can I take melatonin or other sleep aids?
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4 articles from healthcare institutions
What to Know About Melatonin and Sleep Aids During Pregnancy
Sleep problems are very common in pregnancy, and it’s understandable to look for relief. However, the safety of melatonin and other sleep aids during pregnancy is not fully established, and recommendations vary depending on the type of sleep aid.
Melatonin: Limited Evidence and Not Routinely Recommended
Melatonin is a hormone your body naturally produces to regulate sleep. During pregnancy, your body actually makes more melatonin on its own. Melatonin supplements are widely available, but:
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There is not enough research on the safety of melatonin supplements in pregnancy. Most available studies are small or based on animal data, and there are no large, high-quality trials in pregnant people.
1ArticleThe Role of Melatonin in Pregnancy and the Health Benefits for the Newborn - PMCAlthough several studies have confirmed that melatonin supplementation in pregnancy and immediately after has a positive effect on the mother and fetus, long-term clinical trials are imperative to reach clinical outcomes that serve as a final consensus about the use of melatonin as a treatment in pregnancy and newborns. This suggests that the use of melatonin in early life could preserve the safety of life in the future.→
PubMed Central
2ArticleHow do you Zzz during pregnancy? A brief review of Z-drug use and management of insomnia during pregnancy - PMCRamelteon was shown to have dose-dependent teratogenicity in animal studies, but no human data on either pregnancy or lactation are available.22 · Doxylamine is a reasonable over-the-counter option to treat insomnia, and it was the only previously listed category A medication by the Food and ...→3ArticleMelatonin use during pregnancy and lactation: A scoping review of human studies - PMCThese levels are even higher in twin pregnancies but, conversely, are significantly lower in severe preeclampsia pregnancies.26 Thus, serum melatonin levels vary throughout pregnancy, as well as between different conditions associated with pregnancy and, although the mechanism for this is not well understood, it may represent a potential therapeutic target.26 · In terms of clinical trials, the present review found no trials whose primary outcomes were the safety or efficacy of melatonin for insomnia or other sleep disorders during pregnancy.→4ArticleTreatment of Insomnia During Pregnancy - MGH Center for Women's Mental HealthAlthough Ambien (zolpidem) and other sedative-hypnotic agents, including Lunesta (eszopiclone) and Sonata (zalepion), are commonly prescribed to women with sleep disturbance, the data regarding their reproductive safety is limited and generally we try to avoid their use during pregnancy.→MGH Center for Women's Mental Health - Women's Mental Health Across the Life Cycle
5ArticleA review of sleep-promoting medications used in pregnancy - PubMedMedications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations.→PubMed
6ArticlePregnancy, breastfeeding and fertility while taking melatonin - NHSMelatonin is not usually recommended during pregnancy because little is known about its effect on babies.→nhs.uk
7ArticleTreating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental HealthThere is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...→ -
Because of this lack of evidence, most experts and organizations do not recommend routine use of melatonin supplements during pregnancy unless specifically advised by your OB/GYN.
3ArticleMelatonin use during pregnancy and lactation: A scoping review of human studies - PMCThese levels are even higher in twin pregnancies but, conversely, are significantly lower in severe preeclampsia pregnancies.26 Thus, serum melatonin levels vary throughout pregnancy, as well as between different conditions associated with pregnancy and, although the mechanism for this is not well understood, it may represent a potential therapeutic target.26 · In terms of clinical trials, the present review found no trials whose primary outcomes were the safety or efficacy of melatonin for insomnia or other sleep disorders during pregnancy.→5ArticleA review of sleep-promoting medications used in pregnancy - PubMedMedications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations.→6ArticlePregnancy, breastfeeding and fertility while taking melatonin - NHSMelatonin is not usually recommended during pregnancy because little is known about its effect on babies.→7ArticleTreating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental HealthThere is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...→
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Melatonin supplements can raise blood levels much higher than what your body naturally produces, and the effects of these higher levels on a developing baby are unknown.
5ArticleA review of sleep-promoting medications used in pregnancy - PubMedMedications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations.→6ArticlePregnancy, breastfeeding and fertility while taking melatonin - NHSMelatonin is not usually recommended during pregnancy because little is known about its effect on babies.→
Over-the-Counter (OTC) Sleep Aids: What’s Commonly Used
Some OTC sleep aids have been more widely studied in pregnancy:
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Antihistamines like diphenhydramine (Benadryl) and doxylamine (Unisom) are commonly used and generally considered safe for occasional use in pregnancy. Large studies have not shown an increased risk of birth defects with these medications.
