Simple Steps to Get You Back to Sleep Fast

Insomnia: relax ... and stop worrying about lack of sleep 

What is the solution to the torture of insomnia? Drugs? Therapy? Or are different sleep patterns natural? A new book investigates

Every night, about a third of adults have problems falling or staying asleep that aren't related to a persistent sleep disorder. As they lie in bed, many are caught in the classic paradox of insomnia: wanting sleep so badly that they can't get it. "The condition of sleep is profoundly contradictory," notes Emily Martin, a professor at New York University who has studied insomnia. "It is a precious good ... but it is a good like none other, because to obtain it one must seemingly give up the imperative to have it

For doctors, insomnia presents a chicken or egg problem. Is sleeplessness a result of another condition such as depression, or is the insomnia the root of the other problem? One report by the US National Institute of Mental Health found that depression rates were 40 times higher for patients with insomnia than those without sleep problems. Mental health experts increasingly view depression or anxiety as an effect, rather than a cause, of insomnia. Taking care of insomnia may therefore calm other aspects of a patient's life.And yet insomnia is a unique and difficult condition to treat because it is self-inflicted. The cause is often the brain's refusal to give up its unequalled ability to think about itself, a metaphenomenon that Harvard professor Daniel M Wegner has called "the ironic process of mental control". To illustrate this concept, imagine someone telling you that you will be judged on how quickly you can relax. Your initial reaction most likely is to tighten up. After he posed that challenge to research subjects, Wegner found that the average person becomes anxious as his or her mind constantly monitors its progress toward its goal, caught up in the second-by-second process of self-assessment.In the same way, sleep becomes more elusive as a person's sleep needs become more urgent. This problem compounds itself each night, leading to a state of chronic insomnia.Treating insomnia isn't easy. Part of the reason is that science, as a whole, has a fuzzy definition of what constitutes the disorder. One night of bad sleep because of a blaring car alarm or an upcoming stressful day at work doesn't classify as insomnia. Instead, it is generally thought of as a string of otherwise peaceful nights during which a patient can't fall asleep when he or she wants to. The US National Institutes of Health (NIH) identifies the condition as "difficulty getting or staying asleep, or having non-refreshing sleep for at least one month". The classic form has no known cause, yet is widespread. About one in 10 people in the US suffer from it during their lifetime.There is no medical test that proves whether someone is suffering from a temporary bout of sleepless nights or a more serious disorder. Some patients go to sleep labs and undergo tests to rule out conditions such as sleep apnea, but knowing what they don't have offers little help in treating what they do.Instead, doctors rely on self-reports from patients, which can be maddeningly vague, a result of the difficulty that we have with accurately noting how many hours we truly spent sleeping on any given night. Patients who have spent a night in a sleep lab, for instance, often complain that it took them more than an hour to fall asleep when a chart of their brain waves shows they were asleep within 10 minutes. Problems of self-reporting aren't limited to judging how long it took to get to sleep. Some patients wake up in labs claiming that they didn't sleep at all during the night, despite hours of video and brain wave evidence to the contrary.It is a part of the paradox that sleep presents to a conscious mind. We can't easily judge the time that we are asleep because that time feels like an absence, a break from the demands of thought and awareness. The times that we do remember are those that we wish we couldn't: staring at the clock in the middle of the night, turning the pillow over desperately hoping that the other side is cooler, kicking the covers off or pulling them up close. Those experiences, even if they last only three minutes, often become exaggerated in our minds and overshadow the hours that we spent sleeping peacefully, simply because we remember them.When insomnia starts to interfere with the routines of normal life, many people turn to pharmaceuticals.Medicines that help someone fall asleep, stay asleep, or be comfortable in between accounted for $ 30bn (£ 18.5bn) in 2010 in the US alone, which is more than what people around the world spend each year going to the movies.The sleeping pill market changed in 1993 when a French company now known as Sanofi introduced a drug called Ambien, also known by its generic name zolpidem. Ambien appeared safe enough for many doctors to break their long-standing refusal to prescribe a medication for run-of-the-mill insomnia. It quickly dominated the sleeping-pill market and rang up more than $ 1bn in sales a year. At one time, Ambien accounted for eight out