Sleeping Positions in Pregnancy: What Is Safe and What Helps

✓ This content has been medically reviewed by an obstetrician and gynaecologist
Written & medically reviewed by: Op. Dr. Ayşet Jane Özcan, Obstetrics & Gynaecology Specialist
Istanbul Faculty of Medicine · Medical Park Bahçelievler · TJOD and TSRM member
Last updated: 24 October 2026 · Last medical review: 24 October 2026

Sleep is one of the first things pregnancy takes from you and one of the last things it gives back. In the first few weeks you may be unable to stay awake; by the third trimester you may be unable to stay asleep. Somewhere in between, most women come across the advice to sleep on their side, often in a half-remembered form that leaves them anxious rather than informed — worried that a few hours on their back has done harm, or convinced that only the left side will do. That anxiety is itself a sleep thief, and it is almost always unnecessary.

This article sets out what is actually known about sleeping positions in pregnancy, where the advice comes from and how firm it is, and what to do about the many other things that wake you at night: reflux, trips to the bathroom, calf cramps, restless legs, hip and pelvic pain, blocked noses and a racing mind. It also covers the night-time symptoms that are not a comfort problem at all and need a phone call rather than a different pillow. Where I give numbers, they describe how common a condition is, not how well any treatment works — and nothing here replaces the advice of the midwife or doctor who knows your own pregnancy.

The Short Answer on Sleeping Positions in Pregnancy

Up to about 28 weeks, sleep in whatever position is comfortable. From around 28 weeks, aim to settle down to sleep on your side — either side — rather than flat on your back. That is the whole of the position advice. Everything else in this article is either the reasoning behind it or help with the practical problem of actually getting to sleep.

A few clarifications, because each of these comes up repeatedly in clinic.

• Front sleeping is not dangerous. In early pregnancy the womb sits within the bony pelvis and is well protected. Lying on your front becomes physically impossible long before it becomes a concern — the bump simply gets in the way, and tender breasts usually end it even earlier.
• Propped up is not the same as flat on your back. If you are tilted onto one hip, or leaning back against a wedge or a stack of pillows at a definite angle, you are not in the fully supine position the advice is about. A partial tilt does most of the job.
• The advice is about going to sleep, not about every minute of the night. You cannot control your position while unconscious, and you are not expected to.
• The same rule covers daytime sleep. After 28 weeks, a nap or an afternoon lie-down counts as going to sleep, so settle onto your side for those too rather than flat on your back on the sofa.
• Sitting up and dozing in a chair is a reasonable option for a bad night with reflux or breathlessness, though it is not a good long-term arrangement for your back or your circulation.

It is worth saying plainly that this is a precaution, not an emergency. Settling on your side is a cheap, simple, no-downside habit, which is exactly why it is recommended — not because the risk of doing otherwise is large. If you have spent part of this pregnancy sleeping on your back, you have not harmed your baby, and no one in your antenatal team will think you have.

Is Sleeping on Your Back Dangerous, and From Which Week?

Lying flat on your back is not recommended for settling to sleep from around 28 weeks onwards. Before that point it is not considered a concern. The 28-week mark is not a cliff edge; it is the point at which the womb is usually large and heavy enough for position to matter mechanically, and it is the threshold used in the research the advice is based on.

What happens mechanically

When you lie fully supine in late pregnancy, the weight of the womb, the baby and the amniotic fluid presses backwards onto the large blood vessels that run along your spine: the inferior vena cava, which carries blood back to the heart, and to a lesser extent the aorta, which carries it away. Compressing the vena cava reduces the volume of blood returning to the heart, which reduces the amount the heart pumps out with each beat, which in turn can reduce the blood flow reaching the womb and placenta. Turning onto your side lifts the womb off those vessels and the circulation returns to normal within moments.

A minority of women feel this happening very clearly. Lying flat brings on light-headedness, nausea, a thumping or racing heart, breathlessness or a cold clammy feeling, all of which settle within a minute or two of rolling onto one side. This is sometimes called supine hypotensive syndrome. It is worth knowing about, but it is not a test you can apply to yourself: most women who lie flat in late pregnancy feel nothing in particular even though the circulation is measurably affected, which is why the advice is given to everyone rather than only to those who notice symptoms.

