Melatonin plays a key role in regulating your body’s circadian rhythms. Naturally occurring melatonin may also help support a healthy pregnancy. Melatonin may even help determine the timing of birth, and research has shown it plays a key role in the baby’s development. Taking a supplement, however, is a lot different, since melatonin supplements can greatly increase levels of this key hormone.
Most pregnant people experience insomnia during pregnancy, especially in the third trimester as finding a comfortable position becomes more challenging. This sleep disruption can make daily life miserable, increase the risk of birth complications, and even lead to depression. Unfortunately, doctors continue to avoid testing supplements and drugs on pregnant people. That includes melatonin. There is no long-term data proving that melatonin supplements are safe during pregnancy, even though many doctors continue to recommend it.
Article at a Glance
- Melatonin is a naturally occurring hormone that may help regulate fetal development and the timing of birth.
- Melatonin in non-pregnant people is well-studied and generally safe.
- There has not been quality long-term research testing melatonin on pregnant people, so doctors do not know for sure if it is safe.
- Other sleep aids have been tested in pregnant people, and may be a safer option.
- People who want to try melatonin should consult a doctor first, then err on the side of caution by taking a very small dose.
Sleep Aids and Pregnancy
For generations, researchers avoided testing any drugs on pregnant people–and sometimes didn’t even bother to test them on non-pregnant women! This means that we have a lot less data than we should. Pregnant people are often left to suffer through treatable health problems because researchers in a bygone era didn’t think those drugs should be tested. Sleep aids are no exception.
Insomnia is a serious health problem during pregnancy. It can affect physical and mental health. It can even affect your job and relationships, making a challenging time needlessly difficult. But few sleep aids, including melatonin, have been thoroughly tested on pregnant people.
There are two noteworthy exceptions to this rule: doxylamine (Unisom) and diphenhydramine (Benadryl). Both drugs show no significant risk of damage to either the developing baby or the pregnant person. Doxylamine is even approved to treat morning sickness when used in combination with vitamin B6.
These drugs are a safe option for people struggling to sleep. Most people find that doxylamine is more potent, so consider starting with Benadryl then graduating to Unisom only if Benadryl does not work. Never take these drugs before driving, watching children, or with alcohol. It’s also a good idea to avoid them if you’re having contractions, since you’ll want to be fully alert and capable of making decisions during labor.
Is Melatonin Safe During Pregnancy?
Because melatonin is a naturally occurring hormone, it is likely safe in low doses during pregnancy. Indeed, there is limited experimental evidence suggesting that using melatonin during pregnancy may even prevent some diseases in the developing baby. A pilot study has even investigated whether melatonin could help prevent preeclampsia.
But no long-term data is available on safety outcomes in mothers or babies. This means no one can conclusively say whether melatonin is safe or not, especially in women who use it for many weeks. For this reason, people who want to take the most cautious possible approach should use another sleep aid, not melatonin.
What Are the Benefits?
Insomnia can be catastrophic for a person’s health. Insomnia even increases the risk of pregnancy complications like preterm labor and low birth weight. So to dismiss it as a minor inconvenience or an inevitable symptom of pregnancy is to dismiss the needs and health of pregnant people and their babies.
The main potential benefit of melatonin is that it may help pregnant people better manage insomnia. Emerging research also suggests that:
- Melatonin may prevent preeclampsia.
- Melatonin could play a role in reducing pregnancy complications.
- Melatonin may reduce the risk of preterm labor and support the health of the developing baby.
However, there is not yet enough evidence to be sure, so people should not take melatonin as an alternative to traditional interventions for improving pregnancy health.
There is no dosage of melatonin that has been proven to be safe in pregnancy. People who want to be as cautious as possible should not take melatonin.
However, people who need help with insomnia and do not get relief from other interventions may find that the benefits outweigh the risks. Start with a very low dose of 2 mg or so, then gradually increase to 5 mg. Be sure to discuss melatonin usage with your doctor or midwife, since melatonin can interact with some other drugs.
If you’re tossing and turning at night but don’t want to try melatonin, doxylamine and diphenhydramine are safe alternatives. But don’t ignore the importance of lifestyle in healthy sleep. A number of simple changes in your routine may help you sleep better for the duration of your pregnancy:
- Spend time in the sun each day to help regulate your circadian rhythm.
- Sleep in a cool, dark room without television or a smartphone.
- Use your bed only for sleep and sex, not for reading or other activities.
- Try using a pregnancy pillow to get more comfortable. Support under your belly and between your knees can ease many discomforts.
- Get regular massages to help with pregnancy aches and pains.
- Avoid caffeine in the afternoon.
- Develop a bedtime routine, then stick with it each night. Go to bed at the same time each evening.
- Limit daytime napping to no more than 20 minutes.
It can be tempting to reach for a natural supplement to deal with pregnancy-related insomnia. But with so little data available, there’s just not enough evidence to know for sure that it is safe. Over-the-counter remedies are better tested, with an excellent safety profile. So start with those, and make sure you implement a great bedtime routine. If OTC remedies don’t work, talk to your doctor or midwife about trying melatonin.