From the Research
Insomnia during pregnancy should be managed through a combination of non-pharmacological approaches and, when necessary, carefully selected medications, prioritizing cognitive behavioral therapy for insomnia (CBT-I) due to its high effectiveness and lack of adverse effects on pregnancy, as supported by the most recent study 1.
Non-Pharmacological Approaches
- Start with lifestyle modifications 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.
- Regular physical activity during the day (but not too close to bedtime) can also improve sleep quality.
- Relaxation techniques such as deep breathing, progressive muscle relaxation, meditation, or prenatal yoga may help reduce anxiety and promote sleep.
Pharmacological Interventions
- For persistent insomnia, short-term use of certain medications may be considered under medical supervision.
- Diphenhydramine (25-50mg at bedtime) is generally considered safe during pregnancy, as is doxylamine (12.5-25mg at bedtime) 2.
- If these are ineffective, healthcare providers might consider prescribing low-dose trazodone (25-50mg) or zolpidem (5mg) for short periods, although the evidence for their use is less clear 3.
- Medication should be used cautiously, especially during the first trimester, and at the lowest effective dose for the shortest duration possible.
Importance of Addressing Insomnia
- Addressing insomnia is important as poor sleep can contribute to pregnancy complications, including increased risk of depression, gestational diabetes, and preterm birth 4.
- Always consult with a healthcare provider before starting any medication during pregnancy to weigh individual risks and benefits.
- The most recent study 1 highlights the need for careful consideration of sleep disorders in pregnancy, including insomnia, and the importance of evidence-based treatment approaches.