What the research actually shows

Several studies, pooled in an analysis of individual participant data, found that women who reported going to sleep on their back in the last weeks of pregnancy had a higher chance of late stillbirth than women who went to sleep on their side. Late stillbirth is uncommon, and the increase in absolute terms is small — but because the change required is so easy, the advice to settle on your side was adopted into national public health advice, including NHS advice in the United Kingdom and similar campaigns in Australia and New Zealand.

Two honest caveats belong with that. First, this evidence is observational: it shows an association between a reported habit and an outcome, not a proven cause-and-effect chain, and the mechanism described above is inferred rather than demonstrated in these studies. Second, the question asked in the research was about the position women settled down in, which is why that is the form the advice takes. Nobody has shown that a spell on your back in the middle of the night carries the same meaning, and there is good reason to think it does not.

Why Side Sleeping Is Advised — and Does the Left Side Matter?

Either side is fine. Left and right are both recommended, and you do not need to force yourself to stay on the left. This is the single most common misunderstanding about sleeping positions in pregnancy, and it causes a great deal of unnecessary night-time distress.

Where the left-side idea came from

The inferior vena cava runs slightly to the right of the spine. On purely anatomical grounds, turning onto the left displaces the womb away from it most completely, which is why left lateral positioning has been used for decades in specific clinical situations — during labour, if a woman becomes faint when lying flat, or when a fetal heart rate trace needs improving. That hospital practice leaked into general antenatal advice as if the left side were the only acceptable option.

When researchers specifically compared going to sleep on the left with going to sleep on the right, they did not find the right side to be worse. The distinction that carries the advice is side rather than back, not left rather than right. Current public advice reflects that: go to sleep on whichever side you prefer, and swap freely during the night.

Why this matters practically

Insisting on one side has real costs. It means lying awake on a shoulder that has gone numb, or on the hip that hurts, rather than turning over. It means waking in the night and feeling you have done something wrong. It means women with one-sided pelvic or rib pain losing hours of sleep for no benefit. Being free to use both sides makes it far easier to find a position your body will actually tolerate for a few hours, and turning over periodically is good for your skin, joints and shoulders.

Full side, or a tilt?

You do not need to be stacked up in a perfect textbook posture. Being tilted clearly onto one hip, with your shoulders turned and a wedge or pillow behind your back so you cannot roll flat, achieves most of what full side-lying achieves. For women with marked pelvic girdle pain in pregnancy, a supported tilt is often far more bearable than lying fully on one side, and it is a legitimate compromise rather than a failure to follow the advice.

"I Woke Up on My Back" — What to Do and Why Not to Feel Guilty

Roll onto your side and go back to sleep. That is the entire answer. Waking on your back is not a reason to panic, to count kicks in a state of dread, or to lie awake for the rest of the night.

Here is why the reassurance is genuine rather than polite. The advice was built around the position you settle into, because that is the position you hold for the longest unbroken stretch of the night — and because it is the only position you can actually choose. Everyone changes position repeatedly while asleep, pregnant or not. Studies in which pregnant women were monitored overnight found that most spend time on their backs at some point, and that nobody can prevent it.

Some women are woken by the discomfort of lying flat — breathlessness, queasiness, light-headedness or a pounding heart that eases as soon as they turn — and that may be part of why mid-sleep supine time appears to matter less than the position you fall asleep in. It is a plausible explanation rather than a proven protective mechanism, and plenty of women feel nothing at all, so waking undisturbed is not proof that your circulation was unaffected. Either way the practical answer is identical: turn onto your side and settle again. What the evidence concerns is the position you deliberately go to sleep in, and that is the one worth getting right.

Practical things that help, instead of worrying

• Make your back unavailable. Put a long pillow, a rolled duvet or a body pillow lengthways behind you so rolling flat meets an obstacle. You are far more likely to end up tilted than fully supine.
• Fix the reason you rolled. People roll onto their back because a shoulder, hip or rib has become painful. Padding that joint properly does more than willpower will.
• Do not set alarms to check your position. Fragmenting your sleep to police a position you cannot control trades a small theoretical gain for a real loss.
• Keep attention on fetal movements instead. Your baby's usual pattern of movement is a far more meaningful signal than your sleeping position. A clear reduction or change in movements should prompt a call to your maternity unit the same day, at any hour — never wait until morning, and never wait for a scheduled appointment.

If anxiety about sleeping position is keeping you awake, say so at your next antenatal visit. It is a reasonable thing to raise, and talking it through properly is more effective than reading about it again at two in the morning.

