We are all given the ability from birth to perform certain bodily functions. Sleep is an innate ability that usually doesn’t take much effort at all. I mean, how simple can it be to sleep? You just close your eyes, relax and get taken away to dreamland. But for many, many people, sleeping isn’t as easy as that.

According to the U.S. Department of Health and Human Services, approximately 60 million people suffer from insomnia. The inability to sleep affects approximately 40 percent of women and 30 percent of men. Are you among them?

So many people have this disorder that there are sleep clinics all over the country meant to help those who are afflicted.

Sleep is meant to revive us and get us ready to live for another day. When people are denied sleep, the effects can be devastating.

There is hope, however, in overcoming insomnia. It’s not easy, but it can be done – even without the help of a professional sleep clinic.

Inside this article, we’ll explore insomnia in depth: its causes and how to finally get a good night’s sleep!

What is Insomnia?

Insomnia is the sensation of daytime fatigue and impaired performance caused by insufficient sleep. In general, people with insomnia experience an inability to sleep despite being tired, a light, fitful sleep that leaves them fatigued upon awakening, or waking up too early.

Common symptoms of insomnia include:

• feeling tired during the day
• having frequent headaches
• irritability
• lack of concentration
• you wake up feeling tired and not refreshed
• sleeping better away from home
• taking longer than 30 or 40 minutes to fall asleep
• waking repeatedly during the night
• waking far too early and being unable to fall back asleep
• being able to sleep only with the aid of sleeping pills or alcohol

Insomniacs often complain of being unable to close their eyes or rest their minds for any period of time. This author certainly knows what it’s like to have your mind racing at bedtime. In our stress-filled world, we are often plagued with unfinished to-do lists in our heads. When it’s quiet and time for sleep, many people have problems pushing those to-do lists aside in favor of dreamland.

Insomnia, usually temporary, is often categorized by how long it lasts:

Transient insomnia lasts for a few days.

Short-term insomnia lasts for no more than three weeks.

Chronic insomnia occurs when the following characteristics are present:

• When a person has difficulty falling asleep, maintaining sleep, or has non-restorative sleep for at least three nights a week for one month or longer.
• In addition, the patient is distressed and believes that normal daily functioning is impaired because of sleep loss.

Chronic insomnia may also be primary or secondary, depending on the cause:

• Primary chronic insomnia occurs when it is the sole complaint of a patient.
• Secondary chronic insomnia is caused by medical or psychiatric conditions, drugs, or emotional or psychiatric disorders.

Some common types of secondary insomnia include:

• Sleep apnea is a sleep disorder caused by difficulty breathing during sleep. For more information, visit www.sleepapnea.org.
• Restless Legs Syndrome is a sleep disorder characterized by unpleasant sensations (creeping, burning, itching, pulling or tugging) in the legs or feet, occurring mostly in the evening and at night. For more information, visit www.rls.org.
• Sleep-wake schedule or circadian rhythm disorders are sleep disorders caused by having sleep-wake schedules that do not match up with your natural sleep schedule.
• Insomnia due to medical conditions: Many common medical problems and the drugs that treat them can cause insomnia, including allergies, arthritis, heart disease, hypertension, asthma, Parkinson's disease, attention deficit hyperactivity disorder, or hyperthyroidism.
• Insomnia due to substance use or withdrawal: Many drugs and medications can cause sleep disturbances, either while taking them or while withdrawing from them (alcohol, stimulants, sedatives,…)
• Insomnia due to an emotional problem: Insomnia can be a symptom of a number of emotional difficulties.

Insomnia may also be defined in terms of inability to sleep at conventional times. The following are examples and are referred to as circadian rhythm disorders.

• Delayed Sleep-Phase Syndrome. Delayed sleep-phase syndrome is the term for a circadian clock that runs late but reliably.
• Advanced Sleep Syndrome. This syndrome tends to develop in older people; it produces excessive sleepiness in the morning and undesired awakening early in the morning.

It might be helpful for you if we look at the basic sleep patterns and how doctors are able to identify specific problems based on what they already know about sleep.

The Sleep Cycle

The daily cycle of life, which includes sleeping and waking, is called a circadian (meaning "about a day") rhythm, commonly referred to as the biologic clock. Hundreds of bodily functions follow biologic clocks, but sleeping and waking are the most prominent circadian rhythms.

