Unisom Was the Only Thing That Helped My Pregnancy Insomnia
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In my mid-30s, I stoppedsleepingthrough the night. First, only occasionally. Thanks to what I assume was a cocktail of hormonal shifts and a new, stress-inducing job, I would rouse at three or four in the morning in a kind of chronophagic purgatory: fully alert, my mind pacing through memories, questions, impending decisions, and tasks, each tinted with conspiracy. Sometimes I read, but mostly I lay inbednext to my husband, trying to bring my focus back to my breath. I counted backward from 100 by threes. In one desperate instance, I tapped the center of my forehead 21 times à la teenage Ally Hilfiger and Jaime Gleicher in MTV’sRich Girls. I would fall back asleep around eight a.m., just in time to wake up.
Medication, at that time, felt out of the question. Melatonin left me in a cloud for a full day. Magnesium barely grazed the problem. NyQuil ZZZ felt like blunt-force trauma. And the insomnia was intermittent enough that prescription sleep aids — especially thosenewly linked to higher risks of dementiawith long-term use — felt disproportionate.
Then I gotpregnant. The nightly hormonal roofie-ing of building a placenta stretched the insomniac behavior into a nightly habit, lasting for months on end. My doctor suggested Unisom, the only sleep aid tested and approved for pregnant women. Desperate, I took it. And it worked.
Unisom is, pharmacologically speaking, quite simple. “It’s an antihistamine — diphenhydramine,” says Aruna S. Rao, MD, assistant professor of neurology and sleep medicine at Johns Hopkins University School of Medicine. As she describes it, histamine is one of the brain’s wake-promoting chemicals; suppress it, and you quiet one of the systems that keeps you alert.
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In my experience, it is a clap-on, clap-off device for my body. Even while pregnant with twins, for my five-foot-five frame, a full pill was too much for me — borderline horse tranquilizer. But a half-tablet offers a perfect eight-hour stretch of uninterrupted sleep with zero hangover. The eight hours is key, according to Dr. Rao. If you feel groggy the next day, it’s usually because your dose was too high or your night was too short.
Now, three pregnancies in, it’s a staple. I take half a pill when hormones or illness tip me into sleeplessness, knowing I’ll still wake if my toddler cries or something actually needs my attention. It’s not so heavy that you’d sleep through a fire alarm but weighted enough that when I inevitably wake up to pregnancy pee in the middle of the night, I can fall immediately back to sleep.
I dose it strategically. On medication-sober nights, if I wake up, a quarter pill will ease me back down until morning. The same amount will deliver ideal sleep-catch-up naps on solo cross-country flights. Half can eviscerate jetlag.
Dr. Rao and, separately, my own MFM are both clear that this isn’t a forever solution. With approval from your own doctor, “you really only want to use medications for the short term — about two weeks — before looking into underlying causes with your doctor,” says Dr. Rao. Chronic insomnia can signal anything from depression to iron deficiency, and antihistamines, while safe for generally everyone (and notably not in the benzodiazepine class), aren’t designed to fix the root problem.
But as an occasional reset? One small, over-the-counter blue pill is remarkably effective.
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