A 26-year-old white woman, gravida 2, para 1, at 10 weeks of gestation, was seen in a pulmonary clinic with a chief complaint of fatigue. Her partner noticed loud snoring during this pregnancy and apneic episodes in sleep. She was sleeping 8 h every night and waking about four to five times to go to the bathroom. She complained of nonrefreshing sleep and excessive daytime sleepiness. Her medical problems included depression, migraine headaches, hypertension, and a history of preeclampsia. Her medications included prenatal vitamins and sertraline. She was a former smoker and was employed as a medical assistant.