Prenatal sleep is probably better known as the elusive land of nod; from heartburn to leg cramps to general anxiety and restlessness, there are myriad reasons why a mama-to-be can’t get the shuteye she desperately needs.
But one cut-throat caveat to pregnancy is that many medications and dietary supplements are off-limits, due in part to possible risks in fetal development or even preterm birth. (Some meds are no-no’s if breastfeeding, too.) To help make sense of pregnancy sleep-help safety, we connected with Jill Purdie, MD, OB-GYN and medical director at Northside Women’s Specialists of Pediatrix Medical Group, on options for warding off insomnia when it strikes. After all, the 40-week journey to motherhood is a long one; give yourself a fighting chance at some real rest before baby’s big arrival.
1| Can pregnant women take melatonin?
Melatonin is typically not recommended for use throughout all weeks of pregnancy. Although it is made by the pineal gland naturally in the body during pregnancy and helps regulate our sleep cycles, there is minimal safety data available to show that any levels of melatonin are safe in pregnancy. The normal doses available over the counter actually raise the melatonin levels in the body well above the natural ranges. Also, since it is not regulated by the Food and Drug Administration (FDA), melatonin supplements may contain other medications and the actual amount of melatonin in the supplement may vary widely. More research is currently being done to assess the effects of melatonin use in pregnant women and whether or not it’s safe.
2| Are there safe sleep aids for pregnancy?
Sleep aids that have been better studied in pregnancy and are regulated by the FDA are more commonly recommended by healthcare providers for sleeping issues during pregnancy. Pregnant women may safely take doxylamine, which in studies showed no increased risk of birth defects. Doxylamine is available over the counter and the typical dose is 25 milligrams nightly. Women may also use diphenhydramine 25 milligrams nightly for sleep. Based on current literature, no increased risks of birth defects were noted.
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3| What about magnesium?
There’s a lack of research on this topic; studies that show that magnesium helps with sleep are small, and the evidence is minimal. However, there also does not seem to be any harmful side effects in trying magnesium for sleep at the appropriate dose. Oral tablets have the most predictable absorption, so would be the most commonly recommended. Specifically, magnesium citrate is the easiest to absorb. Women should take 200 milligrams about 30 minutes prior to bedtime. The topical forms of magnesium (gel, oil, foot soaks) are not absorbed in a high enough amount to help with better sleep.
4| Do you have additional recommends for women experiencing sleep problems?
It is important in pregnancy to have good sleep hygiene: have a sleep routine; avoid caffeine later in the day; have a cool, dark sleeping environment; and avoid phones and other devices right before bedtime. Pregnant women may also try hot tea or milk, a warm bath or varying their sleeping locations. Pregnancy pillows may also be of use for additional support, especially around the pregnant belly. Daily exercise is often also helpful to promote good sleep. Remember that most women have trouble sleeping at some point during pregnancy. Don’t be afraid to talk to your provider for wellness advice, especially when it concerns safety. This should also extend into the postpartum period.