💊 Medication Safety to Treat Sleep Disorders in Pregnancy: What You Need to Know

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.

What to Take When You Can’t Sleep

A good night’s sleep is crucial for overall health and well-being, yet many individuals find themselves struggling with sleeplessness, whether due to stress, lifestyle factors, or underlying health conditions. While sleep problems can sometimes be temporary, persistent insomnia can lead to significant physical and mental health issues. If you’re having trouble sleeping, you may wonder what you can take to help fall asleep and improve your sleep quality. The answer depends on the underlying cause of your insomnia, and the options range from over-the-counter supplements to prescription medications. Below, we explore various remedies that can help when you can't sleep, both natural and pharmaceutical, and how to determine what might be best for you.

1. Over-the-Counter Sleep Aids

For many individuals, over-the-counter (OTC) sleep aids are a go-to solution when they struggle with occasional sleeplessness. These medications are typically sold without a prescription and contain ingredients designed to promote drowsiness or relaxation.

Diphenhydramine or Doxylamine

One of the most common OTC sleep aids is diphenhydramine, an antihistamine commonly found in medications like Benadryl and “PM” medications. Doxylamine is found in Unisom. Diphenhydramine and doxylamine work by blocking histamine receptors in the brain, which reduces wakefulness and promotes sleepiness. While it can be effective for occasional use, it’s important to note that this drug can cause grogginess the next morning, and repeated use may lead to tolerance, meaning its effectiveness diminishes over time. There is concern that long-term use may contribute to dementia risk.

Melatonin

Melatonin is a hormone that your body naturally produces to regulate the sleep-wake cycle. Supplementing with melatonin is a popular remedy for people who have difficulty falling asleep, particularly for those with circadian rhythm disorders or those who are adjusting to new time zones (like in the case of jet lag). Melatonin supplements are available in various doses, and they are generally considered safe for short-term use. However, it’s best to consult a healthcare professional about the right dosage and timing, as too much melatonin can actually disrupt your sleep cycle.

Valerian Root

Valerian root is a herbal supplement often used to treat insomnia and anxiety. It has sedative properties and may help some individuals fall asleep more quickly. The exact way it works is not fully understood, but it is believed to increase the amount of gamma-aminobutyric acid (GABA) in the brain, which promotes relaxation and sleep. While valerian root is generally considered safe for short-term use, it can cause side effects such as headaches or dizziness in some individuals. It’s advisable to use it under the guidance of a healthcare provider.

2. Prescription Sleep Medications

If OTC options do not provide the relief you need, prescription medications might be an option. However, these medications are usually prescribed for individuals who have chronic insomnia or other sleep disorders. Prescription sleep aids should only be used under the supervision of a doctor because they may cause side effects, interactions with other medications, and potential dependency.

Benzodiazepines

Benzodiazepines, such as temazepam (Restoril), lorazepam (Ativan), and alprazolam (Xanax), are often prescribed for short-term insomnia. These medications work by enhancing the effects of GABA, a neurotransmitter that calms brain activity and induces sleep. While they are effective, they are typically not recommended for long-term use due to their potential for dependence and withdrawal symptoms. Benzodiazepines can also cause side effects like dizziness, memory issues and dementia, and daytime drowsiness.

Non-Benzodiazepine Sedatives

Non-benzodiazepine sleep aids, such as zolpidem (Ambien) and eszopiclone (Lunesta), are commonly prescribed to treat insomnia. These medications have a similar effect to benzodiazepines but are often considered to be less habit-forming. Non-benzodiazepines work by targeting the brain’s receptors responsible for sleep and can help people fall asleep more quickly and stay asleep throughout the night. However, like benzodiazepines, they can cause drowsiness the next day, memory impairment, sleep-related behaviors, and have the potential for misuse.

Antidepressants

Certain antidepressants, like trazodone (Desyrel) and amitriptyline (Elavil), are sometimes prescribed off-label to help with sleep. These medications have sedative effects and are often used for individuals who experience insomnia due to anxiety or depression. They are generally considered safe for long-term use, but side effects can include daytime grogginess, dizziness, and weight gain. Additionally, these medications can interact with other antidepressants and should only be used under a doctor’s supervision.

3. Natural and Herbal Remedies

For those who prefer natural approaches, there are several herbal remedies and lifestyle changes that may help promote relaxation and improve sleep. While the evidence for these remedies varies, many people find them helpful for reducing stress and encouraging restful sleep.

Lavender

Lavender is a widely used herb known for its calming and relaxing properties. Studies have shown that lavender can help reduce anxiety, stress, and insomnia. You can use lavender in various forms, such as essential oils, teas, or supplements. Diffusing lavender oil in your bedroom before bed or adding a few drops to your pillow can create a soothing environment that promotes better sleep.

Chamomile

Chamomile is another herb commonly used to improve sleep quality. It has mild sedative effects and is often consumed as a tea before bed. Chamomile has been used for centuries to treat anxiety and insomnia, and it may help calm the nervous system, making it easier to relax and fall asleep. While it is generally considered safe, some people may experience allergic reactions, particularly those who are allergic to ragweed or daisies.

Magnesium

Magnesium is a mineral that plays a vital role in many bodily functions, including muscle relaxation and sleep regulation. Studies have shown that magnesium supplementation may help improve sleep quality, especially for those with low magnesium levels. Magnesium can be found in foods like leafy greens, nuts, and seeds, or it can be taken as a supplement. Some people prefer magnesium supplements or magnesium oil for topical use to promote relaxation before bedtime.

4. Lifestyle and Behavioral Changes

Sometimes, sleep difficulties are not solely resolved by taking medication or supplements. Lifestyle changes and good sleep hygiene can have a significant impact on improving your sleep quality in the long term. A few strategies to consider include:

• Establishing a consistent bedtime routine: Going to bed and waking up at the same time every day helps regulate your body’s internal clock.

• Creating a calming environment: Keeping your bedroom cool, dark, and quiet can help signal to your body that it’s time to sleep.

• Limiting caffeine and alcohol: Both caffeine and alcohol can disrupt your sleep patterns, so try to avoid consuming them several hours before bed.

• Managing stress: Practicing relaxation techniques such as meditation, deep breathing, or gentle stretching before bed can help reduce stress and anxiety, making it easier to fall asleep.

5. When to See a Doctor

If you’ve tried over-the-counter remedies, herbal supplements, and lifestyle changes without success, it may be time to consult a doctor. Persistent sleep problems could be indicative of an underlying condition, such as sleep apnea, restless leg syndrome, anxiety, or depression. A healthcare provider can help determine the root cause of your sleep difficulties and provide more targeted treatment options. Cognitive behavioral therapy for insomnia (CBTI) is the preferred treatment for insomnia that persists beyond 3 months.

Conclusion

There are a variety of options to consider when you can’t sleep, ranging from over-the-counter supplements to prescription medications and natural remedies. What you choose to take depends on your individual circumstances, including the underlying cause of your sleep issues. While medications can provide short-term relief, incorporating lifestyle changes and improving sleep hygiene may offer long-lasting benefits for your sleep quality. Ultimately, if sleeplessness persists, it’s important to seek professional advice to address any potential underlying health concerns.

This article was created using OpenAI’s ChatGPT on February 21, 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.