of every 10 sleeping aids prescribed in the US, a near monopoly enjoyed by few other drugs in history.But here's the twist. A number of studies have shown that Ambien and other shorter-acting benzodiazepines, sometimes known as Z-drugs, such as Zimovane offer no significant improvement in the quality of sleep that a person gets. They give only a tiny bit more in the quantity department, too. In one study financed by the NIH, patients taking popular prescription sleeping pills fell asleep just 12 minutes faster than those given a sugar pill, and slept for a grand total of only 11 minutes longer throughout the night.If popular sleeping pills don't offer a major boost in sleep time or quality, then why do so many people take them? Part of the answer is the well-known placebo effect. Taking any pill, even one filled with sugar, can give some measure of comfort.But sleeping pills do something more than that. Drugs like Ambien have the curious effect of causing what is known as anterograde amnesia. The drug makes it temporarily harder for the brain to form new short-term memories. This explains why those who take a pill may toss and turn in the middle of the night but say the next day that they slept soundly. Their brains simply weren't recording all those fleeting minutes of wakefulness, allowing them to face each morning with a clean slate, unaware of anything that happened over the last six or seven hours. Some sleep doctors argue that this isn't such a bad thing. "If you forget how long you lay in bed tossing and turning, in some ways that's just as good as sleeping," one physician who worked with pharmaceutical companies told the New York Times, voicing what is a widely held opinion among the sleep doctors I spoke with.Serious problems can arise, however, when people taking a drug like Ambien don't actually stay in bed. Some have complained of waking up the next day and finding sweet wrappers in their beds, lit stoves in their kitchens, and bite marks on the pizzas in their freezers. Others have discovered broken wrists that came from falling while sleepwalking, or picked up their cell phones and seen a list of calls that they have no memory of making.Not long after a member of the Kennedy family blamed a car accident on the effects of Ambien, the US Food and Drug Administration issued new rules requiring pharmacists to explain the risk that taking certain sleeping pills could lead to things like sleep-eating, sleep- walking, or sleep-driving.Those warnings have done little to dent the popularity of sleeping pills, especially since the most popular one is cheaper than ever. Ambien went off-patent a few months before the FDA issued its new requirements. The number of patients filling a prescription for them remained steady. Many people who take sleeping pills find that their sleep quality reverts to its previous, poor state the night they decide to go without medication, a vicious cycle that increases their dependency on a drug approved only for short-term use. Facing a night of sleep without backup produces the same form of stress that originally caused the insomnia cycle to begin.Yet there is a way to treat insomnia without setting patients up for a letdown as soon as the prescription runs out. Charles Morin is a professor of psychology at Université Laval in Quebec. For more than 10 years, he has conducted studies into whether modifying behaviour can be as effective at treating insomnia as taking medication. His research focuses on cognitive behavioural therapy (CBT), a treatment that psychologists often use when working with patients suffering from depression, anxiety disorders or phobias. The therapy has two parts. Patients are taught to identify and challenge worrying thoughts when they come up. At the same time, they are asked to record all of their daily actions so that they can visualise the outcome of their choices.When used as a treatment for insomnia, this form of therapy often focuses on helping patients let go of the fear that getting inadequate sleep will make them useless the next day. It works to counter another irony of insomnia: Morin found that people who can't sleep often expect more out of it than people who can.Patients with insomnia tend to think that one night of poor sleep leads to health problems or has a severe impact on their mood the next day, a mental pressure-cooker that leaves them fretting that every second they are awake in the middle of the night is another grain of salt in the wound. In the inverted logic of the condition, sleep is extremely important to someone with insomnia. Therefore, the person with insomnia can't get sleep.In a study in 1999, Morin recruited 78 test subjects who were over the age of 55 and had dealt with chronic insomnia for at least 15 years. He separated his subjects into four groups. One group was given a sleeping pill called Restoril (temazepam), a benzodiazepine sedative often prescribed for short-term insomnia. Another group was treated with CBT techniques that focused on improving their expectations and habits when it came to sleep. The members of this group were prompted to keep a sleep diary and talk to a counsellor, as well