Light signals coming through the eyes reset the circadian cycles each day. The response to light signals in the brain is an important key factor in sleep and in maintaining a normal circadian rhythm.

The approach of dusk each day prompts the SCN to signal the nearby pineal gland (named so because it resembles a pine-cone) to produce the hormone melatonin.

Melatonin is an important hormone released in the brain that some experts believe is critical for the body's time-setting. The longer a person is in darkness the longer melatonin is secreted. Levels drop after staying in bright light. Research is ongoing to determine if high levels of melatonin cause sleep regardless of whether it is dark.

In sleep studies, subjects spend about one-third of their time asleep, suggesting that most people need about eight hours of sleep each day. Infants may sleep as many as 16 hours a day. Individual adults differ in the amount of sleep they need to feel well rested, however.

Sleep consists of two distinct states that alternate in cycles and reflects differing levels of brain nerve cell activity.

• Rapid Eye Movement (REM) Sleep
• Non-Rapid Eye Movement (NREM) Sleep

During a normal night's sleep, one progresses through these stages about five or six times:

The cycle between quiet (NREM) and active (REM) sleep generally follows the same pattern.  After about 90 minutes of Non-REM sleep, eyes move rapidly behind closed lids, giving rise to REM sleep.  As sleep progresses the Non-REM/REM cycle repeats.  With each cycle, Non-REM sleep becomes progressively lighter, and REM sleep becomes progressively longer, lasting from a few minutes early in sleep to perhaps an hour at the end of the sleep episode.

What Causes Insomnia

While there is no one cut and dried reason why some people can’t sleep, most experts agree that insomnia is brought on by stress, anxiety, medications, and/or caffeine – among other things. Transient and short-term insomnia has many causes.

A reaction to change or stress is one of the most common causes of short-term and transient insomnia. This condition is sometimes referred to as adjustment sleep disorder.

The precipitating factor could be a major or traumatic event such as the following:

• An acute illness.
• Injury or surgery.
• The loss of a loved one.
• Job loss.

Temporary insomnia could also develop after a relatively minor event, including the following:

• Extremes in weather.
• An exam at school.
• Traveling.
• Trouble at work.

In such cases, normal sleep almost always returns when the condition resolves, the individual recovers from the event, or the person becomes acclimated to the new situation. Treatment is needed if sleepiness interferes with functioning or if it continues for more than a few weeks.

Fluctuations in female hormones play a major role in insomnia in women over their lifetimes. Such insomnia is most often temporary.

Insomnia may also be perpetuated by psychological distress provoked by this life passage. In most cases, insomnia is temporary. Cases of chronic insomnia in women after 50 are more likely to be due to other causes.

Chronic insomnia can also have deep seated roots. In many cases, it is unclear if chronic insomnia is a symptom of some physical or psychological condition or if it is a primary disorder of its own. In most instances, a collaboration of psychological and physical conditions causes the failure to sleep.

Psychophysiological insomnia is the revolving door of sleeplessness:

• An episode of transient insomnia disrupts the person's circadian rhythm.
• The patient begins to associate the bed not with rest and relaxation but with a struggle to sleep. A pattern of sleep failure emerges.
• Overtime, this event repeats, and bedtime becomes a source of anxiety. Once in bed, the patient broods over the inability to sleep and the loss of mental control. All attempts to sleep fail.
• After such a cycle is established, insomnia becomes a self-fulfilling prophecy that can persist indefinitely.

It should be noted, however, that insomnia may cause emotional problems, and it is often unclear which condition has triggered the other, or if the two conditions, in fact, have a common source.

Anxiety accounts for almost 50 percent of the cases of chronic insomnia. Feeling uptight and anxious can keep you from relaxing enough to go to sleep.

A national survey by the US Department of Health and Human Services found that 47 percent of those reporting severe insomnia also reported feeling a high level of emotional distress. It could be that you become so tense and restless during a hard day at work that you don't even expect to sleep well at night.

There may also be a genetic link to insomnia. Sleep problems seem to run in families; approximately 35% of people with insomnia have a positive family history, with the mother being the most commonly affected family member. Still, because so many factors are involved in insomnia, a genetic component is difficult to define.

So we’ve seen that there can be many reasons why some people simply cannot sleep. Does this disorder affect certain people more than others?

