Melatonin in pregnancy: Is it safe to take melatonin while pregnant?

Is there anything more enraging than hearing, “Sleep now before the baby gets here,” when you are pregnant? Between the physical and hormonal changes to your body, the pending arrival, and the never-ending to-do list that seems to get longer as your body grows more limiting, it’s no wonder so many have a difficult time falling asleep during pregnancy.

According to a 2007 poll conducted by the National Sleep Foundation which focused on women and sleep, up to 1 in 5 people reported that they were told by a medical professional that they have a sleep disorder [1]. Other studies have shown these problems get worse during pregnancy – especially during the third trimester. (Which is the perfect time to learn how to sleep with a pregnancy pillow.)

There has more recently been increasing interest in taking melatonin supplementation for its beneficial effects on the body, particularly because its natural production helps regulate sleep patterns. Taking melatonin as a sleep aid has become popular because it feels more natural than other sleeping aid types. Still, you may wonder whether taking melatonin is safe during pregnancy and whether it may cause problems with fetal development.

The answer unfortunately is not simple. While your body makes melatonin to help with natural sleep-wake cycles, there is not enough scientific evidence that shows intake of melatonin supplements during pregnancy is safe or that it is effective in helping you sleep.

IN THIS ARTICLE:

Is it safe to take melatonin in pregnancy?

Benefits of natural melatonin in pregnancy

Side effects and risks of melatonin supplements in pregnancy

Can melatonin cause a false positive pregnancy test?

Safe alternatives to melatonin during pregnancy

8 sleep tips instead of melatonin in pregnancy

Takeaway

Melatonin during pregnancy FAQ

Is it safe to take melatonin in pregnancy?

While your body’s natural melatonin production brings many advantages to yourself and your little one, dietary supplements may not necessarily carry these same benefits. It is not known whether melatonin supplements are beneficial or harmful to fetal development. 

Melatonin is made by the pineal gland in the brain and its production is based on a recurring day-night cycle (circadian rhythm) based on how much light your eyes are receiving throughout the day. Normally, melatonin levels rise in the early evening, peak at around 2:00 am, and then return to a low level in the morning. Many things can influence the natural cycle of melatonin production, but typically its production is affected by the length of darkness at night [2].

The circadian rhythm heavily influences your body’s desire to sleep but also regulates many other bodily functions such as reproduction, ovarian function, immunity, and protection against some cancers.

During pregnancy, melatonin is also produced by the developing placenta. Research has shown that blood melatonin levels increase as pregnancy progresses, with the highest levels in the third trimester and rapidly returning to normal following delivery. 

Benefits of natural melatonin in pregnancy

Did you know that melatonin, the hormone naturally produced by humans, can do more than just regulate our circadian rhythms? [3] Studies of non-pregnant people have shown that melatonin can:

• Influence reproductive hormone cycles and ovarian function

• Slow the growth of some cancers

• Improve immune function

• Act as an antioxidant in preventing damage to cells

Talk about a multitasking hormone! Researchers are currently exploring how taking melatonin supplements might provide protective benefits during pregnancy. More studies need to be done, but current research [4] has suggested that: 

• Melatonin crosses the placenta and may influence your baby’s brain development, circadian rhythm, and sleep cycles.

• Melatonin may help sustain pregnancy by impacting the production of hormones such as prolactin, oxytocin, and progesterone.

• Melatonin might help lower blood pressure and may help to prevent preeclampsia

• Melatonin might work as an antioxidant for your little one’s overall health.

• Melatonin may play a role in determining the onset of labor and delivery.

Side effects and risks of melatonin supplements in pregnancy

Melatonin is considered a dietary supplement and is not regulated by the U.S. Food and Drug Administration (FDA) for safety or effectiveness. However, there are known side effects to taking melatonin supplements, especially with higher doses and extended-release pills. [5] These side effects can include:

• Drowsiness

• Daytime sleepiness

• Headaches

• Nausea

• Nightmares

• Upset stomach

People with certain medical conditions such as kidney disease, organ transplant, and autoimmune diseases like rheumatoid arthritis should avoid using melatonin altogether because of its potential toxicity.

Melatonin does not have an FDA pregnancy category that identifies risks to your baby. As an alternative, the Infant Risk Center [6], an international center that evaluates the risk to the baby from exposure to multiple drugs, notes that melatonin supplements cross the placenta and can be passed into human breast milk, and confirms there are not enough studies to say whether melatonin supplements are safe for your baby.

Can melatonin cause a false positive pregnancy test?

Pregnancy testing relies on the presence of a specific hormone, Human Chorionic Gonadotropin (HCG), in the blood and urine of a pregnant individual. These pregnancy tests are usually accurate to identify pregnancy as early as your first missed period.

