Considerations in Treating Insomnia During Pregnancy: A Literature Review

Psychosomatics. 2018 Jul-Aug;59(4):341-348. doi: 10.1016/j.psym.2018.03.009. Epub 2018 Mar 21.


Background: The prevalence of pregnancy-associated insomnia is high. Although insomnia may flow from normal physiologic features of pregnancy, it may also be an early warning sign of a relapse, or a trigger for a relapse, of a psychiatric illness. Those at risk for psychiatric illnesses may require medications as well as behavioral and psychotherapeutic interventions, to prevent relapse in the perinatal period. Unfortunately, few reviews of psychotropics used to treat pregnancy-related sleep disorders exist.

Objective: We discuss issues related to sleep and sleep disorders in pregnancy in the context of co-morbid psychiatric illness, and review the literature on the commonly-used medications (e.g., benzodiazepines, sedative-hypnotics, antihistamines, trazodone, and melatonin) for insomnia during pregnancy.

Keywords: insomnia; medication safety; pregnancy; sleep medications; women's mental health.

Publication types

  • Review

MeSH terms

  • Benzodiazepines / therapeutic use
  • Central Nervous System Depressants / therapeutic use
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Melatonin / therapeutic use
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Psychotropic Drugs / therapeutic use
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sleep Initiation and Maintenance Disorders / complications
  • Sleep Initiation and Maintenance Disorders / drug therapy*
  • Trazodone / therapeutic use


  • Central Nervous System Depressants
  • Histamine Antagonists
  • Hypnotics and Sedatives
  • Psychotropic Drugs
  • Serotonin Uptake Inhibitors
  • Benzodiazepines
  • Melatonin
  • Trazodone