Valium, Ambien (zolpidem), Lunesta, and Sonata should generally be avoided during pregnancy due to potential risks to the fetus and limited data on their safety. Nonbenzodiazepines, including zolpidem, have been associated with an increased risk of low birth weight, preterm delivery, and C-sections.
If you are struggling to sleep during pregnancy, it is recommended to consult with a healthcare provider to determine the best course of action. They may suggest non-pharmacological measures or, in some cases, recommend certain sleep aids if the benefits outweigh the risks.