Studies estimate that between a quarter and one-third of American and European adults experience some insomnia each year, with between 10% and 20% of them suffering severe sleeplessness.

In spite of this widespread problem, however, studies suggest that only about 30% of American adults who visit their doctor ever discuss sleep problems. Conversely, physicians seem rarely to ask patients about their sleep habits or problems.

Overall, insomnia is more common in women than men, although men are not immune from insomnia. Sleep efficiency deteriorates equally in men and women as they get older.

One major study suggested that as men go from age 16 to 50, they lose about 80% of their deep sleep. During that period, light sleep increases and REM sleep remains unchanged. (The study did not use women as subjects, and there is some evidence to suggest they are not as affected). After age 44 REM and total sleep diminish and awakenings increase.

How Serious is Insomnia

A 2002 study of sleeping habits in over one million people reported that people who slept seven hours a night enjoyed the longest lifespan. Those who slept 8 hours or more or 6 hours or less had higher mortality rates. People with insomnia did not have elevated mortality rates, which supported earlier evidence. People who took sleeping pills, however, did have lower survival rates.

As many as 200,000 automobile accidents in the US and 1,500 deaths from such accidents are caused by sleepiness. Studies continue to report that drowsy driving is as risky as drunk driving. Estimates on fatigue as a cause of automobile crashes range from 1% to 56%, depending on the study.

Insomnia can have an effect on your waking behaviors such as job performance and thinking. In fact, sleep disorders will probably worsen some behaviors in the following way:

• Reduced concentration. Some experts report that deep sleep deprivation impairs the brain's ability to process information.
• Impaired task performance. One study reported that missing only two to three hours of sleep every night for a week significantly impaired performance and mood.
• Effect on learning. Whether insomnia significantly impairs learning is unclear. Some studies have reported problems in memorization, although others have found no differences in test scores between people with temporary sleep loss and those with full sleep.

The inability to sleep can be a major cause of depression. Signs to look out for that link insomnia with depression include:

• waking in the middle of the night or early morning and being unable to get back to sleep
• loss of interest, energy, and appetite
• aggression and anti-social behavior
• aches and pains that have no physical explanation

There’s no doubt that insomnia can take its toll on the human body. Lack of sleep does more than make us tired. If the disorder exists for a period of time, it can have serious health consequences. We can give you all sorts of signs to look out for to see if you have insomnia, but many times, going to a professional can help you find out if you have insomnia.

Diagnosing Insomnia

Diagnosing sleep disturbance and its cause is the most important step in restoring healthy sleep. There is little agreement, even among experts, however, on the best methods for effectively assessing a patient's insomnia.

A number of questionnaires are available for determining whether a patient has insomnia or other sleep disorders. For example, the physician may ask the following questions:

• How would the sleep problem be described?
• How long has the sleep problem been experienced?
• How long does it take to fall asleep?
• How many times a week does it occur?
• How restful is sleep?
• Does the difficulty lie in getting to sleep or in waking up early?
• What is the sleep environment like (Noisy? Not dark enough?)?
• How does insomnia affect daytime functioning?
• What medications are being taken (including the use of self-medications for insomnia, such as herbs, alcohol, and over-the-counter or prescription drugs)?
• Is the patient taking or withdrawing from stimulants, such as coffee or tobacco?
• How much alcohol is consumed per day?
• What stresses or emotional factors may be present?
• Has the patient experienced any significant life changes?
• Does the patient snore or gasp during sleep (an indication of sleep apnea)?
• Does the patient have leg problems (cramps, twitching, crawling feelings)?
• If there is a bed partner, is his or her behavior distressing or disturbing?
• Is the patient a shift worker?

 

It may be suggested that you keep a sleep diary to keep track of your sleeping habits. Every day for two weeks, the patient should record all sleep-related information, including responses to questions listed above described on a daily basis. A bed partner can help by adding his or her observations of the patient's sleep behavior.

Here’s what you should include in your sleep diary:

• Time you went to bed and woke up
• Total sleep hours
• Quality of sleep
• Times that you were awake during the night and what you did (e.g. stayed in bed with eyes closed or got up, had a glass of milk and meditated)
• Amount of caffeine or alcohol you consumed and times of consumption
• Types of food and drink and times of consumption
• Feelings - happiness, sadness, stress, anxiety
• Drugs or medications taken, amounts taken and times of consumption.

