Pregnancy is an exciting time for any soon-to-be parent. But it can also be stressful, especially if you aren’t getting enough quality sleep. In the U.S., more than 5 million adults take melatonin supplements on a monthly basis, many of them to help with sleep. And while melatonin is widely considered safe for adults, there are some questions as to whether or not it’s okay to take while pregnant.
Below, we’ll explain how melatonin helps promote sleep, as well as the effects on pregnant bodies and whether or not it’s safe for pregnant people to take melatonin.
How Does Melatonin Work?
Melatonin is a naturally occurring hormone that helps regulate your sleep-wake cycle, which is also called your circadian rhythm.
The pineal gland in your brain secretes melatonin as the light outside begins to get darker, which signals to your brain that it’s time to wind down for sleep. When melatonin levels increase, your body temperature lowers, and your brain activity slows. In the morning when the sun rises, melatonin production slows to help your body wake back up.
Though your body typically produces enough melatonin on its own, certain conditions can make production harder. Evidence shows that melatonin supplements can help with jet lag and insomnia.
Is Melatonin Safe During Pregnancy?
There’s not enough existing research to definitively state whether or not melatonin supplements are safe to take while pregnant. Generally speaking, you can’t overdose on melatonin — there’s no life-threatening level of toxicity. However, melatonin moves quickly from parent to fetus via the placenta, and it’s hard to determine exactly how much melatonin the fetus absorbs this way.
Melatonin shows some early signs of potential benefits for some conditions such as gestational diabetes, preeclampsia, and preterm labor, but it's still considered experimental. Currently, there are no official guidelines recommending its use for these conditions, and we lack strong phase clinical trial data specifically in pregnant people.
Because there haven’t been any long-term trials, experts don’t know exactly how melatonin can affect pregnant people or their children. It’s best to avoid taking melatonin while pregnant unless you’re directed to do so by your doctor.
Potential Risks
Some researchers say that melatonin is probably safe for use while pregnant or breastfeeding. However, they’re also careful to say that it hasn’t been studied enough to show that it’s clearly safe. In some animal studies, supplemental melatonin was shown to affect birth weight, gestational length, and mortality rates. But these results haven’t been duplicated in humans.
The major potential risk of taking melatonin while pregnant is the risk of the unknown. Melatonin moves from parent to fetus through the placenta, but experts aren’t sure how much the fetus absorbs. And, some experts think supplemental melatonin could affect babies’ ability to regulate sleep on their own.
It’s important to also keep in mind that the supplement industry isn’t regulated by the U.S. Food and Drug Administration (FDA). A bottle of melatonin could contain other unlisted ingredients or incorrect dosages.
Are There Alternatives to Melatonin During Pregnancy?
When you have difficulty sleeping during pregnancy, it feels easy and safe to take something over the counter to help. However, it's often better to look at alternative therapies that are proven effective. There are a number of effective alternatives to melatonin that you can safely try during pregnancy.
Improve Sleep Hygiene
Your body makes melatonin on its own. Improving your sleep hygiene can boost melatonin levels naturally. Going to sleep and waking up at the same time every day trains your body to fall asleep more easily. Turn down the lights a few hours before bed, avoid screens, and limit caffeine after noon.
Your sleep environment can make a difference too. Invest some time and energy into finding comfortable sheets, bedding, and the right mattress for your needs.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
CBT-I is a therapeutic treatment for insomnia that has been widely researched and proven effective for many people with sleep disorders. One study shows a 50% reduction in insomnia symptoms following CBT-I.
CBT-I usually takes place over six to eight sessions, in person or virtually. The practice uses four components: sleep restriction therapy (SRT), stimulus control therapy (SCT), sleep hygiene (SH), and cognitive therapy (CT). When implemented by a professional, these methods can be more effective for long-term insomnia than hypnotic drugs.
Relaxation Techniques
Consider winding down before bed by using the following relaxation techniques to help you fall asleep.
- Breathing exercises: Mindful breathing, belly breathing, and box breathing (inhale for 4 counts, hold for 4 counts, exhale for 4 counts, hold for 4 counts, and repeat) can help de-stress the nervous system and promote relaxation.
- Taking a warm bath: A bath itself can be relaxing, and the change in temperature between the bathwater and your bedroom can help signal to your body that it’s time for bed when you get out of the bath.
- Progressive muscle relaxation: Try tensing each muscle group in your body, then releasing it.
- Light stretching: Before getting into bed, a gentle yoga or stretching routine can help you relax and tell your body that it’s time to fall asleep.
Address Pregnancy Symptoms That Affect Sleep
Unfortunately, there are some pregnancy symptoms that can make sleep uncomfortable. Addressing the root cause of these issues can help you sleep through the night and stay comfortable.
- Frequent urination: Limit how much you drink before bed and use the bathroom before going to sleep, even if you don’t feel like you have to.
- Discomfort: Some pregnant people swear by body pillows and pregnancy pillows that take the pressure off joints and growing bellies.
- Acid reflux: Acid reflux and GERD are common pregnancy symptoms, and ones that can be treated safely during pregnancy with over-the-counter acid relievers. Speak with your doctor before choosing a medication.
- Sleep apnea: Obstructive sleep apnea (OSA) can develop or worsen during pregnancy. If you suspect that you may have sleep apnea, the first step is a diagnostic, easy-to-use at-home sleep study.
When to Talk to Your Doctor
It’s critical to take changing symptoms seriously during pregnancy, including changes in sleep. If you notice any of the following sleep-related issues, you should speak with your doctor.
- Inability to fall asleep or stay asleep
- Daytime sleepiness that affects your mood or work
- Increased snoring
- Choking, gasping, or pauses in breathing
- Severe or repeated leg or muscle cramps
Frequently Asked Questions
Can you take sleeping pills while pregnant?
Certain types of sleeping pills are generally considered okay to take while pregnant, but some are not. Some providers don’t recommend any sleep aids because there’s not much research showing the effects on pregnant people.
Antihistamines aren’t well-studied in pregnant people, but they’re widely taken. Melatonin is considered safe for non-pregnant people, but there haven’t been any specific trials investigating its effects on pregnant people. And sedatives like benzodiazepines and barbiturates aren’t safe during pregnancy.
One very large study shows that prescription nonbenzodiazepines, or Z-drugs like Ambien and Lunesta, don’t carry a high risk of congenital birth defects during the first trimester. However, you should always consult your doctor before starting any kind of medication.
What can I take for sleep while pregnant?
Pregnancies and pregnancy-related sleep issues vary between people, and there’s no one-size-fits-all sleep remedy. You should talk to your doctor before taking any kind of sleep aid while pregnant, natural or otherwise.
You can make impactful changes to your sleep hygiene and environment, though. CBT-I is also a helpful treatment for pregnancy insomnia.
Can you take melatonin while breastfeeding?
Breastmilk already contains mom’s naturally produced melatonin, and evidence shows that levels in breastmilk vary throughout the day as the infant nurses. Melatonin is transferred to the fetus through breastmilk and helps establish the infant's circadian rhythm.
However, there’s no specific literature showing what supplemental melatonin does to your baby if you take it for sleep. Experts think it’s most likely safe, but since there are no long-term studies proving its safety, you should consult your doctor before taking melatonin while breastfeeding.
Can melatonin affect fetal development?
There isn’t any specific research pointing to melatonin’s effects on fetal development, but there’s also a lack of research looking into melatonin’s effects on pregnant people and their fetuses in general. As a natural hormone, melatonin helps fetal development. When taken as a supplement, experts aren’t sure what the additional levels do.
