Herbie Murray
Sleep disturbances and disorders are common during pregnancy, with insomnia affecting one in four women in the first trimester and over two-thirds by the end of the third trimester. While sleep aids can provide much-needed relief, the safety of many sleep aids for pregnant people and their fetuses has yet to be verified, as studies used to assess medication safety rarely include pregnant people. Pregnant women are generally advised to avoid medications, including sleep medicines, during pregnancy, and to try natural sleep aids and lifestyle adjustments first. However, for those with severe sleep disorders or other medical conditions causing sleep problems, a doctor may recommend medication. Some sleep aids that have been studied in pregnancy and are commonly recommended by healthcare providers include doxylamine (Unisom) and diphenhydramine (Benadryl), which have shown no increased risk of congenital abnormalities. Melatonin supplements are also commonly used during pregnancy, although there is limited research on their effects, and some experts worry that they may affect the fetus's ability to establish healthy sleep-wake cycles.
| Characteristics | Values |
|---|---|
| Common sleep aids | Melatonin supplements, antihistamines, magnesium supplements, herbal supplements, antidepressants |
| Safe sleep aids | Doxylamine (Unisom), diphenhydramine (Benadryl) |
| Unsafe sleep aids | Eszopiclone (Lunesta), passionflower |
| Risk factors | Teratogenicity, fetal harm, birth defects, increased risk of C-sections, preeclampsia, gestational diabetes, sleep-wake cycle issues |
| Recommendations | Lifestyle adjustments, non-medication alternatives, consulting a healthcare provider |
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What You'll Learn
Melatonin supplements
Sleep disturbances and disorders are common in pregnancy, with 46% to 78% of pregnant women experiencing sleep disorders. By the third trimester, nearly 80% of women experience insomnia. Melatonin supplements are often marketed as sleep aids, so pregnant women with sleep problems might be curious about them as a potential remedy.
The human body naturally produces melatonin, a hormone that helps people fall asleep and wake up at appropriate times. Taking melatonin supplements helps some people with sleep difficulties fall asleep more easily. Melatonin levels tend to naturally increase with each trimester during pregnancy. However, melatonin supplementation might not be a good idea for pregnant women without a documented health issue associated with low melatonin levels. Melatonin levels naturally rise throughout pregnancy, and one potential risk of supplementing with melatonin during this time could be too much melatonin in the body.
Research suggests that melatonin supplementation is safe during pregnancy when used under medical supervision. Using the correct dosage is crucial for the safety and development of the pregnancy. However, the safety of many sleep aids for pregnant people and their fetuses has yet to be verified, as studies used to assess the safety of medications rarely include pregnant people. While studies have found that melatonin use in pregnant animals has some risks, such as lower birth weights, there is currently no evidence that melatonin supplements are harmful to pregnant humans or their fetuses.
Pregnant women should always consult with a healthcare provider before starting any new medication or supplement. If you are pregnant and curious about melatonin and sleep troubles, consider asking your doctor about the potential benefits and risks of supplementing with melatonin while pregnant, given your medical history and overall health.
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Doxylamine and diphenhydramine
Sleep disturbances and disorders are common during pregnancy, with insomnia reported by 5% to 38% of women in early pregnancy, and a prevalence of up to 60% in late pregnancy. Other sleep disorders, such as restless leg syndrome and sleep apnea, are also more common during pregnancy.
Both medications can be used to treat nausea and vomiting during pregnancy when combined with pyridoxine (vitamin B6). Doxylamine succinate with pyridoxine is approved as a first-line treatment for these symptoms under the brand name Bonjesta. Diclegis, a medication combining doxylamine succinate and pyridoxine hydrochloride, is also approved by the FDA for morning sickness treatment but can be expensive. Healthcare providers often recommend the more affordable combination of Unisom SleepTabs (doxylamine) and vitamin B6 instead.
While doxylamine and diphenhydramine are generally considered safe during pregnancy, it is important to consult a healthcare provider before taking any new medication or supplement. Some studies have suggested that taking antihistamines during the first trimester may increase the risk of birth defects, such as cleft lip and cleft palate. However, these findings have been criticized and are not supported by all studies.
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Sedating tricyclic antidepressants
Sleep disturbances and disorders are common during pregnancy, with insomnia reported in early pregnancy by 5% to 38% of women and in late pregnancy by as many as 60%. Sleep disorders such as restless leg syndrome and sleep apnea are more common during pregnancy and may cause significant sleep disruption. Sleep disturbance may also be a symptom of depression or an anxiety disorder.
