Can You Take Unisom During Pregnancy?

The common over-the-counter sleep aid can be used for occasional bouts of insomnia, or paired with vitamin B6 to help manage morning sickness.
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Published February 23, 2023
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Insomnia and nausea are two unpleasant symptoms many moms-to-be face throughout pregnancy. (And, yes, some lucky people are blessed with both!) It’s true that growing a human comes with plenty of uncomfortable side effects; some are manageable, while others are downright debilitating. The good news? If you’re having trouble getting adequate sleep or experiencing morning sickness, there are some steps you can take to get relief—whether that means snagging a few hours of uninterrupted rest or catching a break from relentless retching.

One option that can help encourage sleep and quell nausea: Unisom, the popular over-the-counter sleep aid. Your doctor may recommend it on its own for insomnia or paired with vitamin B6 for morning sickness. Ready to get relief? Here’s what you need to know about the safety and effectiveness of taking Unisom during pregnancy.

What Is Unisom?

Unisom is a nighttime sleep aid that contains the active ingredient doxylamine succinate, an antihistamine that blocks how histamine works in the body and makes you feel sleepy. In addition to helping with occasional insomnia, Unisom is used in combination with vitamin B6 to treat nausea and vomiting during pregnancy, according to the American College of Obstetricians and Gynecologists (ACOG).

Reasons for Taking Unisom During Pregnancy

There are two main reasons you’d turn to Unisom in pregnancy: to get some much-needed sleep or to curb nausea.

Sleep problems during pregnancy are common, thanks in part to major changes in your hormone levels. But if you’re still struggling to get shut-eye—and simple lifestyle changes aren’t moving the needle—you can ask your doctor if Unisom might help. Sarah Bernstein, MD, a maternal-fetal medicine specialist at Massachusetts General Hospital, says that Unisom is a go-to option she recommends for pregnant patients with sleep issues.

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If morning sickness is your big pregnancy battle, the ACOG recommends taking a daily dose of vitamin B6 to curb nausea. However, when B6 alone doesn’t do the trick, pairing it with doxylamine (aka Unisom) may help. “It’s our first line of treatment when patients call the office and aren’t feeling well, because it has the most safety evidence behind it,” says Bernstein.

Is Unisom Safe During Pregnancy?

Unisom is considered safe to use during pregnancy by major medical groups, including the FDA and ACOG. “It’s been around for a really long time,” says Bernstein, adding that studies have shown there’s no legitimate concern.

That said, you’ll want to talk to your doctor before using any medication during pregnancy, whether it’s prescription or over-the-counter. Not every medication is universally recommended for all pregnant people, and it’s important that your doctor has a chance to rule out any other potential causes for the symptoms you’re experiencing. Moreover, be sure your practitioner is aware of any diagnosed chronic health conditions, especially breathing problems (such as asthma or chronic bronchitis) or glaucoma, as Unisom may not be a good option for you, according to the US National Library of Medicine.

Potential side effects of Unisom in pregnancy

The main potential side effect of Unisom is drowsiness, notes BMC Pregnancy and Childbirth—which you can feel acutely, since pregnancy may already have you feeling extra tired. Some people experience symptoms such as dry mouth, throat and eyes, as well as headache or blurred vision. “In some individuals, Unisom may have the opposite effect, and make them feel jittery or excited,” adds Melody L. Berg, PharmD, MPH, editorial director of the American Society of Health-System Pharmacists.

Taking Unisom for Pregnancy Insomnia

Unisom is an antihistamine that can help encourage sleep. Histamine, a chemical found in many of the body’s cells, is involved with sensations of wakefulness. Histamine receptors exist in many tissues in the body, including the brain. “When doxylamine blocks these receptors in the brain from working with histamine, you’ll feel sleepier,” says Berg.

Always check with your provider about when and how to take Unisom during pregnancy. Berg says that doctors generally recommend taking one 25 mg regular strength Unisom tablet at bedtime.

