After having seen what is insomnia and the causes of insomnia in pregnancy, we will take a tour of the best remedies to get a better sleep in pregnancy. More than 85% of pregnant women suffer changes in their sleep pattern at some time during pregnancy and although they cannot always speak properly of "insomnia" (this should be determined by a specialist), the reality is that it is time for bed and You can get desperate getting around in bed.
If you are in that high percentage of women who sleep poorly during pregnancy, you will want to know if there are appropriate medications, if there are recommended infusions, if there is any natural remedy, alternative treatments ... and ultimately what can you take for insomnia in pregnancy.
But, first of all, it is very important to remember that you cannot take any medication on your own if you are pregnant, or ignore the "advice of the grandmother" or the neighbor to improve the quality of sleep, since at this stage so delicate any substance not supervised by a health professional could harm you or the fetus.
Medications for insomnia while pregnant?
As we have pointed out, the diagnosis of insomnia is fundamentally clinical, based on the symptoms described by the patient. According to sleep specialists, The therapeutic approach to insomnia should always be multidisciplinary and include non-pharmacological methods., such as sleep hygiene, physical exercise and diet.
In other words, the treatment of insomnia should be comprehensive and its purpose will be to improve the quality and quantity of sleep, reduce its latency and nighttime awakenings, in addition to increasing the total sleep time and improving the woman's daytime functioning.
During pregnancy, taking medications must be very controlled and in the case of drugs for chronic insomnia, in general, they have a high risk of side effects such as withdrawal syndrome, hypnotic effects ... Therefore, if in the general population the assessment of the benefit / risk of insomnia drugs has to be thorough, In the case of pregnant women, the specialist will tell you that the drugs are contraindicated..
As we know, during the gestational stage in women there are a series of important adaptive physiological changes that interfere and modify the way in which the medications used interact with the body, being able to influence both their efficacy and safety. Any decision to initiate a treatment during pregnancy must be made after an individual assessment of each case on the expected benefits, potential risks, possible therapeutic alternatives and the consequences of not prescribing such treatment.
The pharmacological treatment of insomnia is only recommended (in the general population) if it is severe and causes significant disorders in the subject. In addition, the use of hypnotics should be reserved for cases in which non-pharmacological measures, discussed below, fail, or when insomnia persists after treatment of the underlying mental or medical cause.
During pregnancy it is not recommended to take drugs for insomnia, either because of its proven risks in pregnant women, or because of its side effects in general, or because studies have not been done in pregnant women.Let's look at some cases of these Insomnia drugs that are not recommended to take in pregnancy according to Clinical Practice Guide for the Management of Patients with Insomnia in Primary Care:
In the case of benzodiazepines (BZD), which are depressing agents of the nervous system and promote physical and mental relaxation, reducing nerve activity in the brain, there is insufficient evidence of their safety during pregnancy. It is not possible to determine whether the potential advantages of BZD for the mother outweigh the possible risks to the fetus, and especially in advanced stages of pregnancy (or breastfeeding) these drugs can cause adverse effects in neonates (neonatal hypotonia, withdrawal, sedation and hypothermia syndrome). According to the Clinical Practice Guide, if the use of BZD is required during pregnancy, the lowest effective dose and the shortest possible duration of treatment should be used to avoid the risk of birth defects.
On non-benzodiazepine hypnotics there are no specific studies in pregnant women, and they also have many side effects: daytime sleepiness, vertigo, fatigue, headache, hallucinations, nausea, disorientation and confusion, anxiety or panic crisis, weakness, tremor, palpitations and tachycardia. In some studies, rebound insomnia and withdrawal syndrome and the danger of dependence have also been described. Naturally, you cannot add these risks to pregnancy.
Therefore, the AEMPS (Spanish Agency for Medicines and Health Products) and other health agencies recommend using these hypnotic drugs only when essential, at the minimum effective dose, and for a period not exceeding four weeks, periodically reviewing the Need to maintain the treatment. In pregnant women, better avoid it and go to non-pharmacological remedies.
Antidepressants There is enough evidence to recommend the use of antidepressants for insomnia associated with depression disorder, but not for primary insomnia. In the case of pregnant women with depression and insomnia, the specific case and its risks must be assessed. The initial treatment of anxiety and mild-moderate depression during pregnancy should be psychotherapy and each different antidepressant has particular risks.
Ramelteon (melatonin receptor agonist medication). More long-term comparative studies are needed to recommend the use of ramelteon in the treatment of insomnia.
The use of chloral hydrate, meprobamate and barbiturates is not recommended for the treatment of insomnia.
Herbs and infusions for insomnia in pregnancy
Surely for good rest they will have recommended infusions or certain natural supplements. We talk about phytotherapy or herbalism, which consists of the treatment of diseases by plants or plant substances. However, phytotherapy during pregnancy has been questioned in several studies and documents.
The ECEMC (Spanish Collaborative Study of Congenital Malformations), which investigates the causes of congenital defects and malformations observed in newborn children, talks about the use of infusions and natural supplements from plants during pregnancy. Among the most used herbs are those that apply to depression, anxiety and sleep disturbances.
