Lifestyle activities can play an important role in overcoming insomnia.

General Guidelines

To improve insomnia, include all of the following:

• Treat underlying disease
• Avoid medications that can cause insomnia
• Reduce stress
• Adjust daily activities
• Avoid nicotine, caffeine, and alcohol
• Follow bedtime rituals if working night shifts
• Create good sleep habits and environment
• Prepare for jet travel

Managing Insomnia

  Treat Underlying Disease

Chronic disease and pain can cause insomnia. Diseases or conditions that may disrupt sleep include:

• Depression, mania, and anxiety
• Diabetes and kidney disease
• Chronic lung disease
• Arthritis
• Alzheimer disease and Parkinson disease
• Heart disease
• Gastroesophageal reflux disease (GERD) or ulcer
• Sleep apnea (stopping breathing for short periods of time while sleeping)
• Restless leg syndrome and other disorders that cause involuntary limb movements during sleep

Discuss with your doctor whether these conditions or any other physical problems can be treated. Proper and timely treatment for these conditions can reduce symptoms and may lead to an improved night’s sleep.

  Avoid Certain Medications

Certain medications can cause sleeping difficulties as a side effect. Having to take one or more of these drugs can lead to insomnia. Some medications that may affect sleep include:

• Decongestants and other cough and cold remedies
• Headache remedies that contain caffeine
• Diet pills
• Steroids
• Some high blood pressure medications like beta-blockers
• Theophylline for asthma
• Phenytoin for seizures
• Levodopa for Parkinson disease

If you are taking a prescription medication that disturbs sleep as a side effect, discuss this with your doctor. You may be able to take an alternative drug that does not disturb your sleep.

Note —Do not stop any prescription medication without the approval of your doctor.

  Reduce Stress

Stress is considered by most sleep experts to be the number one cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or relationship problem, or a serious illness or death in the family. Try some stress-relieving activities such as exercise, meditation, or deep breathing. Regular exercise can help relieve stress, but do so at least 3 hours before bedtime. A workout after that time may actually keep you awake because your body has not had a chance to cool down and relax.

  Adjust Daily Activities

Habits and activities that you do during the day or night can interfere with getting a good night's sleep. Adjust your time schedule to avoid:

• Exercising close to bedtime
• Following an irregular morning and nighttime schedule
• Working or doing other mentally intense activities right before or after getting into bed
• Napping during the day, which may interfere with your ability to sleep at night (if you do nap, be sure to try to do so at the same time each day, and do not nap for more than an hour)
• Eating large meals close to bed time

Regular exercise is probably helpful in improving sleep quality in adults who are inactive. To help regulate your internal clock, try to get out in the daylight at least 30 minutes a day.

  Avoid Nicotine, Caffeine, and Alcohol

Nicotine and caffeine stimulate the nervous system. Although this may give you a sense of energy during the day, these substances interfere with the ability to sleep at night. Avoid caffeine for at least 6 hours prior to your bedtime. Alcohol depresses the nervous system and makes you feel drowsy at bedtime, but it interferes with normal sleep patterns during the night and causes restlessness. Avoid using tobacco products and drinking beverages that contain caffeine or alcohol in the afternoon or evening. They can create a cycle of poor sleep at night, and an increased use of stimulants during the day to counteract the drowsiness from poor sleep.

  Follow Bedtime Rituals If Working Night Shifts

Night shift work forces you to try to sleep when activities around you and your own "biological rhythms” signal you to be awake. Night shift workers are more likely than employees with regular, daytime hours to fall asleep on the job because of poor sleep quality. If you are working the night shift, speak with your employer about how to minimize the dangers of fatigue. Discuss your need for creating a sleep environment in the daytime with your family or those with whom you live. Try to keep a consistent schedule for sleep throughout the week, even on your days off. Make your daytime home environment conducive to sleep by keeping light out of the room you sleep in and minimizing external noise.

  Create Good Sleep Habits and Environment

A distracting sleep environment, such as a room that's too hot or cold, too noisy or too brightly lit, can be a barrier to sound sleep. Do not put your TV or computer in your bedroom. Keep the temperature on the cool side. Interruptions from pets, children, or other family members can also disrupt sleep. Other influences may be the comfort and size of your bed and the habits of your sleep partner. Try to create an environment that is restful using shades to block light, and playing soothing music or “white noise” (such as a fan). Seek medical help for a sleeping partner who snores loudly, and consider separate sleeping arrangements.

Establish a regular, relaxing bedtime routine that will allow you to unwind and send a "signal" to your brain that it's time to sleep. Avoid exposure to bright light before bedtime. Taking a warm bath may help. Do not use your bed for anything other than sleep or sex. Your bed should be associated with sleep. Avoid “clock watching” after going to bed, as well as drinking fluids just before bed. If you cannot sleep, get up and read until you feel tired again. That way you will not feel frustrated by your inability to sleep, which can create a vicious cycle.

  Prepare for Jet Travel

Jet lag is the inability to sleep as a result of crossing many time zones in a short period of time. This can disturb your biological rhythms and deprive you of good sleep. To help minimize its effect, get a good night’s sleep before traveling, drink plenty of water, and avoid alcohol during the trip.

When to Contact Your Doctor

Transient and intermittent insomnia are often in response to a short-term event (like jet travel or a job stress) and usually resolve in several days. If you have sleeplessness that continues for more than a week, contact your doctor for an evaluation and consultation about your treatment options.