as carry out other actions. The third group was given a placebo, and the fourth was treated with a combination of Restoril and the therapy techniques.The experiment lasted for eight weeks. Morin then interviewed all of the subjects about their new sleeping habits and the quality of their sleep each night. Patients who had taken the pill reported the most dramatic improvements in the first days of the study, sleeping through the night without spending any of the lonely hours awake they had come to expect. Subjects who were treated with CBT began to report similar results in sleep quality a few days later. Over the short term, sleeping pills had a slight edge in smoothing down the rough edges of insomnia.Then after two years, he contacted all his subjects and asked them about their sleeping habits again. It was a novel approach to investigating a disorder that often appears solved as soon as a patient sleeps normally for a few nights.Morin wanted to determine whether sleeping pills or therapy would do a better job of reshaping the underlying causes of persistent insomnia. Subjects who had taken the sleeping pills during the study told him that their insomnia returned as soon as the drugs ran out. But most of those who went through therapy maintained the improvements they had reported in the initial study. Lowering patients' expectations of sleep and helping them recognise what contributed to their insomnia combined to be more powerful over the long term than medication. "In the short run, medication is helpful," Morin told the New York Times. "But in the long run, people need to change their actual sleep habits - that's what CBT helps them do."Therapy is also helpful at breaking a person's reliance, either real or imagined, on sleeping pills. In a 2004 study, Morin found that nine of every 10 subjects who combined a gradual reduction in their medication with CBT were drug-free after seven weeks. Only half of those who tried to stop using the pills by reducing dosage alone were as successful. Further tests revealed that subjects who relied on therapy experienced better sleep quality as well, with longer amounts of time in deep sleep and REM sleep. A separate study the same year found that one out of two subjects who began a cognitive behavioural treatment plan no longer felt the need to take sleeping pills. The results from these and other CBT studies have been compelling enough for organisations ranging from the National Institutes of Health to the NHS to recommend therapy as a technique for treating insomnia.Yet some people with insomnia may never respond to therapy like this, simply because their sleeplessness isn't a reflection of the mind putting pressure on itself. Instead, it may be due to nothing more than age. As we get older, the structure of our sleep undergoes subtle changes. The amount of time that adults spend each night in REM sleep begins to decline at around the age of 40. At that age, the brain begins a process of readjusting its sleep pattern and devoting more time to the lighter stages of sleep. Soon the barking dog that someone was able to sleep through at the age of 25 is a nuisance that makes sleep impossible. These changes, a decade in the making, often become more apparent once someone turns 50. By the time a person reaches 65, he or she often settles into a pattern marked by falling asleep around nine o'clock at night and waking up at three or four in the morning.What many older adults call insomnia may in fact be an ancient survival mechanism. Carol Worthman, an anthropologist at Emory University in Atlanta, has argued that the modern comforts of silence, deep foam mattresses, and climate control have given us the expectation that sleep should always come easily. The wiring of our brains hasn't caught up with the comforts of our bedrooms, however. Early humans were at their most defenceless when they laid down on the ground for several hours in the middle of the night.Sleeping patterns that change as we age show that our brains expect us to be living and sleeping in a group, Worthman says. To illustrate this idea, she noted that the three basic stages of adulthood - teenage, middle age, old age - have drastically different sleep structures. Teenagers going through puberty find it impossible to fall asleep early and would naturally sleep past 10 in the morning if given the choice. Their grandparents often fall asleep early in the night, but then find that they can't stay that way for more than three or four hours at a time.Middle-aged adults typically fall between these two extremes, content to fall asleep early when circumstances allow it, yet able to pull an all-nighter when a work project calls for it. These overlapping shifts could be a way to ensure that someone in the family is always awake and keeping watch, or at least close to it. In this ancient system, it makes sense that older adults who are unable to move as fast as the rest of the family are naturally jumpy, never staying in deep sleep for long, simply because they were the most vulnerable to the unknown. Those survival instincts are of little help when life takes place in a bungalow in the suburbs