7ArticleTreating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental HealthThere is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...→8ArticleInsomnia and sleep deficiency in pregnancy - PMC - NIHThis class of drug is available over-the-counter and is widely used in pregnancy for symptoms besides insomnia such as nausea, vomiting, and cold/ allergy symptoms57; 92% of women reported using an over-the-counter sleep aid occasionally during their pregnancy.58 Diphenhydramine was equally efficacious compared with the antidepressant trazadone for improving sleep quality and depressive symptoms compared with placebo.56 Overall, data from the National Birth Defects Prevention study suggested that exposure to antihistamines in early pregnancy did not show any increased risk in cardiac effects, birth defects or major malformations.57→9ArticleSleep in Pregnancy | GW Medical Faculty AssociatesThere are overthe- counter sleep aids that are safe to use during pregnancy, including Benadryl, Tylenol PM, and Unisom.→
George Washington University Medical Faculty Associates
10ArticleMelatonin - MotherToBaby | Fact Sheets - NCBI Bookshelf - NIHDoes taking melatonin increase the chance of birth defects? Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. It is not known if taking melatonin would increase the chance of birth defects.→National Center for Biotechnology Information
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These medications can cause drowsiness and should be used according to package directions. They are not recommended for long-term use and should be discussed with your OB/GYN, especially if you have other health conditions.
9ArticleSleep in Pregnancy | GW Medical Faculty AssociatesThere are overthe- counter sleep aids that are safe to use during pregnancy, including Benadryl, Tylenol PM, and Unisom.→10ArticleMelatonin - MotherToBaby | Fact Sheets - NCBI Bookshelf - NIHDoes taking melatonin increase the chance of birth defects? Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. It is not known if taking melatonin would increase the chance of birth defects.→
Prescription Sleep Medications: Use With Caution
Prescription sleep aids (such as benzodiazepines or “Z-drugs” like zolpidem/Ambien) are generally avoided in pregnancy unless absolutely necessary:
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Some of these medications may be associated with risks like preterm birth or low birth weight, and their safety profiles are less well established in pregnancy.
5ArticleA review of sleep-promoting medications used in pregnancy - PubMedMedications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations.→8ArticleInsomnia and sleep deficiency in pregnancy - PMC - NIHThis class of drug is available over-the-counter and is widely used in pregnancy for symptoms besides insomnia such as nausea, vomiting, and cold/ allergy symptoms57; 92% of women reported using an over-the-counter sleep aid occasionally during their pregnancy.58 Diphenhydramine was equally efficacious compared with the antidepressant trazadone for improving sleep quality and depressive symptoms compared with placebo.56 Overall, data from the National Birth Defects Prevention study suggested that exposure to antihistamines in early pregnancy did not show any increased risk in cardiac effects, birth defects or major malformations.57→ArticleA review of sleep-promoting medications used in pregnancy - ScienceDirectThis review also provides guidance ... special populations. ... Therefore, no sleep aids, prescription or OTC, are presently considered safe and efficacious for insomnia during pregnancy....→
sciencedirect.com
- If sleep problems are severe and not helped by other methods, your OB/GYN may discuss the risks and benefits of specific prescription options with you.
Non-Medication Strategies: First-Line Approach
Most experts recommend trying non-medication approaches first, such as:
- Practicing good sleep hygiene (consistent bedtime, limiting screens, relaxing bedtime routine)
- Cognitive behavioral therapy for insomnia (CBT-I)
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Gentle exercise, massage, or relaxation techniques
2ArticleHow do you Zzz during pregnancy? A brief review of Z-drug use and management of insomnia during pregnancy - PMCRamelteon was shown to have dose-dependent teratogenicity in animal studies, but no human data on either pregnancy or lactation are available.22 · Doxylamine is a reasonable over-the-counter option to treat insomnia, and it was the only previously listed category A medication by the Food and ...→7ArticleTreating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental HealthThere is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...→11Article💊 Medication Safety to Treat Sleep Disorders in Pregnancy: What You Need to Know — Brandon Peters, MDWhen it comes to sleep and pregnancy, medication isn’t off the table—but it should be approached with caution and professional guidance. Some sleep aids, like diphenhydramine or doxylamine, may be considered safe for occasional use, while others, especially prescription drugs, carry real risks.→
brandonpetersmd.com
What’s Still Unknown
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There is no sleep aid—prescription, OTC, or supplement—that is universally considered completely safe and effective for insomnia during pregnancy.
ArticleA review of sleep-promoting medications used in pregnancy - ScienceDirectThis review also provides guidance ... special populations. ... Therefore, no sleep aids, prescription or OTC, are presently considered safe and efficacious for insomnia during pregnancy....→
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The decision to use any sleep aid should be individualized, weighing the risks of poor sleep against the potential risks of medication or supplements.
