"Sleep on side": Awareness and anxiety around sleeping position during late pregnancy

The "Sleep on Side" policy was recently introduced in Australian antenatal clinics to reduce the risk of late stillbirth associated with going-to-sleep on the back.

To assess knowledge of side sleeping recommendations in pregnancy and explore feelings of anxiety in relation to this policy, and how these feelings may impact sleep.

Cross-sectional study of sleep position measured for seven nights between 32 and 36 weeks of pregnancy. Participants completed a sleep diary each morning, and at the end of the week completed a survey regarding knowledge and anxiety around sleeping position.

Sleep position data was collected in 80 participants, with 43 participants completing anxiety surveys. Almost all participants (95 %) reported receiving side sleeping advice during pregnancy, the most common source being their antenatal care provider. Twenty-three percent of women reported "moderate" or "very much" anxiety around their sleeping position or waking on their back overnight. Anxiety towards sleeping position was associated with self-reported supine sleep (p < .001), and use of additional pillows to support behind the back (p < .001). Overall self-reported sleep quality was not affected by anxiety, apart from alertness upon awakening (p = .001).

In this cohort, the Sleep on Side policy has been disseminated widely with women understanding the rationale for encouraging a safe sleeping position. While many women receive this advice with minimal worry, almost a quarter of women may experience anxiety that may potentially affect their sleeping behaviour.

Advice on sleeping position should be carefully balanced with potential harms to maternal sleep and mental health.