From the FDA Drug Label
Stop use and ask a doctor if sleeplessness persist continuously for more than 2 weeks. Insomnia may be a symptom of a serious underlying medical illness. Uses for relief of occasional sleeplessness The treatment options for insomnia during pregnancy include relief of occasional sleeplessness using diphenhydramine (PO) 1, 1. However, it is crucial to stop use and ask a doctor if sleeplessness persists continuously for more than 2 weeks, as insomnia may be a symptom of a serious underlying medical illness. Key considerations for treatment:
- Relief of occasional sleeplessness
- Monitoring for persistent sleeplessness
- Medical evaluation for underlying illness
From the Research
Insomnia during pregnancy can be effectively managed with cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment, which has been shown to improve insomnia severity and sleep quality in pregnant women 2.
Treatment Options
The following non-pharmacological approaches can be used to manage insomnia during pregnancy:
- Sleep hygiene practices, including maintaining a consistent sleep schedule, creating a comfortable sleep environment, limiting screen time before bed, and avoiding caffeine and large meals close to bedtime
- Relaxation techniques, such as deep breathing, progressive muscle relaxation, and prenatal yoga, to reduce anxiety and promote sleep
- CBT-I, which is highly effective and safe during pregnancy, and can be used to improve short-term insomnia 2
Medications
For persistent insomnia, certain medications may be considered under medical supervision, including:
- Diphenhydramine (Benadryl) 25-50mg at bedtime, which is generally considered safe in the second and third trimesters for short-term use
- Doxylamine (Unisom) 12.5-25mg at bedtime, which may be recommended by some providers
- Low-dose trazodone (25-50mg), which may be considered for more severe cases, though this requires careful physician oversight
- Melatonin (0.5-3mg), which may be used short-term, though research on its pregnancy safety is limited 3
Important Considerations
It's essential to avoid benzodiazepines and many prescription sleep medications during pregnancy due to potential risks to the developing fetus 3. Always consult with your healthcare provider before taking any medication during pregnancy, as individual circumstances may affect recommendations. A recent study found that CBT-I can prevent postpartum insomnia, highlighting the importance of addressing insomnia during pregnancy 4.