In cases where a physician is unable to help with your insomnia, you may be referred to a sleep disorder clinic for diagnosis and treatment.

Sleep Disorder Clinics

While the thought of going to a clinic and having people watch you sleep is just a little much for you, fear not.

Actually, sleep disorder centers are there for that specific reason and you will most likely get some answers to your sleeping problems.

Among the signs that may indicate a need for a sleep disorders center are the following:

• Insomnia due to psychological disorders.
• Sleeping problems due to substance abuse.
• Snoring and sudden awakening with gasping for breath (possible sleep apnea).
• Severe restless legs syndrome.
• Persistent daytime sleepiness.
• Sudden episodes of falling asleep during the day (possible narcolepsy).

What can you expect when you go to a clinic like this? You will be participating in a sleep study or polysomnogram which is a test that will record your physical state during various stages of sleep and wakefulness.

It provides data that are essential in evaluating sleep and sleep-related complaints, such as identifying sleep stages, body position, blood oxygen levels, respiratory events, muscle tone, heart rate, amount of snoring and general sleep behavior.

Based on the results of your sleep study, you may be given treatment for a specific sleep disorder. For example, patients with sleep apnea may be prescribed Continuous Positive Airway Pressure or CPAP, which is a device that gently blows air into your nasal passages to keep the airway open while you are asleep.

Once you have the diagnosis of insomnia, you might be wondering what you can do to overcome it. With the help of your doctor or sleep specialist, you can work together to overcome your sleeplessness. You should also be aware of what natural cures there are to treat insomnia.

Natural Cures for Insomnia

Many people with insomnia choose herbal remedies for treating their insomnia. Some such as chamomile tea or lemon balm are harmless for most people. It should be strongly noted that a being labeled "natural" is neither equal to being safe or necessarily to even being natural. Herbal remedies are not regulated. Some even contain conventional medicines.

You may want to give melatonin a try. Melatonin is the best studied natural remedy for insomnia, although in the US it remains unregulated. Evidence on its effects remains unclear.

Some studies have found that although many people fall asleep faster with melatonin, it has no effect on total sleep time or daytime feeling of sleepiness or fatigue. Some studies suggest that it may help specific individuals, such as the following:

• Elderly people. It may help certain older people with insomnia, such as those with evidence of low melatonin levels and those dependent on prescription sleeping medications. It is not clear, however, how significant the benefits are.
• People without sight. A 2000 study reported that melatonin can help people without sight retrain their circadian cycle so that they can sleep at regular hours. The best dosages and timing, however, need to be clarified. High doses (10 mg) may be needed to start with, but can probably be reduced over time.
• Travelers and Jet Lag. Some studies have reported that melatonin may help prevent jet lag in some travelers. The optimal dosages or timing for preventing jet lag are still unclear, however.
• During withdrawal from prescription sleep medication. Melatonin may help people who are dependent on sleeping medications withdraw from these agents and maintain good quality sleep.
• People with delayed sleep syndrome. It might be somewhat helpful for people with who fall asleep very late at night or in early morning hours but then they sleep normally.

Be aware though as high doses of melatonin have been associated with the following adverse events:

• Mental impairment.
• Drowsiness.
• Severe headaches.
• Nightmares.
• It may increase the risk for seizures in children with existing neurological disorders.
• Interactions with other drugs are not completely known.

Keep in mind that alternative or natural remedies are not regulated and their quality is not publicly controlled. In addition, any substance that can affect the body's chemistry can, like any drug, produce side effects that may be harmful.

You don’t have to use drugs – whether natural or chemical to help you beat insomnia. There are some great behavior therapies that can be implemented to help you get to sleep.

Sleep Hygiene

Sleep hygiene refers to sleep habits and conditions which promote sleep as opposed to habits such as drinking alcohol or caffeine in the evening, which make it hard for you to unwind and get to sleep.

Sleep hygiene should be your first line of attack against insomnia, and it is often used in conjunction with stimulus control and cognitive behavior restructuring (see below). Review your habits and make some changes in your routine to see if behavioral and environmental changes improve your sleep.

