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Sleep position and total sleep time for each night of both weeks were objectively monitored, with a sleep study and foetal heart rate monitoring performed on the last night of each week.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Primary outcome\u2009=\u2009percentage of sleep time in the supine position; secondary outcomes\u2009=\u2009apnoea\u2013hypopnoea index, foetal heart rate decelerations and birthweight centile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010one individuals were randomised with data collected on 35 participants over 469 nights. There was no difference in percentage of total sleep time in the supine position overnight between the control or intervention pillow week (13.0% [6.1, 25.5] vs. 16.0% [5.6, 27.2], <jats:italic>p<\/jats:italic>\u2009=\u20090.81 with a mean difference of 2.5% [95% CI]\u2009=\u2009\u22120.7, 5.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.12), and no difference in the severity of SDB or foetal heart rate decelerations across weeks. However, increased supine sleep was significantly related to a higher apnoea\u2013hypopnoea index (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u2009=\u20090.37, <jats:italic>p<\/jats:italic>\u2009=\u20090.003), lower birthweight (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u2009=\u2009\u22120.45, <jats:italic>p<\/jats:italic>\u2009=\u20090.007) and lower birthweight centile (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u2009=\u2009\u22120.45, <jats:italic>p<\/jats:italic>\u2009=\u20090.006). The proportion of supine sleep each night of the week varied widely both within and across participants, despite awareness of side\u2010sleeping recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found no evidence to suggest that the adoption of a pillow designed to discourage supine sleep was effective in late pregnancy, with women spending an average of 1\u2009h per night supine. Alternative devices should be investigated, incorporating lessons learnt from this study to inform trials of supine sleep minimisation in pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Clinical Trial: (Australia New Zealand Clinical Trials Registry): ACTRN12620000371998<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17952","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T08:59:34Z","timestamp":1726477174000},"page":"145-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Position Modification Device for the Prevention of Supine Sleep During Pregnancy: A Randomised Crossover Trial"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6754-7359","authenticated-orcid":false,"given":"Danielle L.","family":"Wilson","sequence":"first","affiliation":[{"name":"Institute for Breathing and Sleep, Austin 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Melbourne  Parkville Victoria Australia"},{"name":"Mercy Perinatal, Mercy Hospital for Women  Heidelberg Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark E.","family":"Howard","sequence":"additional","affiliation":[{"name":"Institute for Breathing and Sleep, Austin Health  Melbourne Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Stillbirth Foundation Australia \u201cResearch \u201d North Sydney NSW: Stillbirth Foundation Australia 2019 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