How to Sleep Comfortably While Pregnant: Pillows and Supported Positions

The goal is to take the load off three places: the bump, the upper hip and knee, and the lower shoulder. Most night-time discomfort in late pregnancy comes from one of those three, and each has a simple fix. You do not need to buy anything special — ordinary pillows, a rolled towel and a folded blanket will do — but a shaped pregnancy pillow saves rearranging things at three in the morning.

The basic side-lying set-up

• A pillow or small cushion under the bump, tucked into the gap between the bump and the mattress. This stops the weight of the womb dragging your abdomen and lower back forwards, which is a major source of low backache at night.
• A firm pillow between your knees, with the knees bent and the top leg brought forward. This keeps your pelvis level rather than twisted, which matters enormously if you have pelvic or hip pain. The pillow needs to be thick enough that the top knee sits at roughly hip height, not slumped down.
• One pillow — not three — under your head, at a height that keeps your neck in line with your spine. Too many pillows under the head bends the neck and does nothing useful for reflux.
• A long pillow behind your back, acting as a stop so you settle into a tilt rather than rolling flat.
• Arm position matters more than people expect. Bringing the lower shoulder forward and hugging a pillow takes the pressure off it. Letting the upper arm rest on a cushion rather than hang across the bump reduces night-time hand numbness and tingling.

Variations for specific problems

For reflux, raise the whole head of the bed by ten to fifteen centimetres — blocks, books or a wedge under the mattress at the head end — so that your chest sits above your stomach along a gentle slope. Piling pillows under your head alone concentrates the bend at your abdomen and often makes reflux worse.

For breathlessness in late pregnancy, a semi-upright tilt on your side, or propping yourself higher on the whole upper body, usually helps more than any position change below the waist.

For hip and pubic pain, keep your knees close together when turning over and move as one unit — roll your shoulders, hips and knees at the same time rather than letting your top leg swing across. Satin or silky sheets and nightwear genuinely make turning easier, which sounds trivial until you have tried to turn on brushed cotton at 36 weeks. If sharp pulling pains in the groin wake you as you turn, read about round ligament pain in pregnancy, which is harmless but very startling at night.

For a large bump early — which is usual in a twin pregnancy — expect to need the full supported set-up from the second trimester rather than the third, and expect to need more upright positions sooner.

For numb, tingling or painful hands waking you at night, which is common in pregnancy because of fluid retention around the wrist, many women find a neutral wrist splint worn at night helps. It is worth asking your midwife or doctor about rather than trying to hold your hands in a particular position while asleep, which is not something you can do.

How Sleep Changes by Trimester

Pregnancy does not simply make you sleep less. It changes the problem three times. Knowing which stage you are in helps, because the solutions are different.

First trimester: too sleepy, and interrupted

Overwhelming daytime sleepiness in the first weeks is normal and largely hormonal, with rising progesterone having a sedating effect. Yet night sleep is often already fragmented, because nausea can be worse when the stomach is empty and because the need to pass urine at night starts remarkably early — the result of increased blood flow through the kidneys rather than pressure from the womb, which is still small.

Position is not a concern at this stage. The useful moves are a dry biscuit or a few plain crackers at the bedside for early-morning nausea, eating something small before lying down, and allowing yourself a short early-afternoon nap rather than fighting the fatigue. If vomiting is constant, you cannot keep fluids down and you are losing weight, that is beyond ordinary morning sickness — see hyperemesis gravidarum and seek help early rather than enduring it.

Second trimester: usually the best stretch

For many women the middle months are the easiest for sleep: nausea has eased, the bump is not yet unwieldy, and energy returns. This is the right moment to build the side-sleeping habit, before you have to, and to put the pillow arrangement in place while you are still sleeping reasonably well. Heartburn and leg cramps often make their first appearance in this window, and first fetal movements can be distracting at night simply because you notice them most when lying still.

Third trimester: fragmented by everything at once

Late pregnancy sleep is broken rather than short, and usually for several reasons simultaneously: physical bulk, reflux, bathroom trips, rib and hip pain, restless legs, cramps, an active baby, nasal congestion, breathlessness, Braxton Hicks tightenings, vivid dreams and a mind that will not stop planning. Sleep becomes lighter and the number of awakenings rises. Some of this is modifiable and some of it is simply the last weeks of pregnancy.