Here are some tips for effective sleep hygiene habits:

• Establish a regular time for going to bed and getting up in the morning and stick to it even on weekends and during vacations.
• Use the bed for sleep and sexual relations only, not for reading, watching television, or working; excessive time in bed seems to fragment sleep.
• Avoid naps, especially in the evening.
• Exercise before dinner. A low point in energy occurs a few hours after exercise; sleep will then come more easily. Exercising close to bedtime, however, may increase alertness.
• Take a hot bath about an hour and a half to two hours before bedtime. This alters the body's core temperature rhythm and helps people fall asleep more easily and more continuously. (Taking a bath shortly before bed increases alertness).
• Do something relaxing in the half-hour before bedtime. Reading, meditation, and a leisurely walk are all appropriate activities.
• Keep the bedroom relatively cool and well ventilated.
• Do not look at the clock. Obsessing over time will just make it more difficult to sleep.
• Eat light meals and schedule dinner four to five hours before bedtime. A light snack before bedtime can help sleep, but a large meal may have the opposite effect.
• Spend a half hour in the sun each day. The best time is early in the day. (Take precautions against overexposure to sunlight by wearing protective clothing and sunscreen).
• Avoid fluids just before bedtime so that sleep is not disturbed by the need to urinate.
• Avoid caffeine or other stimulants in the hours before sleep. A general recommendation is not to consume anything that might hinder your sleep 4-6 hours before your anticipated bedtime.
• Don’t drink alcohol before going to bed.
• If one is still awake after 15 or 20 minutes go into another room, read or do a quiet activity using dim lighting until feeling very sleepy. (Don't watch television or use bright lights).
• Give yourself a quiet time right before bed. One or two hours before you retire, take a few moments to spend quietly relaxing and meditating.
• Your bedroom should be exclusively for sleeping. Well, maybe one other activity, but avoid eating, reading, smoking, drinking or watching television in bed. The bedroom should be a peaceful place and when it is,
• If distracted by a sleeping bed partner, moving to the couch or a spare bed for a couple of nights might be helpful.
• If you can't sleep -- don't stay in bed. Get out of bed, move to another room, and return to your bed when you are tired.

Sleep hygiene is just one of the behavioral techniques you can use to help with your insomnia.

Stress Management and Relaxation

Learning to be physically and mentally relaxed before going to bed will help you fall asleep more quickly. Additionally, many relaxation techniques can be put to use when you wake up in the middle of the night and need to get back to sleep.

Quieting your mind and body is not something that can be done immediately, so you should try to start winding down at least an hour before bed. Some people find that reading a book, taking a bath, playing solitaire or working a crossword puzzle are good ways to slow down from activity of the day.

You may want to try one or more of the following activities:

• Progressive Muscle Relaxation (PMR) – PMR is a set of exercises you can use to reduce anxiety and stress at bedtime. PMR is a two-step process where you first tense certain muscle groups and then relax them. As you go through the process, you should be focused on actively tensing and then relaxing, helping to relax your mind as well as your body.
• Diaphragmatic breathing – Learning to breathe slowly and deeply from your belly or diaphragm is a good way to slow down. To practice belly breathing, put a hand on your stomach and take slow breaths, letting your stomach expand as you breathe in. As you breathe out, relax your chest and shoulders. Concentrate on your breathing as you do it to encourage your mind away from stressful or anxious thoughts.
• Visual imagery relaxation – Practicing visual imagery means choosing peaceful, soothing thoughts to focus on which calm you and allow you to stop thinking of your to do list.
• Stress management – If you learn to deal with stress more effectively through meditation or self-guided imagery, you should be able to fall asleep more easily. Try the following suggestions to help reduce your stress:
• Change or resolve the things causing you stress when possible.
• Accept situations you can't change.
• Keep your mind and body as relaxed as much as possible throughout the day.
• Give yourself enough time to do the things you need to do -including eating.
• Don't take on too much and avoid unrealistic demands.
• Live in the present, rather than worrying about the past or fearing the future.
• Talk to your partner if there are problems in your relationship.
• Have some relaxing, non-competitive activities - something you do just for pleasure, for fun.
• Give yourself some 'quiet time' each day.
• Practice a relaxation technique or breathing exercises regularly.
• Anger management –A few things that might help you deal with your anger or anxiety:
• Exercise daily – it will help you release excess anger and frustration.
• Think about the cause of your anger. If there isn’t anything you can do to resolve it, move on. If you can resolve it, make steps to do so.
• Develop a method of releasing the anger by the end of the day, before you try to relax or go to sleep. For example, you might choose to write it down in your journal or talk to a spouse or friend about it. After you have processed the anger and let it out, try to move on
• Word and imagination games – For some, playing mental games at bedtime may not be helpful at all. But others find that engaging their mind in something unimportant can be a good way to unwind and shift attention away from actively trying to fall asleep. Try playing some mental games:
• Spell long words and sentences backwards.
• Think of a poem or song and then count how many a’s or b’s there are in it.
• Work your way through the alphabet thinking of a four-letter word beginning with each letter
• Repeat long pieces of poetry or prose.
• Recall in great detail a favorite painting, a piece of music or place.