While melatonin stimulates the secretion of some pregnancy hormones such as progesterone, there is no scientific evidence that melatonin influences the production of HCG, or that it causes a false positive pregnancy test.

Safe alternatives to melatonin during pregnancy

While it may seem like a natural option to take melatonin, research studies and medical guidelines actually don’t support its use as a sleep aid even in cases outside of pregnancy. For example, the National Center for Complementary and Integrative Health [7] and the American Academy of Sleep Medicine [8] do not recommend melatonin for chronic insomnia because there is no evidence for its effectiveness.

Instead of using melatonin as a sleep aid, you could explore with your obstetric provider why you are having such a hard time with sleep and treat those conditions. There could be other issues, like obstructive sleep apnea or restless legs syndrome. Insomnia has many causes and is more common in women than in men according to the National Institutes of Health [9]. It can be especially rough during pregnancy and postpartum due to the many hormonal and physical changes happening in your body.

This may be maddening to hear when you’re battling sleep deprivation on top of the many ways pregnancy limits your options for relief…but don't despair. There are some alternatives to melatonin during pregnancy to consider in order to get a good night’s sleep. In addition to the sleep tips listed below, safe and effective medical therapy for insomnia in pregnancy may also be considered with your obstetrician. 

Medicated sleep aids

Some over-the-counter and prescription sleep aids such as doxylamine, doxepin, and zolpidem. These medications have strong clinical evidence of being effective in helping you sleep while also being safe for your kiddo. Be sure to discuss all options with your obstetrician before you take any sleep aid or medications.

Sleep environment

Take a look at your sleep environment. Noisy and bright surroundings can make it tough to fall asleep, especially if you have a different sleep schedule than the people you live with. 

Noises

If you share a household with others, consider working out a plan to get more rest and try to find a quiet, dark, and comfortable room without distractions like clinking dishes, loud TVs, or droning lawnmowers. We realize this can be especially difficult to achieve with additional little ones around, but any support you can lean on to carve out some uninterrupted quiet time to rest is useful. 

White noise & blackout curtains

You can also block out the world and drown out the noise with blackout curtains and white noise. As a bonus, you can consider your room all prepped for the baby and check two more things off the to-do list! 

Mental & spiritual well-being

Don't forget about your mental and spiritual well-being. Sometimes difficulty sleeping is linked to deeper issues like anxiety and depression. It’s normal to feel a little anxious about the big life changes ahead but if you're feeling down, be sure to talk to your obstetric provider and see if you need further evaluation and treatment. Prioritizing your mental health is especially important as you prepare for your baby’s arrival. 

Cognitive Behavioral Therapy for Insomnia (CBT-I)

This is a method of treating insomnia that targets underlying physical, environmental, emotional, and behavioral issues without the use of sleep medications or supplements. CBT-I during pregnancy has also been shown to improve symptoms of postpartum depression and reduce some cases of major depression.

8 sleep tips instead of melatonin in pregnancy

If you are having trouble sleeping, consider these lifestyle changes and sleep hygiene practices before taking a sleep aid:

1. Develop a routine sleep schedule.

2. Know how to sleep when pregnant using the safest positions.

3. Have a cozy, comfortable sleep environment.

4. Take time to unwind without screens before going to sleep. Save the binge-watch for another time and put down your phone. 

5. Try to get moving regularly. You don’t need to go full cardio, but a walk around the block helps.

6. Explore yoga and the helpful mind-body-spirit benefits that can be enjoyed with its body postures, meditation, relaxation, and breathing techniques.

7. Don’t consume caffeine within 8 hours of going to sleep.

8. Don’t drink alcohol or use nicotine products.

Takeaway

• Melatonin is a natural hormone that provides many benefits to your body throughout your lifespan. There is evidence that your placenta also produces melatonin during pregnancy and naturally produced melatonin likely has beneficial effects to support your pregnancy and your baby’s health.

• Taking melatonin supplements will increase the amount of melatonin circulating in your body, and it is unknown whether the additional melatonin may harm your pregnancy.

• Make an appointment with your OB-GYN to discuss your sleep concerns. They can go over your symptoms and look for any possible medical problems that should be referred to a Sleep Specialist. 

• Evaluate your home environment, diet, and other modifiable stressors to get into a better sleep hygiene practice.

• Watch out for any symptoms of anxiety or depression and seek help from your obstetrician or mental health provider if you have any.

• Do not drink alcohol – not only is it unhealthy for your baby, but alcohol also makes it more difficult to get good sleep.

• If you are considering a sleep aid, be sure to chat with your obstetric provider before you take anything – they can help target any therapies that will be the most effective and safe for you and your little one.