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What Can You Take to Help You Sleep While Pregnant?

Sleep medicines are advised against using during pregnancy, but there are other medicines and home remedies that can help you sleep. These include over-the-counter medicines (antihistamines), herbal remedies (ginseng, honey, nutmeg), melatonin, and prescription medications. Always check with your doctor first on what medications would be safe.
Sleep medicines are advised against using during pregnancy, but there are other medicines and home remedies that can help you sleep. These include over-the-counter medicines (antihistamines), herbal remedies (ginseng, honey, nutmeg), melatonin, and prescription medications. Always check with your doctor first on what medications would be safe.

Pregnant women are generally advised to avoid medications, including sleep medicines, during pregnancy. Most drugs are not tested on pregnant women and the effects on the unborn baby are unknown. 

However, sleep problems are very common during pregnancy. Causes of insomnia during pregnancy may include:

  • Hormonal changes
  • Discomfort due to the increased size of the belly
  • Back pain
  • Heartburn
  • Waking frequently to urinate in the night
  • Anxiety
  • Anticipation of the arrival of the baby
  • Frequent and vivid dreams

For pregnant women who have severe sleep disorders or other medical conditions that cause sleeping problems, a doctor may recommend medication to help you sleep while pregnant. Never take any medication, even over-the-counter (OTC) medicines or supplements, during pregnancy without first talking to your doctor.

Medicines that may be recommended for pregnant women to help them sleep include the following remedies in the table below.

Sleep Remedies During Pregnancy
Sleep Aid Type Examples and Uses
Over-the-counter medicines
  • Antihistamines: diphenhydramine hydrochloride (Benadryl) and doxylamine (Unisom) cause drowsiness and may be used as sleep aids
  • Do not take OTC medicines without first talking to your doctor

Herbal remedies
  • Ginseng, honey, nutmeg, and oats may be safe for use during pregnancy
  • Because herbal remedies are classified as dietary supplements in the U.S. and not drugs, they are less strictly regulated by the Food and Drug Administration (FDA) 
  • Avoid use of American hellebore, arnica, black seed (kalonji), blue cohosh, chamomile, echinacea, feverfew, ginkgo biloba, kava kava, marijuana, mugwort, passion flower, Petasites, Rauwolfia, Salvia divinorum, taumelloolch, tulip tree, and valerian
  • If you wish to take herbal remedies, talk to your doctor first before taking anything, including herbal teas
Melatonin
  • This is a hormone and its effects on pregnancy and a developing baby are unknown, and it's generally recommended to avoid its use during pregnancy

Prescription medications for pregnant women who have severe insomnia or anxiety
  • Benzodiazepines: temazepam (Restoril), estazolam (ProSom), flurazepam (Dalmane), quazepam (Doral), and triazolam (Halcion).
  • Nonbenzodiazepine sleep aids: zolpidem (Ambien), zopiclone (Imovane), eszopiclone (Lunesta), and zaleplon (Sonata)
  • Benzodiazepines and nonbenzodiazepine sleep aids may increase the risk of preterm birth, low birth weight, small-for-gestational-age infants, and cesarean delivery (C-section)
  • Barbiturates: amobarbital, pentobarbital, and secobarbital
  • Birth defects have been reported with amobarbital when taken in the first trimester and using any barbiturate near delivery can cause sedation in the newborn that can last several days
  • Other prescription sleep medicines include: chloral hydrate (Chloralum), etomidate (Amidate), ramelteon (Rozerem), suvorexant (Belsomra), and tasimelteon (Hetlioz)
  • The risks of these drugs during pregnancy are unknown but may be similar to those of benzodiazepines, non-benzodiazepines, and barbiturates 

Prescription sleep medications should be avoided during late pregnancy because they may cause breathing and muscle tone problems in infants exposed to these medications.

What Are Tips to Sleep Better While Pregnant?

There are a number of ways to improve sleep during pregnancy that don’t involve medications. 

  • Limit caffeine during the day and avoid it in the afternoon and evening
  • Drink less in the evening to reduce urination during the night
  • Avoid heavy meals and spicy foods before bedtime which can cause heartburn and indigestion
  • Snacking before bedtime may reduce morning sickness
  • Drink warm milk before bed
  • Take naps: keep naps 30 to 60 minutes and do not nap too late in the day
  • Write down the things you worry about before bed and to reduce waking in the middle of the night with anxiety
  • Enroll in a class about labor and delivery, baby care, or breastfeeding, so you don’t worry about what to expect
  • Practice relaxation techniques
    • Yoga
    • Stretching 
    • Deep breathing
    • Progressive muscle relaxation
    • Guided imagery 
  • Get a massage
  • Choose the right pillows
  • A pillow tucked between bent knees can support the lower back
  • A pillow tucked behind the back can help you sleep on your side 
  • Special pillows can support the belly
  • Use extra pillows under the head to help relieve heartburn
  • An egg-crate foam mattress pad may help relieve hip discomfort
  • Practice good sleep hygiene
  • Keep a regular sleep schedule
  • Keep the room cool and dark
  • Maintain a relaxing bedtime routine
  • Sleep on your side
  • Use the bed only for sleep and sex
  • If you can’t sleep after 20 to 30 minutes, get out of bed and listen to soft music or read
  • Go back to bed when you feel sleepy

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References
https://www.babycenter.com/pregnancy/your-body/the-basics-of-good-sleep-during-pregnancy_7820

https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/insomnia-during-pregnancy-988/