Two practical expectations help. First, aim for total sleep across the twenty-four hours rather than one unbroken night — a planned daytime rest is not a failure, and from 28 weeks it is worth taking that rest on your side, just as you would at night. Second, judge yourself by how you function in the day, not by hours recorded on a watch. Sleep-tracking devices in late pregnancy tend to produce anxiety rather than insight.

When It Is Not the Position: Reflux, Nocturia, Cramps and Restless Legs

Most pregnancy insomnia is not a positioning problem. Four specific causes account for a large share of it, and each has its own fix.

Reflux and heartburn

Progesterone relaxes the muscular valve at the top of the stomach while the growing womb raises the pressure inside the abdomen — a combination that pushes acid upwards, especially when you lie down. What helps: smaller, more frequent meals; finishing your last meal two to three hours before lying down; sitting upright for a while after eating; cutting back on the usual provokers (fatty or fried food, very spicy food, chocolate, citrus, fizzy drinks, caffeine); raising the head of the bed; and lying on your left side, which tends to keep the junction between stomach and oesophagus above the pool of stomach contents.

Antacids and alginate preparations — the class of medicines that neutralise acid or form a raft on top of the stomach contents — are commonly used in pregnancy, and acid-suppressing medication can be prescribed when simple measures are not enough. Discuss which is appropriate with your own doctor or pharmacist rather than taking whatever is in the cupboard, and note that antacids containing calcium can interfere with the absorption of iron tablets, so space them a couple of hours apart. If your digestion is sluggish in both directions, dietary fibre, fluids and gentle daily activity are worth combining with these measures.

One important caveat: pain high in the abdomen or under the right ribs that does not behave like ordinary heartburn — particularly with headache, visual disturbance, sudden swelling of the face, hands or feet, or feeling generally unwell — needs same-day assessment, because it can be a sign of preeclampsia rather than reflux. Do not treat new, severe upper abdominal pain as indigestion.

Getting up to pass urine

Night-time urination in pregnancy has three causes: your kidneys filter more blood, the womb presses on the bladder, and in late pregnancy the fluid that has pooled in your legs during the day returns to the circulation when you lie down and is passed as urine overnight. That last mechanism explains why cutting fluids in the evening often fails.

What actually helps is shifting your fluid intake earlier in the day rather than reducing it, and spending half an hour in the late afternoon or early evening with your legs raised, so that the leg fluid mobilises before bedtime rather than at three in the morning. Do that lying on your side with a cushion under your lower legs, or sitting well propped up at a clear angle with your legs supported — not flat on your back, for the same reason the night-time advice exists. Empty your bladder completely before settling, and lean forwards slightly at the end to drain it. Keep a dim light rather than a bright one on the route to the bathroom, so you are not fully woken. Do not restrict fluids substantially — dehydration and urinary infection are worse problems than a night-time trip. Burning, stinging, urgency, cloudy or offensive-smelling urine, or back pain with fever all need prompt assessment, because urinary infections in pregnancy are treated rather than left.

Leg cramps

Sudden, severe calf cramps that strike at night are common from the second trimester onwards and the cause is not fully understood. During a cramp, pull your toes up towards your shin and straighten the knee; afterwards, walk around briefly and massage the muscle. To reduce them, stretch your calves for half a minute on each side before bed, stay well hydrated across the day, and keep moving regularly. Evidence for supplements is inconsistent, so do not spend money on them on my account, and do not start any supplement in pregnancy without checking it first.

Cramp is harmless; a blood clot is not. Pain, swelling, warmth, redness or tenderness in one calf that persists rather than passing in seconds — especially with any breathlessness or chest pain — needs urgent medical assessment the same day, as pregnancy increases the risk of clots in the leg veins.

Restless legs

Restless legs syndrome is a recognisably different thing from cramp: an uncomfortable, crawling, unbearable urge to move the legs that builds in the evening and is relieved by moving them. It is common in pregnancy, tends to peak in the third trimester and usually settles after birth. It is worth mentioning to your doctor, because iron deficiency is a treatable contributor and a simple blood test can check your iron stores. Regular moderate daytime activity, a consistent bedtime, stretching, a warm bath, leg massage and reducing caffeine all help; the medicines used for restless legs outside pregnancy are generally not used during it. Some antihistamines and anti-sickness drugs can make restless legs worse, so review anything you are already taking with your clinician rather than adding to it.

