Insomnia is common during pregnancy, but is Ambien and pregnancy a safe combination?
Ambien is the brand name for a medicine called zolpidem that is FDA approved for short-term treatment of insomnia. It's considered a "non-benzodiazepine hypnotic," which essentially means it will make you sleepy. It works a little differently from older benzodiazepine drugs like valium, although both can help make you feel relaxed and drowsy.
Ambien is designed to wear off by the end of the night so it doesn't lead to morning sleepiness or a hung-over feeling (some people will find that this does happen, however). Unlike longer-acting drugs, it doesn't seem to accumulate in the body even if it's taken over several nights in a row.
What's Known about Ambien and Pregnancy
Ambien is considered a "Pregnancy Category C" medication. Pregnancy Category C means that:
- The drug hasn't been studied in pregnant women.
- Studies on pregnant animals have shown birth defects or other problems, or no animal studies have been done.
- The medicine should be used in pregnant women only if the benefits justify the risks.
A medical case report, appearing in the journal Pharmacotherapy in early 2007, found traces of Ambien in a newborn baby's umbilical cord blood, suggesting that Ambien can cross the placenta. If this is true, it means that the drug can reach the unborn baby.
Effects in Rats
When pregnant rats were given Ambien at high doses, there were some problems with fetal development. The fetal skulls appeared to develop abnormally while the bones were slow to form. In another high-dose test, the newborn rats had low birth weights and decreased survival.
At lower doses, equivalent to about four or five times the recommended dose in humans, the baby rats appeared to be normal.
Effects in Rabbits
In pregnant rabbits, high doses of Ambien made miscarriage more likely. There were also some problems with bone formation. At lower doses, equivalent to about nine or ten times the recommended dose in humans, there did not appear to be any problems with the fetuses.
General Information about Sleep Drugs and Pregnancy
There are some concerns about sleep drugs in pregnant women which may apply to Ambien and pregnancy.
- Sleep drugs can sedate the unborn baby when used during the final weeks of pregnancy.
- Use of some sleep drugs can cause the baby to have withdrawal symptoms after birth.
- Sleep drugs can lead to daytime drowsiness, which could increase the risk of injury.
- Sleep drugs can occasionally cause emotional disturbances, hallucinations, worsening of depression, suicidal thoughts, or other mental changes.
Is Ambien and Pregnancy a Safe Combination?
Whether or not you can take Ambien during pregnancy is a decision you and your doctor should make together. Many women will want to avoid all medications which are not known to be 100 percent safe. Since there is incomplete information on the risks of Ambien and pregnancy, you may want to choose another way to deal with insomnia.
Many obstetricians recommend using diphenhydramine (sold under many different brands, including Benadryl) for insomnia during pregnancy. However, even this popular standby isn't proven to be completely safe in pregnancy.
A better bet may be to concentrate on sleep hygiene and simple home remedies. Practicing good "sleep hygiene" means taking control of your sleep schedule, sleep surroundings, and habits regarding sleep. Relaxation techniques, including meditation and massage, can also help.
- Try to go to bed at the same time every night.
- If you haven't fallen asleep after 20 minutes, get up and do something else until you feel sleepy. Try to choose something that isn't stimulating. For example, don't read an exciting book or play a video game.
- Don't use your bed to do work, watch TV, or do anything else but sleep (but having sex is ok).
- Try eating a light, healthy snack a little before bedtime. Warm milk may help you feel sleepy.