Many pregnant women find they have difficulty sleeping due to increased hormone levels, discomforts such as nausea or heartburn, restless legs, difficulty finding a comfortable position and kicks from the baby. Although taking sleeping pills can be tempting, doctors generally discourage pregnant women from using them due to safety concerns. Pregnant women should always consult their doctor before taking any prescription, over-the-counter or herbal sleeping pills.
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The FDA categorises drugs as Class A, B, C, D or X for safety in pregnant women. Only Class A drugs have been proven safe, and there currently are no Class A sleeping pills available. However, both the prescription sleep aid Ambien and the over-the-counter medication benadryl (which often causes drowsiness) are Class B for pregnancy, meaning that they have been proven safe in animal studies, and are not known to cause harm in humans. For this reason, doctors may prescribe or recommend these or similar drugs for pregnant women with occasional sleep disturbances or severe sleep disorders.
Doctors may be more likely to recommend or prescribe sleeping pills for pregnant women who only need them for a short time, such as after changing time zones during a long trip, or who have chronic and severe insomnia or sleep disorders. Since sleeping pills can be habit forming, most doctors do not recommend taking them throughout pregnancy. When doctors do approve sleeping pills, they are likely to have pregnant women take the smallest effective dose for the shortest possible amount of time.
Some pregnant women may hope they can use herbal or natural sleep remedies instead of prescription or over-the-counter pills. However, not all natural sleep aids are safe for pregnant women, and some may be just as risky as pills. Ingredients such as kava, valerian, melatonin, passion flower and Siberian ginseng may be particularly unsafe. Since the safety and effectiveness of herbal sleep remedies, including teas, has not been proven, most doctors recommend avoiding them during pregnancy and while nursing.
Many people who take sleeping pills become so used to them that they can no longer fall asleep without them. When this happens in pregnant women, the baby may become used to the habit as well and go through withdrawal after delivery. Barbiturates, such as Phenobarbital or Luminal, can be particularly addictive, and some studies suggest that these drugs can also cause jaundice and a lowered IQ in babies whose mothers used them heavily. Although most modern prescription sleeping pills are probably less harmful, drugs such as Lunesta, Rozerem and Sonata are all Class C, meaning that animal studies have shown some possibility of harm to the baby or pregnant woman.
Rather than relying on sleeping pills, most experts recommend that pregnant women practice good sleeping habits to help them fall asleep. This may include avoiding caffeine, drinking plenty of water during the day but cutting back shortly before bed, and avoiding eating (especially spicy foods) two hours before trying to sleep to prevent heartburn, though some women may want a few crackers before bed to prevent nausea. Many women find that taking a 30-minute nap during the day, as well as getting moderate exercise, can also help them sleep better at night. Some pregnant women also find that a relaxing evening routine, such as soft music or a warm bath, helps them sleep. Maternity or regular pillows propped between the legs or behind the back can also help pregnant women find a more comfortable sleep position.