Until further study, pregnant women are generally not recommended to take sleeping pills. Your doctor will likely only prescribe sleeping medications that have been tested on pregnant women and are proven safe, or if the health benefits outweigh any risk. If you are pregnant and experiencing insomnia or having trouble sleeping, always talk to your doctor before using any type of sleep aid to make sure it will not affect your baby.
There are generally two types of sleeping pills: prescription sleep aids and over-the-counter (OTC) sleep aids. Prescription sleeping pills are classified as sedative hypnotics and affect the receptors in your brain to slow down your nervous system and induce sleep. OTC sleeping aids typically contain antihistamines, the same ingredient used in allergy medication. Antihistamines prevent histamines, the chemical messengers in your brain that promote wakefulness, from attaching to the cells in your body.
The FDA breaks down a medication’s effect on pregnancy into five different categories, from safest to least safe. Category A medications have been tested in pregnant women and proven safe. On the opposite end of the scale are Category X drugs, which should never be taken by pregnant women since they can cause birth defects. There are no sleeping pills currently classified as Category A.
Limited data exist on the risks of prescription sleeping pills on pregnancy. The newer, non-benzodiazepine variety of sleeping pills like Ambien, Lunesta, and Rozerem are considered Category C medications, meaning that initial tests on animals have raised concerns over the risks of the drug on the fetus, though no studies have been conducted on pregnant women. While initial studies of benzodiazepine drugs such as Valium and Xanax indicated that they could cause birth defects like cleft lip if taken while pregnant, later studies have shown no association between benzodiazepines and increased risk in birth defects, though doctors still urge caution.
Most sleeping pills that can be purchased over-the-counter, such as Sleep-Eze, Unisom, Sominex or Benadryl, contain antihistamines. The safest of the OTC sleep aids is Unisom, which contains the antihistamine doxylamine. When taken as advised, doxylamine shows no evidence that it is harmful to your baby. Sominex and Benadryl contain an antihistamine called diphenhydramine. These drugs are rated a Category B. Meaning that even though they are presumed to be safe, you should check with your doctor.
Prescription sleeping pills can be addictive. If taken while a woman is pregnant or breastfeeding, the addiction can be passed to your baby and cause withdrawal symptoms. These symptoms typically include short-term effects like difficulty breathing, muscle weakness and jitteriness. Side effects for OTC drugs containing antihistamines can include next-day drowsiness and difficulty concentrating.