Q&A: I'm 35 weeks pregnant with twins and I haven't had a good night's sleep in weeks. Is it safe for me to take a sleeping pill or can you recommend some herbal remedies that might help?

Usually I like to target the approach to exactly what is interfering with sleep. Is it that you can't fall asleep or you keep waking? Are you unable to get comfortable? Are you having whirling thoughts? Does your bladder wake you up repeatedly? So without knowing exactly what the problem is, here are some suggestions that have worked for others.

• For discomfort in bed: be sure you have lots of pillows, and use them to support your body in the most comfortable way. If you sleep on your side, one pillow under your tummy, another between your knees, and maybe one behind your back. A body pillow can help too. Accept that you will have to reposition during the night. Some moms-to-be find they can sleep better in a recliner.

• If your bladder is the size of a walnut, try drinking less fluids in the evening, and more during the day.

• If you can't fall asleep at first, try making a bedtime ritual like a warm bath, listening to calming music, or reading something comforting.

• The yoga inversion lying on your back with your legs straight up against a wall (Viparita Karani) is good for sleep, too. You can do it with your right hip wedged so the weight of your tummy is tipped to the left of the midline—so you are not flat on your back. Just a few peaceful minutes in this position can help to relax you for sleep.

• If your bladder capacity isn't too much of a problem, try some herbal tea or warm milk before bed. Avoid caffeine after noon-time and avoid alcohol altogether.

• If you wake and have trouble falling back to sleep, don't drive yourself crazy watching the clock. Remember that resting is almost as good as sleep. Sleep experts advise that if you can't fall back to sleep in 10 or 15 minutes, you should get up and do something quiet like reading or needlework. Stay away from computer screens since the light tells your mind it is daytime.

If you have tried all the non-medical approaches and feel that you need medications, doxylamine is an over-the-counter sleeper found in the brand-name medication Unisom®. Doxylamine has been shown to be safe in pregnancy. Benadryl® is also often used in pregnancy and is available in an over-the-counter sleep formulation. Prescription medications like Ambien® are probably safe in pregnancy but can have side effects like sleep walking. Be sure to talk to your doctor or midwife before taking sleeping medications during pregnancy.

Remember that this is time-limited. Pretty soon you will have two little reasons for missing sleep and you may find yourself wondering why you couldn't sleep when you had the time! Enjoy the adventure!