Insomnia is a problem that women can experience at a higher rate when they go through any hormonal transition. This is especially true during pregnancy. It is reported that up to 80 percent of women have sleep problems in their first trimester and up to 97 percent by their third trimester.
For many, sleep issues during pregnancy are relatively minor and simple behavioral modifications may be all that is needed to get a restful night of sleep. However, other women experience more severe insomnia that has an extreme impact on their life, and potentially the health of their unborn child.
Zolpidem (Ambien), a sedative-hypnotic agent used for the short-term treatment of insomnia, is often prescribed in pregnant women. However, when abused, Ambien can be potentially dangerous during pregnancy.
What Is Insomnia?
Insomnia is a sleep disorder where a sufferer has difficulty falling asleep and/or staying asleep.
It is the most common sleep disorder, with roughly 40 million Americans suffering from it. There is a slightly higher prevalence in women and older adults.
Insomnia can be diagnosed as either acute or chronic. Acute insomnia is typically brought on because of specific life circumstances that are temporary, and it tends to resolve without any treatment. Chronic insomnia is defined as being at least three nights a week, lasting for at least three months. Chronic insomnia disorders can have many causes and present many problems.
Those with insomnia may experience a host of side effects due to lack of quality sleep. These may include:
- excessive drowsiness
- lack of energy
- difficulty performing daily tasks
- trouble learning or remembering
Treatment options for insomnia range from behavioral therapy to prescription or over-the-counter medications, or a combination of both.
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Insomnia While Pregnant
Many things could disrupt sleep during pregnancy. Physical, hormonal, and physiological changes can all impact the quality of sleep. Severity changes with each trimester, but it does appear that insomnia worsens shortly before labor because of the secretion of the wake-promoting hormone, oxytocin.
Some women are more susceptible to insomnia during pregnancy than others. Researchers are not sure why this is the case. However, they have determined that higher levels of estrogen and progesterone could contribute due to their influence on other hormones, such as the cortisol-melatonin ratio.
Dangers Of Insomnia While Pregnant
There are several ways that prolonged lack of sleep could be harmful to both a pregnant woman and her unborn baby.
Researchers say that lack of sleep could result in many adverse pregnancy outcomes, including:
- stress (which exposes a fetus to stress hormones)
- an increased inflammatory state
- increased risk of gestational diabetes
- elevated blood pressure
- worsened labor pain
- higher risk for long labors and C-sections
- increased risk of preterm birth
Because of these potential dangers, if insomnia persists, many doctors may suggest prescription sleep aids, such as Ambien.
What Is Ambien?
One very common prescription sedative prescribed for insomnia is a drug called Ambien (brand name for zolpidem). It belongs to a class of medications called sedative-hypnotics and works by binding to something in the central nervous system called the GABA receptors. The active ingredient can produce a calming effect, helping a person fall asleep faster and stay asleep longer, but it comes with a long list of potential side effects.
In the general public, typical side effects of using Ambien could include drowsiness, headaches, diarrhea, nausea, memory problems, and hallucinations.
Doctors typically only recommend short treatment periods of two weeks or less.
Is Ambien Safe To Take While Pregnant?
The FDA breaks down the safety of drugs during pregnancy by putting them into categories.
These categories are designed as a way to assess the likelihood that a substance will cause harm to the fetus if the mother takes it.
Ambien is classified as a pregnancy category C drug, which means that the potential for risks to a human fetus has not been studied enough to be ruled out.
There is not a lot of solid research on how sleep aids, such as Ambien, could harm a fetus. One study did conclude that these types of medications do not seem to bring about an increased risk for congenital malformations. However, they did find that they could be associated with increased rates of C-section, preterm labor, and low birth weight and/or small-for-gestational-age infants.
There are also indirect risk factors to consider. One symptom of Ambien is dizziness, which could result in falling and causing harm to the fetus. Dehydration is also a potential side effect, which can be dangerous while pregnant.
Pregnant women diagnosed with insomnia must also be screened for underlying mood disorders, such as anxiety and depression. If someone is suffering from a mood disorder, addressing this issue first could resolve sleep issues.
In some cases, a doctor may determine that despite the risks that could be associated with a category C drug, benefits outweigh the potential harm that a lack of sleep could have.
Withdrawal is a common symptom associated with this drug. If you discover that you are pregnant and are already taking Ambien, you should consult with a doctor before suddenly stopping your medication. There is currently no significant research on whether withdrawal symptoms happen in babies whose mothers took Ambien.
If insomnia is diagnosed after a baby is born, the mother should talk with her doctor about the risks of taking Ambien, especially if she is breastfeeding. Studies have shown that the drug is present in the breast milk of mothers taking Ambien. However, one small study found very little of the drug was present in as little as three hours after taking the medication.
Another possible issue is that sleep aids could potentially interfere with the ability to respond to a newborn during the night.
In short, Ambien comes with many potential risks that could affect a mother and her child before and after pregnancy. Abusing Ambien only increases the risk of these negative side effects.
Alternatives To Ambien During Pregnancy
Depending on the root cause of a sleepless night, doctors may try different holistic or behavioral modifications.
Some possibilities include:
- establishing regular sleep-wake cycles
- avoiding naps
- stimulus control (not going to bed until sleepy and getting up if unable to sleep)
- minimizing fluid intake close to bedtime
- cognitive-behavioral therapy (CBT)
- relaxing music
- a warm bath before bed
- exercise (at least four to six hours before bedtime)
- solutions for physical discomfort (pregnancy pillows, room temperature, etc.)
Doctors may suggest natural supplements such as melatonin. They may also consider prescribing prescription drugs believed to have a lower risk than Ambien, such as tricyclic antidepressants.
Ambien Addiction And Withdrawal
People can sometimes become dependant on Ambien, resulting in addiction. If someone has a history of addictive behaviors, studies have found that he or she is more likely to become addicted to Ambien. However, the risk of addiction is also a concern for those that have never suffered from addiction. Studies have proven that the “high” associated with drugs like Ambien can still result in abuse even for people that have never displayed addictive behaviors.
Doctors typically prescribe the lowest dose of Ambien possible. Someone taking Ambien should be closely monitored by their physician and discuss alternative therapies if the drug is needed for longer than two weeks.
People can also experience withdrawal symptoms if they suddenly stop taking Ambien. These symptoms typically come about within 48 hours after the last dose. Withdrawal symptoms can be very dangerous and include things like uncontrollable crying, depression, panic attacks, anxiety, mood swings, sweating, tremors, abdominal cramping, vomiting, and rebound insomnia.
If you have prescribed Ambien, it is crucial that you take it exactly as directed by your doctor.
If you or a loved one is pregnant and struggling with Ambien abuse or addiction, there is hope. We have a trained and compassionate staff that can help you decide which treatment facility offers the most appropriate program for your unique needs and situation.
To learn more about Ambien abuse during pregnancy, contact a treatment specialist today.