Although pregnancy may bring on insomnia, sleeping pills and pregnancy may not be a good combination. Doctors don't know what effects many of these drugs might have on a developing fetus.
Types of Sleeping Pills
There are many different types of sleeping pills. A lot of the older choices are in a class of drugs called benzodiazepines. Different types of benzodiazepines have varying lengths of action, so some wear off quickly, some will last through the night, and some will leave you feeling "hung over" in the morning. Newer prescription sleeping pills are often called "non-benzodiazepines" because they have a different chemical structure, but they work in a similar way.
Most over-the-counter sleeping pills are actually other types of medicines that happen to cause drowsiness as a side effect. Antihistamines, like the medicine in Benadryl, are also packaged as sleep aids.
Doctors aren't sure whether benzodiazepines are safe during pregnancy. In animal studies, benzodiazepines appear to cause birth defects including cleft lip and skeletal abnormalities. Early human studies suggested that birth defects would happen in humans, too. However, later studies failed to show a connection. If there is an increased risk, it appears to be small.
In late pregnancy, benzodiazepines can sedate the fetus. After birth, the baby may show signs of withdrawal, so he or she may have trouble breathing, be unable to keep a stable temperature, be weak or jittery, be irritable, or have trouble sleeping. In most cases, the baby will gradually get better, but may need special care until then.
No one knows for sure if taking benzodiazepines during pregnancy will affect the baby's long-term mental or neurological development. Doctors generally think that there won't be long-term problems, but the relationship between these sleeping pills and pregnancy hasn't been studied very thoroughly.
Lunesta is considered a "non-narcotic" sleep aid. Its active ingredient has a different chemical structure from the benzodiazepines. The manufacturer offers some information about this sleeping pill and pregnancy.
In rats, Lunesta appears to impair fertility, affecting both males and females. When very high doses were given to pregnant rats, their offspring tended to be smaller and less likely to survive. The drug also appeared to cause an increased startle response in the baby rats. However, the doses given to the pregnant rats were 100 times or more the "normal" dose a human would take.
Whether Lunesta has any effect in human pregnancies isn't known. For now, Lunesta is considered Pregnancy Category C, meaning that it should be used only if the benefits outweigh the potential risks.
Ambien (generic name zolpidem) is also different from the benzodiazepines. According to the manufacturer, it did not impair fertility in animal studies. However, high doses in pregnant rats seemed to interfere with the formation of skull bones in the fetuses. Offspring tended toward lower weight and poorer survival. Again, whether any of this would happen in humans isn't known. Like Lunesta, Ambien is Pregnancy Category C.
Rozerem is yet another non-narcotic sleeping pill. Once again, information is limited on this sleeping pill and pregnancy. High doses in rats led to birth defects including skeletal malformations and malformations of the diaphragm. In rabbits, these problems were not seen. There are simply no adequate studies in humans, so doctors don't know whether or not this drug is safe in pregnancy. It, too, is considered Category C, meaning that it should be used only if the benefits are greater than the possible risks.
Over the Counter Choices
Diphenhydramine is the antihistamine in Benadryl, which is sold as Sominex and other over the counter sleeping pills. Unisom also contains another antihistamine called doxylamine. Both of these drugs can leave you feeling drowsy in the morning.
Doctors often suggest Benadryl when sleeping pills and pregnancy must be combined. However, Benadryl is still rated as Pregnancy Category B, which means that it hasn't yet been proven to be completely safe. Category B drugs should be used during pregnancy only if clearly needed.
Alternatives to the Combination of Sleeping Pills and Pregnancy
It's possible to overcome insomnia without sleeping pills. If worries about being a mom keep you awake, finding someone to share your feelings with can help. Morning sickness can also make it hard to sleep; doing things that ease the nausea and indigestion can let you catch some zzz's.
Other tricks to try include:
- daily exercise appropriate to your pregnancy stage.
- good sleep hygiene, meaning setting a regular bedtime and not using the bed for any activities except sex and sleep.