Melatonin During Pregnancy: Safety, Benefits & Side Effects

Insomnia is a common problem of pregnancy, and about 80% of all pregnant women experience it in pregnancy (1). Melatonin is an over-the-counter drug for insomnia. You may consider the use of melatonin during pregnancy but after doctor consultation. However, the safety of the compound during pregnancy is unknown.

Insomnia in pregnancy may occur due to hormonal fluctuations and other physical issues such as backache, frequent peeing, gastroesophageal reflux disease (GERD), and fetal movements. Read this post to learn more about the safety, dosage, benefits, and side effects of melatonin during pregnancy.

What Is Melatonin?

Melatonin is a hormone produced by the pineal gland in the brain and is responsible for regulating the sleep-wake cycle. The level of the melatonin in the body changes according to the circadian rhythms of the body. It usually starts rising with the onset of darkness, stays raised between 2am and 4am, and begins to drop during the second half of the night to awaken you in the morning (2).

Besides natural light, a few foods like walnuts, tomatoes, olives, barley, rice, cherries, strawberries, and cow milk are known to influence the melatonin levels in the body, thereby affecting the natural sleep cycle (3).

Although the US Food and Drug Administration regulates supplements such as melatonin, their regulations and laws are not as strict as that of prescription or over-the-counter medications (4). So, it is essential to know how it affects you during pregnancy.

Is It Safe To Take Melatonin While Pregnant?

There is no scientific evidence to show that these supplements are completely safe, especially during pregnancy.

Leslie Swason, associate professor in psychiatry at Michigan Medicine’s Sleep and Circadian Research Laboratory, says, “Melatonin supplements are safe for adults in short-term use but because there haven’t been any long-term studies in humans, the long-term safety is unknown.” (5)

During pregnancy, the melatonin level elevates naturally in the body. It usually starts rising from 24 weeks and increases significantly after 32 weeks of pregnancy (2). Hence, talk to your doctor about it before taking any supplements.

Although supplements can help to some extent, there are no sufficient studies to prove their efficiency in sleep initiation and sleep efficacy (6). So, it is always safe to opt for natural ways to fight insomnia during pregnancy. But, if you are diagnosed with sleep disorders such as restless leg syndrome or chronic insomnia, then consult your physician before taking a melatonin supplement.

How Much Of Melatonin Is Safe During Pregnancy?

There is no recommended dosage of melatonin for pregnant women. Swason says that smaller doses (0.5mg or less) of melatonin supplements produce similar levels that the brain produces naturally, and any dosage more than that would result in the rise of melatonin levels by 10 times (5).

The following section helps you understand how the melatonin dose can affect the pregnancy and the fetus.

What Are The Side-effects Of Melatonin Supplement During Pregnancy?

An animal study reported the following outcomes of taking melatonin supplement during pregnancy (7):

• Lower maternal weight gain

• Lesser birth weight

• Rare but possible infant mortality

There are limited studies on the effects of melatonin supplements during pregnancy.

In general, melatonin does have some side-effects like (8)

• Sleepiness

• Morning grogginess

• Lower body temperature

• Vivid dreams

• Some change in the blood pressure

• Headache (9)

• Nausea

• Dizziness

It is unclear how the melatonin intake of more than the normal levels during pregnancy can affect you and your child. The ongoing studies on melatonin and its relation to pregnancy are yet to provide convincing evidence to demonstrate its role. Therefore, it is recommended not to take melatonin supplements without the doctor’s advice.

Are There Any Benefits Of Melatonin When Pregnant?

Natural melatonin plays an important role in pregnancy. Its benefits in fetal-embryo development and pregnancy are as follows (2):

• Induces circadian rhythm in the fetus.

• Helps in the development of the nervous and endocrine system.

• It is important for normal placental development.

• It is a powerful antioxidant that aids in mitigating fetal morbidity or mortality due to intrauterine growth restriction (10).

• Melatonin produced by the placenta has anti-free radical properties that counter the preeclampsia (11).

• It helps prevent preterm labor (12).

Before you plan a medical alternative for insomnia, you should try non-medical remedies first.

What Are Some Alternative Ways To Address Insomnia During Pregnancy?

Here are some alternatives for managing insomnia during pregnancy:

Non-pharmacologic interventions (1)

Sleep hygiene and sleep education: This is the first line of treatment considered for insomnia that helps in improving the quality of sleep without the use of any medicines. Here is what you can do to improve sleep hygiene.

• Use dim lights during the night, if necessary.

• Reduce the intake of fluids during late evening to avoid frequent visits to the bathroom at night.

• Avoid spicy and deep-fried foods that can cause heartburn.

• Prefer daytime naps.

• Exercise for 30 minutes before going to bed.

• Take a warm bath.

• Keep away electronic gadgets while you are in bed.

• Avoid caffeine or nicotine use before going to bed.

• Get evaluated by the doctor for RLS (Restless Legs syndrome).

• Set your sleep and wake up time and follow it every day.

Behavioral therapy

• Stimulus control: It helps in establishing a regular sleep/wake cycle. If you are unable to sleep then get up and do something that will stimulate sleep. Worrying about not being able to sleep can also trigger insomnia.

• Relaxation techniques: Progressive muscle relaxation (PMR) technique helps in relaxing the muscles that help you get a good sleep. Abdominal deep breathing also helps in stimulating sleep.

• Sleep restriction: It prevents the shift in circadian clock that further aids in preventing insomnia.

• Cognitive therapy: It helps in developing a realistic expectation about sleep duration in the patients. It can be achieved through research data and considering the patient’s history of insomnia or sleeplessness.

• Cognitive behavioral therapy for insomnia (CBT-I): It includes daily sleep logs, one session on sleep education, two sessions on stimulus control and sleep restriction, which is followed by two sessions on cognitive therapy. This is further followed by a session on sleep hygiene and ends with a session to combine the information from all the sessions.

Pharmacological Interventions

When non-medical interventions fail to treat insomnia, you may have to rely on medical treatment (1).

• Hypnotics: Antihistamines like doxylamine, which is safe during pregnancy, is considered for treating moderate insomnia during pregnancy.

• Antidepressants: If depression or anxiety disorder is the reason for insomnia, then it can be treated using an antidepressant.

This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.

References

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