Pregnancy Sleep Aid Safety

Expert: Jill Purdie, MD

Prenatal sleep is probably better known as the elusive land of nod; from heartburn to leg cramps to general anxiety and restlessness, regardless of whether you’re in you’re first trimester or your last, there are myriad reasons why a parent-to-be can’t get the shuteye they desperately need.

But one cut-throat caveat to pregnancy is that many sleep medications and dietary supplements are off-limits due in part to possible risks of pregnancy complications, fetal development, or even preterm birth. (This goes for a lot of meds when breastfeeding, too.) To help make sense of pregnancy sleep-help safety, we connected with Jill Purdie, MD, an OB-GYN and medical director at Northside Women’s Specialists of Pediatrix Medical Group in Cumming, Georgia, for a Q&A on options for warding off insomnia when it strikes. After all, the 40-week journey to parenthood is a long one; give yourself a fighting chance at a good night’s sleep before baby’s big arrival.

Q: Is Melatonin Safe While Pregnant?

A: Melatonin is typically not recommended for use throughout all weeks of pregnancy. Although it is made by the pineal gland naturally in the body during pregnancy and helps regulate our sleep cycles, there is minimal safety data available to show that any levels of melatonin are safe in pregnancy. The normal doses available over the counter actually raise the melatonin levels in the body well above the natural ranges. Also, since it is not regulated by the Food and Drug Administration (FDA), melatonin supplements may contain other medication, and the actual amount of melatonin in the supplement may vary widely. More research is currently being done to assess the effects of melatonin use in pregnant people and whether or not it’s safe.

Q: What Sleep Aid Can You Take While Pregnant?

A: Sleep aids that have been better studied in pregnancy and are regulated by the FDA are more commonly recommended by health care providers for sleeping issues during pregnancy. Pregnant people may safely take doxylamine, such as Unisom, which showed no increased risk of congenital abnormalities in studies. Doxylamine is available over the counter, and the typical dose is 25 milligrams nightly. An expecting parent may also use diphenhydramine, such as Benadryl, 25 milligrams nightly, for sleep. Based on the current literature, no increased risks of congenital anomalies were noted.

Q: Is Magnesium Approved for Use in Pregnancy?

A: There’s a lack of research on this topic; studies that show that magnesium helps with sleep are small, and the evidence is minimal. However, there also does not seem to be any harmful side effects in trying magnesium for sleep during pregnancy at the appropriate dose. Oral tablets have the most predictable absorption and are the most commonly recommended. Specifically, magnesium citrate is the easiest to absorb. Adults should take 200 milligrams about 30 minutes prior to bedtime. The topical forms of magnesium (gel, oil, foot soaks) are not absorbed in a high enough concentration to help with better sleep.

Q: Any Other Tips for Better Sleep During Pregnancy?

A: During pregnancy, it is critical to have good sleep routines: have a sleep routine; avoid caffeine later in the day; have a cool, dark sleeping environment; and avoid phones and other devices right before bedtime. Pregnant people may also try hot tea or milk, a warm bath, or varying sleeping locations. Pregnancy pillows may also be useful for additional support, especially around the pregnant belly. Daily exercise is often also helpful in promoting good sleep. Remember that most expecting parents have trouble sleeping at some point during pregnancy. Don’t be afraid to talk to your provider for wellness advice, especially when it concerns safety, both when you’re pregnant and through the postpartum period.

Note: You should never begin taking any medication or supplement while pregnant without consulting your health care provider first.