Self-help strategies are usually effective and aren’t addictive. Using these alternatives to over-the-counter or prescription medication are less expensive than pharmacological treatment, have fewer side effects, and can provide longer lasting relief particularly when behavioral treatments are used as well.

Light for Healing

The circadian rhythm is more a function of darkness and light rather than actual time of day. Bright light can discourage drowsiness, and darkness can cause sleepiness, day or night. Light therapy is a treatment used for people who suffer from circadian rhythm sleep disorders. Your body has an internal clock that tells it when it is time to be asleep and when it is time to be awake.

The goal for treating patients who have circadian rhythm problems is to combine a healthy sleep pattern with an internal clock that is set at the right time. This will allow them to enjoy the benefits of good sleep.

Light therapy can help someone “re-set” a clock that is off. Regular sleep patterns help to keep the clock set at the new time. Light therapy is only part of a treatment plan that should be guided by a doctor who is familiar with sleep disorders.

The procedure is noninvasive and simple. The patient sits a few feet away from a box-like device that emits very bright fluorescent light (over 4,000 lux) for about 30 minutes every day. The following people might benefit from light therapy in specific ways.

• Shift workers. Light therapy should be maximized during hours they are at work and minimized when they need to sleep.
• Frequent travelers. Light therapy may be useful for adjusting to new time zones and reducing jet lag.
• Nursing home patients.
• People with delayed sleep-phase syndrome. (These people have a natural tendency to fall asleep very late at night or in early morning hours, but then sleep normally)

Bright light therapy has not been known to show any major side effects. Some patients have reported minor side effects including: eye irritation and dryness, headache, nausea, and dryness of skin. To reduce the chance of experiencing these minor side effects, it is highly recommended that you begin light therapy very slowly and consult your doctor before use.

Pre-Sleep and When You Wake Up in the Middle of the Night

The following suggestions are general and can help you have a good night’s sleep.

• Keep a regular schedule. Try to go to bed and wake up at the same time every day, even on the weekends. Keeping a regular schedule will help your body expect sleep at the same time each day. Don’t oversleep to make up for a poor night’s sleep – doing that for even a couple of days can reset your body clock and make it hard for you to get to sleep at night.
• Incorporate bedtime rituals. Listening to soft music, sipping a cup of herbal tea, etc., cues your body that it's time to slow down and begin to prepare for sleep.
• Relax for a while before going to bed. Spending quiet time can make falling asleep easier. This may include meditation, relaxation and/or breathing exercises, or taking a warm bath. Try listening to recorded relaxation or guided imagery programs.
• Don’t eat a large, heavy meal before bed. This can cause indigestion and interfere with your normal sleep cycle. Drinking too much fluid before bed can cause you to get up to urinate. Try to eat your dinner at least two hours before bedtime.
• Bedtime snacks can help. An amino acid called tryptophan, found in milk, turkey, and peanuts, helps the brain produce serotonin, a chemical that helps you relax. Some pistachios might work too. Try drinking warm milk or eat a slice of toast with peanut butter or a bowl of cereal before bedtime. Plus, the warmth may temporarily increase your body temperature and the subsequent drop may hasten sleep.
• Jot down all of your concerns and worries. Anxiety excites the nervous system, so your brain sends messages to the adrenal glands, making you more alert. Write down your worries and possible solutions before you go to bed, so you don't need to ruminate in the middle of the night. A journal or "to do" list may be very helpful in letting you put away these concerns until the next day when you are fresh.