This is what they tell us about some natural remedies for nervousness, in a document prepared by the Department of Pharmacology of the Faculty of Medicine of the Complutense University of Madrid:
Moderate use is recommended for lime, peppermint and valerian, since they can have adverse effects in combination with other medications, hepatoxicity ... Below we talk again about Valerian in particular.
Chamomile seems to have no risks, although possible exacerbations of asthma are indicated in the possible effects, among others.
Melissa and passionflower are used to reduce stress and help you rest better, but they are not recommended during pregnancy because there are not enough studies to support your safety during pregnancy.
Finally, according to the Clinical Practice Guide there is not enough evidence to recommend the use of valerian or the combination of it with hops for the treatment of insomnia. In the study "Phytotherapy in pregnancy and lactation: benefit or risk?" it is noted that valerian It is used to combat nervousness, but there are no studies that show its benefits or its harmful effects on pregnancy, so its use is not recommended.
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Acupuncture for insomnia: There are no studies with sufficient methodological quality to recommend the use of acupuncture in the treatment of insomnia.
Chiropractic massage: There is no known contraindication of chiropractic care in pregnancy, provided it is performed by a professional. What is not documented is the efficacy of this type of treatment for insomnia, unlike the reduction of back pain or postural improvement.
Homeopathy It is advertised as effective for calming stress (and therefore possible as a sleep aid), but its effects are not scientifically proven, equivalent to those of placebo, and we have already spoken on several occasions about this method that does not work and therefore It can be considered a scam.
Bach's flowers, often associated with the attainment of a sleep-relaxing relaxation, are rather homeopathy. They have no side effects but their effect has not been shown to be different from placebo.
What to take for insomnia while pregnant?
Having seen everything that cannot be done for insomnia during pregnancy, we go with some remedies that are harmless at this delicate stage. Anyway, remember that each case is different and if your insomnia problems are serious (that is, they visibly affect your quality of life, with physical and mental consequences during the day) you should see a specialist.
If your sleep difficulties don't go that far, can you take this to sleep better in pregnancy.
Moderate use of chamomile, lime, peppermint, for its relaxing power, as we have noted previously.
Warm milk before bedtime. Milk contains melatonin, a hormone that helps create the desire to fall asleep, but it has not yet been confirmed that it can effectively impact sleep. However, it will not make you feel bad and you add calcium as necessary at this stage.
Natural remedies for sleeping during pregnancy
As we see, there is not much to take for insomnia, but there is much we can do to try to avoid it. We are talking about carrying out some measures of sleep hygiene that will help us rest better:
- Keep a fixed time to go to bed and get up, including weekends and holidays.
- Avoid drinks that contain caffeine and theine throughout the day, as well as stimulating drinks, carbonated drinks, sugary drinks…
- Do enough physical activity, because if your body works during the day, it will need to regain strength. Do not exercise in the previous two hours before going to sleep. The best exercises during pregnancy (as long as there is no contraindication), are walking, cycling, water and swimming exercises, the Pilates method, yoga, doing a birth preparation exercise chart ...
- Keep the bedroom at a pleasant temperature and with minimum levels of light and noise, ventilating it during the day.
- Try to eat a smooth and balanced diet, without too fatty or spicy foods that make digestion difficult. This is especially important at dinner time.
- Do not go to bed hungry or dine immediately before bedtime. It is a light dinner without hurry, chewing the food well.
- Avoid spending more time in bed than necessary, without doing activities such as watching TV, reading, listening to the radio ... Staying in bed for a long time can cause a light and fragmented sleep.
- Avoid daytime naps, unless you have found that they do not affect nighttime sleep. After eating, a nap of no more than 30 minutes can be beneficial.
- Avoid alcohol and tobacco.
- Do not drink too many liquids at dinner, to avoid getting up to the bathroom so often.
- Sleep on your side, on the left side and with flexed legs. Lying on your back during the third trimester could be dangerous for the fetus and also intensifies in the mother the risk of problems such as backaches, digestive difficulties, constipation, hemorrhoids ...
- It will help you rest better to use pillows or cushions to make your body fit.
- Use comfortable cotton clothing to sleep, which does not squeeze you. Bedding must be ideal for not being cold or hot.
- Do not do stressful activities before bedtime, do not work and avoid sticking to the mobile screen or computer: you need to relax in a quiet environment, maybe watching TV for a while, reading, taking a bath ...
- Receive a relaxing massage that predisposes you to tranquility and sleep.
- Perform homemade relaxation exercises and conscious breathing to facilitate sleep.
Finally, remember, no matter how much it costs you to sleep during pregnancy, drugs cannot be used to improve sleep, nor hypnotics for insomnia. We hope that these natural and risk-free remedies help you sleep at this stage.
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In Babies and more | If you are pregnant, changing the time is just one more reason why you sleep poorly, not finding the position to sleep during pregnancy (and despair about it), Sleep during pregnancy, trimester to trimester