Snoring and Sleep Apnoea: When to Raise It

New or louder snoring in pregnancy is common and usually harmless, but snoring with pauses in breathing, choking awakenings or severe daytime sleepiness should be mentioned to your doctor rather than laughed off.

Pregnancy makes snoring more likely for straightforward physical reasons. Hormonal changes swell the lining of the nose, producing a persistent blocked or runny nose that has nothing to do with a cold — often called rhinitis of pregnancy. Weight gain and fluid retention narrow the upper airway, and the enlarging womb pushes the diaphragm upwards so the lungs hold a smaller reserve of air. Many women who never snored begin to do so in the third trimester, and it resolves after birth.

The features that matter

• Someone has witnessed you stopping breathing, or you make choking or gasping sounds during sleep.
• You wake with a headache most mornings, or with a very dry mouth and a pounding heart.
• You feel unrefreshed however long you sleep, and struggle to stay awake sitting still during the day.
• You have fallen asleep, or come close to it, while driving — in which case stop driving and seek advice promptly.
• Your blood pressure has been creeping up, or there is protein in your urine.

Obstructive sleep apnoea in pregnancy — repeated collapse of the upper airway with brief interruptions of breathing — is associated with raised blood pressure, preeclampsia and gestational diabetes, which is why it is worth identifying rather than tolerating. It can be assessed with a sleep study, often done at home, and treated with continuous positive airway pressure, which is used in pregnancy. The practical point is simply to raise it: snoring is treated as a joke in most households, so it rarely reaches a consultation unless you bring it up. Nasal congestion itself can often be eased with saline rinses or sprays, a humidified bedroom and a tilted sleeping position; decongestant sprays and tablets should not be used in pregnancy without advice.

Breathlessness deserves a separate word. Mild breathlessness on exertion is normal in pregnancy. Breathlessness that is new and severe, that comes on at rest, that wakes you suddenly, or that comes with chest pain, palpitations or a cough is not, and needs assessment the same day.

Practical Sleep Hygiene for Pregnancy

The usual sleep advice still applies in pregnancy, with three modifications: naps are allowed, your target is total sleep across the day, and you should stop trying to force a whole unbroken night.

• Keep your wake time fixed rather than your bedtime. A consistent morning start anchors the whole rhythm, and it is the one part of the schedule pregnancy cannot take from you.
• Nap early and briefly. Twenty to thirty minutes in the early afternoon restores a good deal without wrecking the following night. Long naps after about four in the afternoon make the evening worse. From 28 weeks, settle onto your side for naps and daytime rests too — the position advice is about falling asleep, whatever the hour.
• Get daylight in the morning and dim the lights in the last hour of the evening. Light is the strongest signal your body clock receives.
• Keep the room cool. Body temperature runs slightly higher in pregnancy and overheating is a common reason for waking. A cooler room, lighter bedding and separate covers from your partner help more than most gadgets.
• Do not lie awake fighting it. If you have been awake for twenty minutes or more and are becoming frustrated, get up, go somewhere dimly lit, do something undemanding, and return when you feel sleepy. Lying in bed awake and anxious teaches your brain that the bed is a place for worrying.
• Deal with the worry list before bed, not in it. Five minutes with a notebook in the evening — what is on your mind, what you will do about it tomorrow — is a genuinely effective technique, not a platitude.
• Move during the day, but finish vigorous exercise an hour or two before bed. Regular activity in pregnancy improves sleep as well as a good deal else.
• Keep caffeine modest and early. NHS advice in pregnancy is to have no more than 200 mg of caffeine a day — roughly two mugs of instant coffee — and to remember that tea, cola, energy drinks and chocolate all contribute. Caffeine lingers longer in the body during pregnancy than outside it.
• No alcohol. It is not advised in pregnancy at all, and as a sleep aid it is counterproductive in any case, fragmenting the second half of the night.
• Eat something small before bed if nausea or early-morning hunger wakes you — a plain biscuit, some yoghurt, a banana — and keep it light enough not to provoke reflux.

If you are regularly unable to fall asleep or stay asleep for a month or more and it is affecting your days, that is insomnia and it is treatable. Cognitive behavioural therapy for insomnia is the first-line approach and is suitable in pregnancy. Persistent sleeplessness also travels closely with low mood and anxiety in pregnancy, in both directions, so if sleep is bad and your mood is low, mention both at the same appointment rather than treating them as separate problems.

