Concerns About Ambien Use During Pregnancy

Julie Kirk
Co-author Beth S M.D.
Pregnant woman having difficulty falling asleep

Insomnia is common during pregnancy, however is Ambien and pregnancy a safe combination? If you are considering taking Ambien while pregnant, learn the facts about this drug and how it may impact you when having a baby.

What's Known About Ambien and Pregnancy

Ambien is considered a "Pregnancy Category C" medication by the U.S. Food and Drug Administration (FDA). 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.

Ambien also has the ability to cross the placenta and the sedative effects can reach the unborn baby.

The Effects of Ambien on Pregnant Rats and Rabbits

The FDA reports that studies done on pregnant rats and rabbits that were given Ambien showed adverse effects. 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.

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 for the pregnant woman, which could increase the risk of injury.
  • Sleep drugs can occasionally cause the pregnant woman to have emotional disturbances, hallucinations, worsening of depression during pregnancy, 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.

About Ambien

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.

You Should Not Abruptly Stop Taking Ambien

It is best to stop taking Ambien gradually or you may experience withdrawal symptoms such as:

  • Fatigue
  • Lightheadedness
  • Nausea
  • Vomiting
  • Nervousness
  • Uncontrollable crying
  • Panic attacks

Other Options

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. Unisom is another popular sleep aid option for pregnant woman and is considered safe by the FDA as short-term treatment for sleeplessness.

Sleep Hygiene

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 pregnancy massage can also help.

  • Try to go to bed at the same time every night.
  • Change sleep positions or use a body pillow.
  • Try soft, relaxing music.
  • 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.
  • Take a warm bath before bed.
  • Do some light to moderate exercise during the day.
  • Avoid long naps.

Sleep and Pregnancy

If you are experiencing insomnia and the lack of sleep is disrupting your daytime routine and affecting your health and well-being, you should let your doctor know and he will determine if Ambien or another option would be best for you. It is extremely important that you get adequate sleep for you and your baby when you are pregnant.

Concerns About Ambien Use During Pregnancy