7ArticleTreating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental HealthThere is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...→8ArticleInsomnia and sleep deficiency in pregnancy - PMC - NIHThis class of drug is available over-the-counter and is widely used in pregnancy for symptoms besides insomnia such as nausea, vomiting, and cold/ allergy symptoms57; 92% of women reported using an over-the-counter sleep aid occasionally during their pregnancy.58 Diphenhydramine was equally efficacious compared with the antidepressant trazadone for improving sleep quality and depressive symptoms compared with placebo.56 Overall, data from the National Birth Defects Prevention study suggested that exposure to antihistamines in early pregnancy did not show any increased risk in cardiac effects, birth defects or major malformations.57→11Article💊 Medication Safety to Treat Sleep Disorders in Pregnancy: What You Need to Know — Brandon Peters, MDWhen it comes to sleep and pregnancy, medication isn’t off the table—but it should be approached with caution and professional guidance. Some sleep aids, like diphenhydramine or doxylamine, may be considered safe for occasional use, while others, especially prescription drugs, carry real risks.→12ArticleSleep Pharmacotherapy for Common Sleep Disorders in Pregnancy and Lactation - PMCHowever, narcolepsy is an important consideration in perinatal patients due to concern for medication safety in pregnancy and breastfeeding, the prevalence of poor sleep (including added factors leading to sleep restriction postpartum), and the potential influence of the disorder on pregnancy outcomes and mode of delivery.→
Wrapping Up: What to Consider Next
If you’re struggling with sleep, it might be beneficial to start with non-medication strategies and talk with your OB/GYN before using any sleep aid—including melatonin or OTC options. Your doctor can help you weigh the risks and benefits based on your specific situation and guide you toward the safest options for you and your baby.
3
Article
Melatonin use during pregnancy and lactation: A scoping review of human studies - PMC
These levels are even higher in twin pregnancies but, conversely, are significantly lower in severe preeclampsia pregnancies.26 Thus, serum melatonin levels vary throughout pregnancy, as well as between different conditions associated with pregnancy and, although the mechanism for this is not well understood, it may represent a potential therapeutic target.26 · In terms of clinical trials, the present review found no trials whose primary outcomes were the safety or efficacy of melatonin for insomnia or other sleep disorders during pregnancy.
5
Article
A review of sleep-promoting medications used in pregnancy - PubMed
Medications that we investigated included benzodiazepines, hypnotic benzodiazepine receptor agonists, antidepressants, and antihistamines. Overall, the examined studies showed no correlation of increased risk of congenital malformations.
6
Article
Pregnancy, breastfeeding and fertility while taking melatonin - NHS
Melatonin is not usually recommended during pregnancy because little is known about its effect on babies.
7
Article
Treating Insomnia During Pregnancy: Is Trazodone Safe? - MGH Center for Women's Mental Health
There is good evidence to support the use of cognitive behavioral therapy for the treatment of insomnia during pregnancy. If sleep medications are needed, the following options may be considered. Doxylamine is an over-the-counter medication for insomnia (contained in Unisom Sleep Tabs, 25 – ...
8
Article
Insomnia and sleep deficiency in pregnancy - PMC - NIH
This class of drug is available over-the-counter and is widely used in pregnancy for symptoms besides insomnia such as nausea, vomiting, and cold/ allergy symptoms57; 92% of women reported using an over-the-counter sleep aid occasionally during their pregnancy.58 Diphenhydramine was equally efficacious compared with the antidepressant trazadone for improving sleep quality and depressive symptoms compared with placebo.56 Overall, data from the National Birth Defects Prevention study suggested that exposure to antihistamines in early pregnancy did not show any increased risk in cardiac effects, birth defects or major malformations.57
9
Article
Sleep in Pregnancy | GW Medical Faculty Associates
There are overthe- counter sleep aids that are safe to use during pregnancy, including Benadryl, Tylenol PM, and Unisom.
10
Article
Melatonin - MotherToBaby | Fact Sheets - NCBI Bookshelf - NIH
Does taking melatonin increase the chance of birth defects? Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. It is not known if taking melatonin would increase the chance of birth defects.
11
Article
💊 Medication Safety to Treat Sleep Disorders in Pregnancy: What You Need to Know — Brandon Peters, MD
When it comes to sleep and pregnancy, medication isn’t off the table—but it should be approached with caution and professional guidance. Some sleep aids, like diphenhydramine or doxylamine, may be considered safe for occasional use, while others, especially prescription drugs, carry real risks.
12
Article
Sleep Pharmacotherapy for Common Sleep Disorders in Pregnancy and Lactation - PMC
However, narcolepsy is an important consideration in perinatal patients due to concern for medication safety in pregnancy and breastfeeding, the prevalence of poor sleep (including added factors leading to sleep restriction postpartum), and the potential influence of the disorder on pregnancy outcomes and mode of delivery.