However, it is important to note that there is limited or no information on the use of specific TCAs, therefore an increased risk of malformations cannot be ruled out. A possible association between in utero clomipramine exposure and cardiac malformation has been suggested but remains unconfirmed. An increased risk of neonatal complications has been reported in the offspring of women with psychiatric illnesses; however, the relative contributions of the underlying maternal condition and specific drug treatments have not been clearly defined. Use of TCAs throughout pregnancy or near delivery may be associated with withdrawal symptoms in the neonate and/or poor neonatal adaptation syndrome (PNAS).
The American College of Obstetricians and Gynecologists (ACOG) recommends that fetal echocardiography should be considered if a woman takes paroxetine in early pregnancy. ACOG also recommends the use of a single medication at higher dosages over the use of multiple psychotropic medications. Treatment with SSRIs, selective norepinephrine reuptake inhibitors, or both should be individualized.
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Lifestyle adjustments
Sleep disturbances and insomnia are very common during pregnancy, with some studies reporting that over two-thirds of women experience sleep difficulties in the third trimester. This can be due to a variety of factors, including restless leg syndrome, sleep apnea, hormonal fluctuations, physical discomfort, and stress.
- Improving "sleep hygiene" by engaging in relaxing activities before bed, such as drinking a cup of tea, taking a warm shower, meditating, or trying some light reading.
- Avoiding screen time and excessive phone use right before bed.
- Taking magnesium supplements, which can be recommended by a doctor.
- Trying herbal supplements, although it is important to consult a healthcare provider first, as the research on herbal remedies in pregnancy is limited.
- Trying melatonin supplements, although there are some concerns about potential risks, such as lower birth weights in animal studies, and the lack of regulation of these supplements.
If lifestyle adjustments do not improve sleep difficulties, it is important to consult a healthcare provider before taking any medication or supplement during pregnancy.
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Herbal supplements
Sleep disturbances and disorders are common during pregnancy, with insomnia reported by 5% to 38% of women in early pregnancy and a prevalence in late pregnancy as high as 60%. The decision to take herbal supplements to aid sleep during pregnancy should be made in consultation with a healthcare provider, as the safety of many sleep aids for pregnant people and their fetuses has yet to be verified.
Some common herbal sleep aids used during pregnancy include melatonin supplements, antihistamines, and herbal teas. Melatonin is a hormone naturally produced by the human body that helps people fall asleep and wake up at appropriate times. While melatonin supplements have not been found to be harmful to pregnant humans or their fetuses, there are concerns about potential unknown side effects as the FDA does not regulate these supplements. Additionally, some experts worry that melatonin exposure in the womb may affect the baby's ability to establish healthy sleep-wake cycles after birth.
Herbal teas are another option for pregnant women experiencing sleep difficulties. However, it is important to note that not all herbs are safe during pregnancy. For example, chamomile has been associated with an increased risk of preterm birth and decreased newborn size, while the safety of valerian and lavender during pregnancy is unknown. Therefore, it is recommended to consult with a healthcare provider before consuming herbal teas as sleep aids during pregnancy.
Other herbal supplements that may promote relaxation and better sleep during pregnancy include magnesium supplements, which can help ease muscle pain and decrease the risk of preterm labor, and aromatherapy, which is generally considered safe but should be discussed with a healthcare provider first. Warm baths before bed can also help relax the body and improve sleep, but it is important for pregnant women to ensure that their core body temperature does not exceed 102 degrees Fahrenheit.
While herbal supplements can provide a more natural approach to managing sleep difficulties during pregnancy, it is always advisable to consult with a healthcare provider to weigh the risks and benefits of any intervention and explore non-pharmacological measures before resorting to sleep aids.
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Frequently asked questions
It is always best to consult a doctor before taking any medication during pregnancy. However, some common sleep aids used during pregnancy are melatonin supplements and antihistamines. Pregnant people can also take doxylamine (Unisom) and diphenhydramine (Benadryl), which have shown no increased risk of congenital abnormalities.
Lifestyle adjustments and natural sleep aids are recommended as the first course of action for pregnant women experiencing sleep difficulties. Some natural sleep aids include drinking tea, taking a warm shower, meditation, and light reading before bed.
Yes, it is recommended that pregnant women avoid taking Eszopiclone (Lunesta) as there is very limited safety data available. Herbal supplements such as passionflower should also be avoided due to the lack of extensive research on their effects during pregnancy.