Sleep Medicines, Supplements and Herbal Remedies

Do not start anything for sleep in pregnancy — prescription, over-the-counter, herbal or supplement — without checking with your own doctor, midwife or pharmacist first. That includes products sold as natural, as that word carries no information about safety in pregnancy.

A few general points, offered as orientation rather than as a prescription for anyone. Melatonin is widely sold but its use in pregnancy is not well established, and it is not something to begin on your own. Herbal sleep preparations are not standardised and have generally not been studied in pregnancy; valerian, passionflower and similar products fall into this category. Some sedating antihistamines are used in pregnancy for other indications and are sometimes discussed as short-term options for sleep, but this is a decision for a clinician who knows your history, not a self-prescription — and as noted earlier, they can aggravate restless legs. Medicines you were taking for sleep before pregnancy should be reviewed rather than simply stopped or simply continued; abruptly stopping some of them is its own problem.

Iron and other deficiencies are a different matter and worth pursuing, because they are identifiable and correctable. Iron deficiency contributes to both restless legs and daytime exhaustion, and is assessed with a blood test rather than guessed at. Equally, do not take iron on the assumption that it will help your sleep — have it checked.

What I would encourage you to spend effort on instead: the pillow arrangement, the timing of meals and fluids, the head-of-bed angle, daylight in the morning, a fixed wake time, and treating reflux, restless legs or nasal congestion specifically. These address causes, and none of them has a safety question attached.

Night-Time Symptoms That Need a Call, Not a Cushion

Some things that keep you awake in pregnancy are not comfort problems. Contact your maternity unit, midwife or doctor — at any hour — if any of the following happens, and do not wait until morning to see whether it settles.

• Reduced or changed fetal movements, or you cannot feel your baby move as usual. This is the most important one. Call the same day, whatever the time; do not drink cold water and wait, and do not use a home monitor to reassure yourself.
• Any vaginal bleeding, at any stage. See bleeding during pregnancy for what the possible causes are, but have it assessed rather than interpreted at home.
• Fluid leaking from the vagina, a sudden gush or a persistent trickle that is not urine.
• Regular, painful tightenings before 37 weeks, or low back and pelvic pressure that comes and goes in a rhythm.
• Severe or persistent headache, flashing lights or blurred vision, sudden swelling of the face, hands or feet, or pain under the ribs on the right side. Together or separately, these can indicate preeclampsia and need urgent review.
• Pain, swelling, warmth or redness in one calf, or new chest pain or severe breathlessness.
• Fever, feeling shivery or generally unwell, or burning and urgency when passing urine.
• Intense itching, particularly of the palms and soles, that is worse at night and has no rash. This classically disturbs sleep and should be tested for, as it can indicate a liver condition of pregnancy that needs monitoring.
• A fall, a blow to the abdomen or a road accident, however minor it felt at the time.

None of these is a reason to be frightened of the night. They are a short list worth knowing, so that you can stop wondering whether something counts and simply make the call.

What to Bring to Your Next Appointment

Sleep is rarely the item people raise in an antenatal visit, partly because it feels like a complaint rather than a medical matter. It is worth raising, and it is easier to help with when you arrive with specifics rather than "I'm not sleeping".

• What wakes you, as precisely as you can: heartburn, the bathroom, hip pain, legs, your baby moving, a blocked nose, worry, or no identifiable reason.
• Roughly how many times a night, and whether you get back to sleep easily or lie awake for an hour.
• How your days are going — whether you are falling asleep unintentionally, struggling to drive or concentrate, or feeling low.
• Whether anyone has noticed snoring, gasping or pauses in your breathing.
• Everything you are taking, including supplements, herbal products and anything bought over the counter.
• What you have already tried, so the conversation starts from where you are rather than from the basics.

Sleep problems in pregnancy are often treated as unavoidable, and a good part of them genuinely is — the last weeks are physically demanding and no pillow fixes that. But reflux, restless legs, iron deficiency, nasal obstruction, pelvic pain, urinary infection, sleep apnoea, anxiety and insomnia are all specific, identifiable and manageable, and together they account for a great deal of lost sleep. Bringing them into a scheduled visit is the right place to sort them out; regular pregnancy follow-up exists exactly so that symptoms like these can be looked at alongside your blood pressure, your blood tests and your baby's growth, rather than separately at three in the morning.