When we think of nausea, especially in the mornings, it is often associated with an early sign of pregnancy, although it can also be linked to a number of other health problems, from motion sickness or anxiety to an adverse effect to medication. Or, it could be morning sickness, just at night …

The term is incredibly deceiving because despite what many people think, morning sickness during pregnancy doesn’t just happen in the mornings. According to Today’s Parent, the symptoms (which can happen as early as 3 weeks into pregnancy, but usually disappear by weeks 12 to 16) can happen later in the day, or even in the night, because of blood sugar. “Some women get sick later in the day if they haven’t maintained a balanced blood sugar level,” midwife Nicola Strydom told the publication.

This can happen if a woman has eaten sugar or carbohydrates, which could cause a spike in blood pressure, and then a crash. But eating too late at night could also cause problems. An expectant mom shared her struggles with What To Expect, explaining that her “morning sickness” is worse at night and she found that eating something small for dinner, or earlier in the night, helped reduced the effects at bedtime.

Nausea occurs more frequently on an empty stomach, so it is important to eat small meals throughout the day to keep the glycemic index balanced and avoid that awful feeling right before bed. Healthline also offers some tips on treatment and prevention, noting that women should avoid triggers (like smells) that make them nauseous, consider adding ginger into their diet and eat dry, bland foods like crackers or toast, as soon as they wake up.

Acid reflux could also be contributing to night sickness, and FirstCry Parenting notes that it’s important to sleep in the right position. Pregnant women should use pillows to prop their heads up, and “sleep on your left side with your right knee bent,” the publication writes.

Final thoughts on the topic: Although no one ever tells you morning sickness isn’t reserved only for mornings, this is a very real and normal side effect of pregnancy. However, it’s hard to self diagnose, and if these symptoms persist, it is always recommended to see your primary care physician who can offer a more accurate evaluation.

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