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Many women develop sleep issues throughout pregnancy. No matter how tired you feel, your body's too busy growing a baby to humor you with a quality snooze. Whether you're tossing and turning over which baby registries to add to your newborn checklist, you might be tempted to try a sleep aid. Here's why you should be careful.
First, knowing melatonin's background and efficacy is essential to understand whether it's safe during pregnancy or if you should avoid it altogether.
"Currently, melatonin is sold over the counter as a dietary supplement and not regulated by the FDA," says Dr. Banafsheh Bayati, OB-GYN and medical cofounder of Perelel. "The doses used in most melatonin supplements are far higher than the body normally produces."
"A typical dose of melatonin (one to three mg) elevates blood melatonin levels up to 20 times normal. How this natural supplement affects our production and melatonin release patterns and how this then affects pregnancy, fetal growth and the fetus’ awake and sleep patterns are all currently being studied."
Banafsheh adds that some studies highlight the importance of melatonin for fetal development—but not the kind you buy at the store.
"It may be best not to alter our melatonin secretions by taking over-the-counter supplements," Banafsheh says. "It may be best to increase activities that allow improvements in our natural production of melatonin as well as decreasing behaviors or actions that lower our melatonin production."
Banafsheh doesn't recommend taking melatonin, but there is a caveat.
"If a patient has been taking it as a supplement before pregnancy for a sustained period, then I allow them to remain on their current dose or continue at the lowest effective dose," Bamafsheh adds.
"Sleep is key for health, and if a supplement is needed, I prefer to start with magnesium, which has been shown to improve subjective and objective measures of insomnia," Banafsheh says. "It also increases serum melatonin concentration produced naturally by our pineal gland."
Ultimately, look at sleep hygiene, activities, diet, caffeine intake and stressors to find the root cause. Switching to coffee alternatives for pregnancy, for example, can relieve at least some pressure to stay awake.
Dr. Banafsheh explains that melatonin is "a serotonin-derived hormone, secreted by a small endocrine gland in our brain, called the pineal gland, which modulates our circadian, awake, and sleep patterns."
The placenta also produces melatonin, but that's a natural and normal source throughout pregnancy and can even act as an antioxidant.
"As an antioxidant, melatonin may have a beneficial effect on fertilization rates and embryo quality," Banafsheh says. "Melatonin receptors are present throughout the developing fetus. It may act as a neuroprotective along with its role in establishing circadian rhythms in the fetus."
Regardless, studies about the effects are ongoing, so always consult your healthcare provider before taking anything over-the-counter.
Sleep is a priority when growing a baby, so keep your bedroom cool and dark and stick to a consistent sleep routine.
If you develop a sleep disorder, your doctor might offer a continuous positive airway pressure (CPAP) device for Obstructive Sleep Apnea or antacids for Gastroesophageal Reflux Disorder. If restless legs are an issue, your doctor may prescribe some supplements.
Likewise, position matters. Sleep on your left side with your legs tucked slightly to help with blood flow and oxygen levels.
Whatever the case, always check with your doctor before taking anything over the counter during pregnancy.
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