Go to sleep when you are sleepy. When you feel tired, go to bed.

• Consider avoiding "over-the-counter" sleep aids, and make sure that your prescribed medications do not cause insomnia. There is little evidence that supplements and other over-the-counter "sleep aids" are effective. In some cases, there are safety concerns. Antihistamine sleep aids, in particular, have a long duration of action and can cause daytime drowsiness. Always talk to your doctor or healthcare practitioner about your concerns!
• Get into a calming bedtime routine that you start 30-60 minutes before your desired bedtime. Avoid watching tense or scary movies, or other highly stimulating activities.
  Find some activities that you find calming, and that take your mind off of things that are bothering you. This could include using a relaxation CD, reading, taking a hot bath, having a warm drink (such as decaf tea or milk), or listening to music. Avoid using alcohol to feel drowsy — it tends to contribute to waking up in the middle of the night.
• Earlier in the evening, before you go to bed, make a list of things you will need to do tomorrow or in the near future. Once you have made the list, put it away and focus on relaxing. You can start working on your list again tomorrow, and you will have more energy to tackle your list if you get some sleep.

When you wake in the middle of the night, you CAN get back to sleep.

• Do visualization. Focus all your attention on your toes or visualize walking down an endless stairwell. Thinking about repetitive or mindless things will help your brain to shut down and adjust to sleep.
• Get out of bed if unable to sleep. Don’t lie in bed awake. Go into another room and do something relaxing until you feel sleepy. Worrying about falling asleep actually keeps many people awake.
• Don't do anything stimulating. Don't read anything job related or watch a stimulating TV program (commercials and news shows tend to be alerting). Don't expose yourself to bright light. The light gives cues to your brain that it is time to wake up.
• Get up and eat some turkey! Turkey contains tryptophan, a major building block for making serotonin, a neurotransmitter, which sends messages between nerve cells and causes feelings of sleepiness. Note that L-tryptophan doesn't act on the brain unless you eat it on an empty stomach with no protein present, so keep some turkey in the refrigerator for 3am.
• Consider changing your bedtime. If you are experiencing sleeplessness or insomnia consistently, think about going to bed later so that the time you spend in bed is spent sleeping. If you are only getting five hours of sleep at night, figure out what time you need to get up and subtract five hours (for example, if you want to get up at 6:00 am, go to bed at 1:00 am).
  This may seem counterproductive and, at first, you may be depriving yourself of some sleep, but it can help train your body to sleep consistently while in bed. When you are spending all of your time in bed sleeping, you can gradually sleep more, by adding 15 minutes at a time.

Conclusion

Insomnia is a common problem, especially with individuals who are suffering from pain or illness. Insomnia has been shown to be associated with a variety of health problems, including reduced functioning of the immune system, increased irritability, increased pain, difficulties with concentration and weight gain.

Fortunately, there are many effective treatments for insomnia. Some of the treatments rely on medications, while others involve the use of a variety of self-management techniques. Recent research has shown that self-management techniques for controlling insomnia in some cases can work even better than approaches using medications.

After dealing with many stressful situations during the day, you are eager to get home and rest. But when you crawl into bed you face another dilemma-you can't sleep. Frustrated, you toss and turn for almost an hour, only to fall into a fitful sleep. By morning you feel worse than you did the night before.

Sleeping, like all other body functions, is a natural 'program' that our own inner computer, our subconscious mind, runs - which means it can be restored very easily with natural means.

Insomnia is just a temporary program that runs while we are feeling overly stressed or fatigued, and so with some minor changes, natural sleep can replace it again very easily.

Sleeping is one of our most basic, natural and instinctive functions we possess, yet due to stress and problems in our lives, this program can become interrupted and prevent us from sleeping properly, deeply, or sometimes even at all.

It can be extremely frustrating to be so tired that you want to sleep but just can’t. The added stress just adds to the sleeplessness causing a vicious cycle.

By paying close attention to your daily life and identifying the reasons why you are unable to sleep, you will be on the way towards a more restful night along with rejuvenating sleep. Taking some steps toward self-healing is well within your power.

If you try the self-help techniques outlined here in this article and still get no relief from insomnia, go see your doctor. He or she will be able to assist you with some medications that will combat your sleep problem and get you on the road to dreamland.