Authored by 
Reviewed by The hormonal changes and physical discomforts associated with pregnancy can significantly affect women’s quality of sleep. Every trimester has its unique sleep challenges. Hence, most are turning into different sleeping aids during pregnancy. While it is best not to take sleeping aids while pregnant, certain conditions such as insomnia and restless leg syndrome may occur more frequently. Other sleep disorders like narcolepsy and sleep behaviors called parasomnias are also hard to treat naturally, thus requiring pharmacologic treatment.
Learn About Sleeping Pills:
Safest Sleeping Aids During Pregnancy
Occasional use of some sleeping pills during pregnancy can be considered safe, especially when recommended by a doctor. It is essential to understand the safe use and dosage of each drug class to avoid possible complications.
Following the classification of the effects of drugs during pregnancy, drugs that fall under category B are safe to be used as sleeping meds. Though there have been no controlled studies in pregnant women that exist yet, they have not shown any fetal risk in animal studies.
Over the counter antihistamines like diphenhydramine and doxylamine succinate are safe sleeping pills during pregnancy at recommended doses, even for extended periods. Aside from its anti-allergic effects, diphenhydramine also produces a sedative effect by blocking the action of acetylcholine, just like doxylamine succinate. Common examples include:
- Benadryl
- Diclegis
- Sominex
- Unisom
Some drugs may be used occasionally with great caution. They can be considered as a safe sleeping aid while pregnant because even if animal studies have shown adverse fetal events, controlled studies in pregnant women do not exist. Anticonvulsants, antidepressants, and depressants can be a prescription sleep medication given by a physician if the potential benefits will outweigh the possible risks:
- Gabapentin
- Amitriptyline
- Doxepin
- Trazodone
Do not try to self-medicate insomnia, especially when pregnant and breastfeeding. Only a doctor shall decide upon the sleep aid that will work best in each individual case.
Sleeping Pills That Are Harmful to Pregnant Women
Drugs that fall under category D and X are never recommended as pregnancy sleeping aids. Studies have shown risks to fetuses, along with other sleeping pill side effects like weakness, constipation, dry mouth, headache, heartburn, and more. These include alcohol, barbiturates, benzodiazepines, and other sedatives and hypnotics like:
- Alprazolam
- Diazepam
- Lorazepam
- Midazolam
- Secobarbital
- Estazolam
- Flurazepam
- Quazepam
- Temazepam
- Triazolam
- Zolpidem
- Amobarbital
- Pentobarbital
- Secobarbital
Skipping Sleeping Pills While Pregnant
While certain natural sleeping aids like the use of extra pillows, vitamins, and supplements and strategies like relaxation, exercising, and creating a bedtime routine may help improve sleep quality, some pregnant women may still require some sleeping pills safe for pregnancy, with the approval of a doctor.
Poor sleep can adversely affect physical and mental health. Lack of sleep during pregnancy has been associated with the following conditions:
- Hypertension
- Gestational diabetes
- Elevated perception of pain and discomfort during labor
- Longer labor
- Preterm labor
- Higher cesarean rates
- Increased levels of pro-inflammatory serum cytokines
Some evidence also shows a possible relationship between sleep deprivation and postpartum depressive mood.
One may skip taking sleeping pills for insomnia as long as it will not cause any maternal complications.
Common Birth Defects Associated with Sleeping Pills Use
The use of hypnotic benzodiazepine receptor agonists like Zolpidem as sleeping pills while pregnant has been associated with an increased risk of low birth weight or small for gestational age infants and preterm labor or cesarean delivery.
Many sedative-hypnotics also pass through the placenta quickly and may cause breathing problems, feeding difficulties, disturbed sleep, temperature regulation, and muscle problems.
The use of any barbiturate sleeping pill near delivery can cause sedation in the newborn that may last for days. Abuse or overdose on sleeping pills like barbiturates also poses a higher risk for significant malformations like cleft lip or cleft palate.
Another adverse effect that barbiturates can have on fetuses is Hemorrhagic Disease. These drugs hinder vitamin K, which is vital in forming blood clotting factors, from reaching the baby. This may cause severe bleeding during the first 24 hours of life. Spinal cord defects, irregular cardiac rhythms and abnormalities, and hypertelorism are also common.
Using Sleeping Pills While Breastfeeding
The sleep deprivation common to nursing moms is legendary, so the thought of needing sleeping pills seems impossible, but it is not.
Despite having natural prolactin, a hormone released during nursing that promotes feelings of calmness and relaxation, and a mounting sleep debt, rest can be easily disrupted by anything from childbirth discomfort to swollen breasts and anxiety.
Sleeping pills while breastfeeding can be used short-term. Antihistamines are the best sleeping aids while breastfeeding because only small amounts are excreted in breast milk. However, the use should still be limited, and babies must be monitored for drowsiness. Extended use of sleeping pills is not advisable because some may interfere with milk production and result in crying, irritability, and sleep problems in babies.
Always consult a doctor before taking any medication when breastfeeding as some substances may harm a baby.
Choosing the Right Sleep Medication for Pregnancy and Breastfeeding
Considering the use of safe sleeping pills for pregnancy and breastfeeding must be discussed thoroughly with a doctor. Symptoms and severity of sleeping problems must be considered to know if the condition will pass on its own or if one will require treatment. If possible, it is best to try non-pharmacological interventions first like lifestyle changes. Addressing stress, altering diet, and improving health through exercise can be very helpful.
If one chooses to take sleeping pills recommended by the doctor during pregnancy, potential risks should be discussed thoroughly. Aside from possible maternal and fetal complications, use should be monitored as certain prescription sleeping pills can lead to dependence or abuse and addiction. In such cases, different types of treatment for addiction may be employed with the help of professionals. Several drug and rehab centers offer excellent facilities for nursing moms and their babies.
Page Sources
- Jen Jen Chang, Grace W Pien, Stephen P Duntley, George A Macones. Sleep Deprivation during Pregnancy and Maternal and Fetal Outcomes: Is There a Relationship? Sleep Med Rev. 2010 Apr; 14(2): 107–114. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824023/
- Cristina A Reichner. Insomnia and sleep deficiency in pregnancy. Obstet Med. 2015 Dec; 8(4): 168–171. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935047/
- Lisa R Dolovich, Antonio Addis, M Régis Vaillancourt, J D Barry Power, Gideon Koren, Thomas R Einarson. Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies. BMJ. 1998 Sep 26; 317(7162): 839–843. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC31092/