Ideally, you should take Unisom only as needed. Berg cautions against frequently using the drug for sleep problems during pregnancy. “Patients can develop tolerance to the drowsy effect of antihistamines,” she says. That said, if Unisom isn’t cutting it, talk to your doctor about upgrading to Benadryl, a different antihistamine. Sofia Buenaventura, MD, an assistant professor of obstetrics and gynecology at the University of Chicago Medicine, says that you may feel a more sedative effect with the latter option.

Alternatives to taking Unisom for sleep

Of course, Unisom won’t solve other causes for sleep issues in pregnancy, such as back pain and heartburn. Fortunately, there are effective medication-free ways to manage insomnia. These pregnancy sleep tricks may help you to get a better night’s rest:

  • Avoid caffeine (coffee, tea, chocolate, etc. in the hours before you hit the sack.
  • Try to go to bed and wake up at the same time every day.
  • Exercise daily—even walking helps!
  • Keep screens, including your smartphone, out of bed.
  • Keep your bedroom cool and dark.
  • If you’re struggling to sleep on your side in the second half of pregnancy, use pillows strategically: Try placing one between your legs or to prop up your bump. You may even want to consider investing in a pregnancy pillow.

Taking Unisom and Vitamin B6 for Nausea

Again, antihistamines block the effects of histamine on the body. In the case of morning sickness, Unisom works to disrupt the vomiting signal that the brain sends to the gastrointestinal tract, explains Berg. Before graduating to Unisom in pregnancy, doctors generally recommend taking 25 mg of vitamin B6 every eight hours, says Berg. If the vitamin alone doesn’t help, they may suggest adding 12.5 to 25 mg (one-half to one full tablet) of regular strength Unisom (doxylamine) at bedtime.

Alternatively, your provider may suggest a prescription medication known as Diclegis. This medication was designed to treat nausea during pregnancy and contains the same active ingredients—doxylamine and B6—combined into one pill. “Sometimes your insurance may cover these medications when they’re prescription versus getting them over-the-counter,” adds Berg.

Alternatives to taking Unisom for nausea

If you’d rather avoid taking Unisom and B6 during pregnancy, but nausea nags you day and night, try these medication-free morning sickness remedies:

  • Eat smaller, more frequent meals (five to six times daily). “Having low blood sugar can also trigger nausea,” says Bernstein.
  • Carbs may settle your stomach; munch on crackers in the morning, before you get out of bed.
  • Try to add healthy proteins, such as nuts and seeds, to each meal.
  • Try foods made with real ginger, including candies, tea and soda.
  • Drink plenty of water, as dehydration can make nausea worse. “Some people say drinking cold water with a straw works,” says Bernstein.
  • Sometimes prenatal vitamins can exacerbate nausea. It’s important to get your daily dose, but taking your vitamin at night before bed may help.
  • Research has shown that acupressure and acupuncture may help reduce morning sickness. Avoid odors that make you nauseous—which might mean having your partner cook or take out the trash. Consider if acid reflux is exacerbating nausea and vomiting. “Uncontrolled acid reflux causes nausea, even if you don’t have a burning sensation,” says Buenaventura.

Separately—or in tandem with Unisom and B6—these lifestyle changes can help reduce episodes of nausea. That said, if you can’t keep food or fluids down, and you begin to lose weight due to morning sickness, you’ll want to talk to your doctor. You may have hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy that may require treatment at the hospital.

For many people, pregnancy is far from a cakewalk. But if you’re dealing with insomnia or morning sickness, there are steps you can take to feel better. Unisom—alone or paired with vitamin B6—is one potential solution to try during this rollercoaster journey. Talk to your doctor to find out if it’s a viable option for you.

About the experts:

Melody L. Berg, PharmD, MPH, BCPS, is the editorial director of the American Society of Health-System Pharmacists. She received her degrees from Midwestern University Chicago College of Pharmacy and the University of Massachusetts Amherst.

Sarah Bernstein, MD, is a maternal-fetal medicine specialist at Massachusetts General Hospital and an assistant professor at Harvard Medical School. She received her medical degree from Tel Aviv University.

Sofia Buenaventura, MD, is an assistant professor of obstetrics and gynecology at the University of Chicago Medicine. She received her medical degree from the University of Texas Medical Branch.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

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