Can't Sleep?

Do you struggle to get to sleep no matter how tired you are? Or do you wake up in the middle of the night and lie awake for hours, anxiously watching the clock? Insomnia is a common problem that takes a toll on your energy, mood, health, and ability to function during the day. Chronic insomnia can even contribute to serious health problems. Simple changes to your lifestyle and daily habits can put a stop to sleepless nights.

Can't sleep? Understanding insomnia and its symptoms

 Insomnia is the inability to get the amount of sleep you need to wake up feeling rested and refreshed. Because different people need different amounts of sleep, insomnia is defined by the quality of your sleep and how you feel after sleeping-not the number of hours you sleep or how quickly you doze off. Even if you're spending eight hours a night in bed, if you feel drowsy and fatigued during the day, you may be experiencing insomnia.Although insomnia is the most common sleep complaint, it is not a single sleep disorder. It's more accurate to think of insomnia as a symptom of another problem, which differs from person to person. It could be something as simple as drinking too much caffeine during the day or a more complex issue like an underlying medical condition or feeling overloaded with responsibilities.The good news is that most cases of insomnia can be cured with changes you can make on your own-without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.

Causes of insomnia: Figuring out why you can't sleep

In order to properly treat and cure your insomnia, you need to become a sleep detective. Emotional issues such as stress, anxiety, and depression cause half of all insomnia cases. But your daytime habits, sleep routine, and physical health may also play a role. Try to identify all possible causes of your insomnia. Once you figure out the root cause, you can tailor treatment accordingly.

     Are you under a lot of stress?
     Are you depressed or feel emotionally flat or hopeless?
     Do you struggle with chronic feelings of anxiety or worry?
     Have you recently gone through a traumatic experience?
     Are you taking any medications that might be affecting your sleep?
     Do you have any health problems that may be interfering with sleep?
     Is your sleep environment quiet and comfortable?
     Are you spending enough time in sunlight during the day and in darkness at night?
     Do you try to go to bed and get up around the same time every day

 Sometimes, insomnia only lasts a few days and goes away on its own, especially when the insomnia is tied to an obvious temporary cause, such as stress over an upcoming presentation, a painful breakup, or jet lag. Other times, insomnia is stubbornly persistent. Chronic insomnia is usually tied to an underlying mental or physical issue.

     Psychological problems that can cause insomnia: depression, anxiety, chronic stress, bipolar disorder, post-traumatic stress disorder.
     Medications that can cause insomnia: antidepressants; cold and flu medications that contain alcohol; pain relievers that contain caffeine (Midol, Excedrin); diuretics, corticosteroids, thyroid hormone, high blood pressure medications.
     Medical problems that can cause insomnia: asthma, allergies, Parkinson's disease, hyperthyroidism, acid reflux, kidney disease, cancer, chronic pain.
     Sleep disorders that can cause insomnia: sleep apnea, narcolepsy, restless legs syndrome.

Insomnia cures and treatments: Changing habits that disrupt sleep

Some of the things you're doing to cope with insomnia may actually be making the problem worse. For example, if you're using sleeping pills or alcohol to fall asleep, this will disrupt your sleep even more over the long-term. Or if you drink excessive amounts of coffee during the day, it will be more difficult to fall asleep later. Often, changing the habits that are reinforcing sleeplessness is enough to overcome insomnia altogether. It may take a few days for your body to get used to the change, but once you do, you will sleep better

 

Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your daily Starbucks habit affects your sleep more than you realize. Or maybe you've never made the connection between your late-night TV viewing or Internet surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.

All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur during the day

Adopting new habits to help you sleep

Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using a sound machine or earplugs to hide outside noise, an open window or fan to keep the room cool, and blackout curtains or a sleep mask to block out light.Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends, even if you're tired. This will help you get back in a regular sleep rhythm.Avoid naps. Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 pmAvoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer, or video game use. Instead, focus on quiet, soothing activities, such as reading, knitting, or listening to soft music, while keeping lights low.Don't read from a backlit device (such as an iPad). If you use an eReader, opt for one that is not backlit, ie one that requires an additional light source.Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least eight hours before bed. Avoid drinking alcohol in the evening; while alcohol can make you feel sleepy, it interferes with the quality of your sleep. Quit smoking or avoid it at night, as nicotine is a stimulant

Preparing your brain for sleep

Your brain produces the hormone melatonin to help regulate your sleep-wake cycle. As melatonin is controlled by light exposure, not enough natural light during the day can make your brain feel sleepy, while too much artificial light at night can suppress production of melatonin and make it harder to sleep. To help naturally regulate your sleep-wake cycle and prepare your brain for sleep:

     Increase light exposure during the day. Take breaks outside in sunlight, remove sunglasses when it's safe to do so, and open blinds and curtains during the day.
     Limit artificial light at night. To boost melatonin production, use low-wattage bulbs, cover windows and electrical displays in your bedroom, avoid bright light and turn off television, smartphone, and computer screens at least one hour before bed. If you can't make your bedroom dark enough, try using a sleep mask

Insomnia cures and treatments: Neutralizing anxiety when you can't sleep   

Insomnia cures and treatments: Neutralizing anxiety when you can't sleep

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that you're going to toss and turn for hours or be up at 2 am again. Or maybe you're worried because you have a big day tomorrow, and if you don't get a solid eight hours, you're sure you'll blow your presentation. But agonizing and expecting sleep difficulties only makes insomnia worse; worrying floods your body with adrenaline, and before you know it, you're wide-awake

Learning to associate your bed with sleeping, not sleeplessness

If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep, sex, and nothing else-especially not frustration and anxiety.

    Use the bedroom only for sleeping and sex. Don't work, watch TV, or use your computer or smartphone. The goal is to associate the bedroom with sleep and sex, so that when you get in bed your brain and body get a strong signal that it's time to nod off or be romantic.
    Get out of bed when you can't sleep. Don't try to force yourself to sleep. Tossing and turning only amps up the anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, drinking a warm cup of caffeine-free tea, taking a bath, or listening to soothing music. When you're sleepy, go back to bed.
    Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can't sleep-knowing that you're going to be exhausted when the alarm goes off-is a surefire recipe for insomnia. You can use an alarm, but make sure you can't see the time when you're in bed.

Insomnia cures and treatments: Harnessing your body's relaxation response 

Relaxation techniques such as deep breathing, meditation, yoga, and tai chi can help quiet your mind and relieve tension. They can also help you fall asleep faster and get back to sleep more quickly if you awaken in the middle of the night. And all without the side effects of sleep medication

Relaxation techniques that can help you sleep

It takes regular practice to master relaxation techniques but the benefits can be huge. You can do them as part of your bedtime routine, when you are lying down preparing for sleep, and if you wake up in the middle of the night.

     Abdominal breathing. Most of us don't breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, it can help relaxation. Close your eyes and take deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth.
     Progressive muscle relaxation. Lie down or make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, and then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your head

Insomnia cures and treatments: Using supplements and medication wisely

 Insomnia cures and treatments: Using supplements and medication wisely

When you're tossing and turning at night, it can be tempting to turn to sleep aids for relief. However, no sleeping pill will cure the underlying cause of your insomnia, and some can even make the problem worse in the long run. Before taking any sleep aid or medication, talk to your doctor or pharmacist

Dietary supplements for insomnia

There are many dietary and herbal supplements marketed for their sleep-promoting effects. Some remedies, such as lemon balm or chamomile tea, are generally harmless, while others can have side effects and interfere with other medications.

They don't work for everyone, but two of the most popular supplements are:

     Melatonin - a naturally occurring hormone that your body produces at night. Evidence suggests that melatonin supplements may be effective for short-term use, especially in preventing or reducing jet-lag. However, there are potential side-effects, including next-day drowsiness.

     Valerian - an herb with mild sedative effects that may help you sleep better. However, the quality of valerian supplements varies widely

 Over the counter (OTC) sleep aids

The main ingredient in over-the-counter (OTC) sleeping pills is an antihistamine, generally taken for allergies, hay fever and common cold symptoms. OTC sleep aids are meant to be used for short-term insomnia only. Sleep experts generally advise against their use because of side effects, questions about their effectiveness, and lack of information about their safety over the long term

Prescription sleeping pills for insomnia

While prescription sleep medications can provide temporary relief, it's best to use medication only as a last resort, and then, only on a very limited, as-needed basis. First, try changing your sleep habits, your daily routine, and your attitudes about sleep. Evidence shows that lifestyle and behavioral changes make the largest and most lasting difference when it comes to insomnia

When to consider seeking professional insomnia treatment

If you've tried the insomnia cures and treatments listed above and are still having trouble getting the sleep you need, a doctor or sleep disorder specialist may be able to help. Seek professional help for insomnia if:

     Your insomnia doesn't respond to self-help strategies
     Your insomnia is causing major problems at home, work, or school
     You're experiencing scary symptoms like chest pain or shortness of breath
     Your insomnia occurs almost every night and is getting worse

Bring a sleep diary with you. Your doctor may be able to diagnose an illness or sleep disorder that's causing your insomnia, or refer you to a sleep specialist or cognitive behavioral therapist

Cognitive behavioral therapy (CBT) for insomnia

CBT is aimed at breaking the cycle of insomnia. Poor sleep tends to lead to stress and anxious thoughts about not being able to sleep. This in turn leads to stress and tension, which leads to poor sleeping habits, such as the use of sleeping pills or alcohol to sleep or taking daytime naps to make up for lost sleep. This leads to worsening insomnia and so on

The Vicious Cycle of Insomnia

As well as improving sleep habits, CBT is aimed at changing thoughts and feelings about sleep that may be causing stress and contributing to your insomnia.

While CBT can be a much safer and more effective insomnia treatment than sleeping pills, it's not an instant remedy but one that requires time and persistence. Your sleep may even get worse at first if your therapist recommends sleep restriction therapy, whereby you initially shorten your sleep time. The idea is that by limiting the time you spend in bed to the number of hours you actually sleep, say from 1 am to 6 am, you'll spend less time awake and more time asleep. As your sleep efficiency increases you'll gradually start going to bed earlier and getting up later until you reach your optimum sleep schedule

Online CBT for insomnia

 

For those who can't access or are unable to afford traditional cognitive behavioral therapy for insomnia, some online programs may offer a cheaper but viable alternative. Initial studies suggest that some online CBT programs can significantly improve sleep length and quality.

However, no online program can take the place of professional medical evaluation and treatment. It's important to first speak to your doctor for a diagnosis and to rule out any underlying medical condition or other sleep disorder that may be causing your insomnia. See Resources & References below to find an online CBT program for insomnia

 

Simple Steps to Get You Back to Sleep Fast 4 

We've all been there. You are wide awake at 3 am, your mind racing with a rising sense of panic about the difficult day ahead if you don't fall back to sleep.

What you're experiencing is a type of insomnia, says sleep disorders specialist Harneet Walia, MD, DABSM, of Cleveland Clinic's Sleep Disorders Center.

Many underlying health problems such as chronic pain, sleep apnea or acid reflex can cause insomnia. But if your difficulty in sleeping is not due to health problems, here are some tips that can help you get back to sleep.

    Stop watching the clock. Marking off the minutes only heightens your distress about being awake.

    Try relaxing your body to fall asleep. Working from your toes to your forehead, tightly tense each muscle group for five seconds, then relax.

    If you can't fall back to sleep within 20 minutes, get out of bed. Use your "mind clock," Dr. Walia says, to estimate how long you've been awake. After 20 minutes of wakefulness, get up and leave your bedroom. "Don't spend time in bed trying to fall asleep," she says. "You probably will start worrying about falling asleep and then learn to associate the bedroom with not sleeping well."

    Find an uninteresting activity. Read something uninteresting. Listen to relaxing music. When you start to feel drowsy, go back to bed.

You also can adopt daytime habits that will help you sleep better at night, Dr. Walia says.

    Create a consistent sleeping and waking schedule - even on the weekends and days off work. "What works best is going to bed at the same time and waking up at same time every day," Dr. Walia says.

    Avoid consuming drinks or food with caffeine before bedtime. Abstain from caffeine for at least five to six hours before you plan to retire, Dr. Walia says. "Caffeine can play a major role in getting a good night's sleep," she says.

    Make your sleeping environment comfortable. The room should have a temperature that is not too warm or too cold. Find a mattress and pillow with a firmness level that you find restful.

    One hour before bedtime, stop doing work or other mentally challenging tasks. Switch to something calming such as reading a book.

    Use your bed only for sleep or intimacy. Do not watch television or play with electronic devices while lying in bed. "Otherwise, we come to associate the bedroom with not sleeping," Dr. Walia says.

Chronic insomnia affects up to 20 percent of adults. Many adults don't seek treatment for it.

It's time to seek medical advice if you experience symptoms that last longer than a month or so. Ditto if lack of sleep interferes with your daytime activities, Dr. Walia says

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