![]() ![]() Restless legs syndrome and pregnancy: a review. Background Sleep disturbance is a common complaint in major depressive disorder (MDD) including impairment of both subjective and objective parameters. Insomnia and sleep deficiency in pregnancy. Cognitive Behavioral Therapy for Prenatal Insomnia: A Randomized Controlled Trial. Manber R, Bei B, Simpson N, Asarnow L, Rangel E, Sit A, Lyell D. Incidence of major malformations in infants following antidepressant exposure in pregnancy: results of a large prospective cohort study. A multicentre prospective controlled study to determine the safety of trazodone and nefazodone use during pregnancy. Management of Obstructive Sleep Apnea in Pregnancy. Risk of hypotension.ĭominguez JE, Street L, Louis J. It is in the serotonin-antagonist-and-reuptake-inhibitor class of medications. Tricyclic antidepressants – Sedating TCAs imipramine, amitriptyline at low doses. Trazodone is a medication used in the management and treatment of major depressive disorder.SSRIs and SNRIs for treatment of anxiety, depression.Benzodiazepines – More data to support reproductive safety.Cognitive behavioral therapy for insomnia.Risk of Major Malformations – Two Studies Increased activity of HPA axis, inflammation.Other negative effects of insomnia during pregnancy Increased risk of perinatal anxiety, OCD.Increased risk of depression during pregnancy.Should insomnia during pregnancy be treated? Sleep apnea (up to 26% in 3rd trimester).Pregnancy-associated symptoms: urinary frequency, heartburn, fetal movements.Up to 73.5% of women report insomnia: mild 50.5%, moderate 15.7%, and severe 3.8%.Sleep disturbance is common: 13% in the first trimester, 19% in the 2nd, 66% in the 3rd.Sleep increases in the 1st trimester, decreases in the 3rd trimester.Sleep problems are common during pregnancy The information is covered in the slideshow below the text. The following is a review of the use of trazodone during pregnancy. For example, if insomnia appears to be related to untreated anxiety, one might select treatments that target anxiety, including cognitive-behavioral therapy for anxiety, SSRI and SNRI antidepressants, and benzodiazepines. The treatment of insomnia involves understanding of the underlying causes of insomnia and choosing medications which target the causes of insomnia. Insomnia, especially when severe, may be associated with worse pregnancy outcomes and may increase risk for depression during pregnancy and the postpartum period. However, information regarding the reproductive safety of these medications has been relatively sparse. Trazodone (Desyrel) is FDA-approved for the treatment of major depressive disorder however, because it is highly sedating, it is more commonly used to promote sleep. While for many women the insomnia is relatively benign and may respond to simple interventions, other women experience more severe insomnia which has a significant impact on their quality of life and ability to function. It is estimated that up to 95% of women experience some type of sleep disturbance during pregnancy. ![]()
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