Sleep can be one of the first things to change when you're expecting. From hormone swings and nighttime bathroom trips to anxiety and physical discomfort, many pregnant people struggle to get the rest they need. While lifestyle changes and natural remedies help some, others may wonder: Is it safe to take medication for sleep during pregnancy?
The answer isn't black and white. Sleep medications should always be approached with caution during pregnancy, and not all are considered safe. In this post, we’ll explore what sleep medications may be used (and avoided) during pregnancy, natural alternatives, and when it’s time to talk to your doctor.
😴 Why Sleep Is So Important in Pregnancy
Sleep isn’t just about feeling rested—quality sleep supports a healthy pregnancy. Poor sleep has been linked to:
Higher risk of gestational diabetes
High blood pressure and preeclampsia
Preterm birth
Postpartum depression
Increased labor difficulties
Because sleep is essential for both mom and baby, it’s understandable to want solutions when tossing and turning becomes the norm.
🚫 Why Sleep Medications Are Tricky During Pregnancy
Many over-the-counter (OTC) and prescription sleep aids haven’t been thoroughly tested for use during pregnancy. Some may impact fetal development, particularly in the first trimester when the baby's organs are forming.
The U.S. Food and Drug Administration (FDA) used to categorize medications by letter (A, B, C, D, X) for pregnancy safety. While that system is being phased out, it can still help frame the conversation:
Category A & B: Generally considered safe
Category C: Risk cannot be ruled out
Category D & X: Known risks—avoid unless absolutely necessary
Let’s look at the most common sleep-related medications and how they fare in pregnancy.
✅ Sleep Aids Sometimes Used During Pregnancy
1. Diphenhydramine (Benadryl)
Type: Antihistamine with sedative effects
Pregnancy Category: B
Common Use: Occasionally used to help with insomnia
Caution: Long-term use is not recommended; may increase uterine activity close to labor
2. Doxylamine (Unisom SleepTabs)
Type: Antihistamine
Pregnancy Category: B
Common Use: Safe in combination with vitamin B6 to treat morning sickness
Note: Some providers suggest it short-term for sleep, but always consult your OB first
3. Melatonin
Type: Hormone that regulates sleep cycles
Pregnancy Category: Not officially categorized
Status: Natural supplement, but safety in pregnancy is not well-established
Note: Use with caution due to hormonal effects—talk to a healthcare provider before taking it
⚠️ Sleep Medications to Avoid or Use Only Under Strict Supervision
1. Prescription Benzodiazepines (e.g., Lorazepam, Diazepam)
Pregnancy Category: D
Risks: Linked to birth defects, withdrawal symptoms in newborns, and low birth weight
Recommendation: Avoid unless prescribed for a serious condition under specialist care
2. Z-drugs (e.g., Zolpidem/Ambien)
Pregnancy Category: C
Risks: Some studies suggest links to preterm birth or breathing issues in newborns
Use: May be prescribed if benefits outweigh risks, but not first-line treatment
3. Over-the-Counter Sleep Aids Containing Alcohol or Multiple Drugs
Examples: NyQuil, Tylenol PM
Concerns: Alcohol content, potential for overmedication
Advice: Avoid unless recommended by your provider
🌿 Safer Alternatives: Non-Medication Options That Really Help
Before turning to medication, most providers recommend trying natural sleep aids and behavioral techniques, especially early in pregnancy.
🛌 Sleep Hygiene Tips:
Go to bed and wake up at the same time every day
Keep your bedroom cool, dark, and free of screens
Avoid caffeine in the afternoon and evening
Use relaxation techniques like breathing exercises, meditation, or prenatal yoga
🌼 Natural Remedies:
Magnesium supplements (under doctor’s advice)
Chamomile tea (in moderation)
Lavender essential oil in a diffuser or pillow spray
Guided meditation or sleep apps like Calm or Headspace
🩺 When to Talk to Your Doctor
If insomnia is affecting your daily function or contributing to depression, anxiety, or high blood pressure, it’s time to involve your healthcare provider. You don’t need to suffer through pregnancy sleeplessly—especially when there may be safe, effective solutions.
Your provider might recommend:
Cognitive Behavioral Therapy for Insomnia (CBTI)
Prenatal counseling to address stress or anxiety
A short-term, carefully monitored sleep aid if the benefits outweigh the risks
💬 Final Thoughts
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.
The best approach? Start with lifestyle changes and non-drug strategies, and talk openly with your doctor if sleep continues to be a struggle. With the right tools and support, restful nights can be part of your pregnancy journey.
This article was created using OpenAI’s ChatGPT on July 11, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.