Why you can't sleep...

...and what you can do about it.

The six most common reasons people have trouble sleeping include:

1. Stress and anxiety: Worrying is probably the most common cause of sleeplessness. Many people worry not only about their current problems, but about the distant future, the distant past, and about other people's problems. That's a sure way to lie awake all night. Sometimes people worry about the idea that they won't get to sleep, which keeps them awake.

2. Depression: Depressed people often wake up early and have problems falling asleep again.

3. Irregular schedules: Abruptly changing bedtimes, due to a shift change, travel across time zones (jet lag) or simply keeping a different weekend schedule can interrupt the body's normal 24-hour sleep cycle, which is affected by light and darkness, the release of hormones such as melatonin, and the number of hours since we last slept.

Melatonin has the effect of re-setting the body's internal clock, and is available as an over-the-counter product. Excessive Melatonin may trigger depression, however. Valerian root is also said to be helpful, though some complain that it lasts too long. Benadryl, sometimes used for a stuffy sinus, also induces sleep, but may wear off slowly in the morning. Take it at least an hour before bedtime, to reduce this effect.

It is also called dephenhydramine. Compare generic brands nearby, sold for perhaps half the price of the brand name.

4. Alcohol: Alcohol may help you to fall asleep, but it results in a light, fragmented sleep. After the sedative effect wears off in a few hours, there is a rebound effect (perhaps a light hangover) that can leave you awake in the middle of the night.

5. Caffeine: Coffee, colas, chocolate and other caffeinated substances prevent us from slowing down. They plug up the receptors for adenosine, a chemical that serves as an "off" switch. Nicotine can also have a stimulant effect.

6. Food or exercise too close to bedtime. These can boost the body's metabolism, which can prevent sleep. Schedule a strenuous workout or a big meal no less than three hours before bedtime. Exercise several hours before bedtime can help promote rest.


Other sleep disorders can be associated with the following:

Sleep state misperception (people who complain in hospitals that they don't sleep at all, are sometimes observed by nurses to be sleeping.)

Narcolepsy, Restless legs syndrome, Sleep related abnormal swallowing syndrome, Primary snoring, Psychoses, Mood disorders, Anxiety disorders, Alcoholism, Dementia, Parkinsonism, Sleep-related headaches, Sleep related asthma, Peptic ulcer disease, Pregnancy associated sleep disorder, Menstrual problems associated sleep disorder, Sleep choking syndrome, Inadequate sleep hygiene, Altitude insomnia, Food allergy insomnia, Nocturnal eating (drinking) syndrome, Time zone change (jet lag), Shift work sleep disorder, Circadian rhythm sleep disorder.


Maintain the same hours every night and morning, including on weekends. Avoid taking naps, unless a midday nap is to be a regular part of your normal routine, including short sleep at night. Otherwise, if your need for a nap seems overwhelming, set your alarm and limit it to 30 minutes.

Avoid exercise, heavy eating, or drinking alcoholic beverages within 3 hours of bedtime. Avoid caffeine or nicotine near bedtime.

Don't believe you can get by on 5 or 6 hours of sleep per night, and then make it up on the weekend. Your body needs sleep, and the harm you do during the week is not erased by sleeping more on the weekend. If your house needs cleaning, and it's 11 p.m., it's better to leave it and take care of it when you actually do have time. If you have two jobs, it is better that the second job be on a weekend, and not on your first job's work days.

The ideal shift change is in the later direction, rather than the direction which requires the worker to begin sleeping earlier than usual. Adjustment will be faster if the shift changes 4 hours rather than 8, or if the shift change is after a weekend. Adjustment will be more durable if the shift changes every 90 days or longer, rather than some shorter period. Adjustment will be quicker if you sleep the same hours on a weekend as on work days.

Adjustment will also be more long lasting if you do that. Accident rates are much higher for late shift workers, mostly because they are not getting proper sleep when at home. Either they shift their sleeping time on a weekend, or because they are shopping or watching TV when they should be sleeping, or because their family disturbs them during their sleeping hours.

Here's a neat trick for getting used to DST/ST time changes. When daylight savings time is changed to standard time, set your alarm 1/2 hour earlier than it was. You'll actually be sleeping a half hour later than before, and getting up a half hour earlier.

In the springtime, do the opposite. A week before DST begins, set your alarm 30 minutes earlier. Then when DST begins, re-set your clock, and set your alarm back to where it had been. You'll be getting up only 30 minutes earlier each time, and it won't be as unpleasant as getting up an hour earlier.

If you need a little more help, practice your earlier rising time on Saturday and Sunday, so that when Monday rolls around, you'll (almost) be used to it. On Friday night, instead of setting your alarm for 6:00, set it for 5:30. Then on Saturday night, just before the time change, set your alarm for 6:30.

You can set the alarm for 6:00 Sunday night, or after about a week of rising at 6:30, set your alarm for 6:00 (if that was your regular rising time) and on the following Saturday morning, you're rising at another half hour earlier. By Monday, you'll be on a summertime schedule like the rest of the world.

However, take care of your bedtime on the other end, too. If TV is keeping you up, set your VCR to record the late show, and watch it later.

Reset your body's clock using light. In the late afternoon, just before sunset, go out in the sun or sit near a bright light. Also, as soon as possible after you awaken. The sunlight entering your eyes tends to re-set your body's clock. [Don't overdo it. There's no need to sunburn your eyes, of course.] The orange color of a sunset also communicates to your brain that sleep time is nearing.

In the fall, do the opposite. Instead of rising an hour later, set your alarm 30 minutes earlier. Then you're getting an extra half hour's sleep, but getting up a half hour earlier. Unless you watch TV until bedtime, you could keep this schedule all winter. If you do, then you're actually watching TV until an hour later than the week before, so then getting up earlier wouldn't agree with you.

If you are on the computer a lot, download a free program at "f.lux.com" It tints your screen slightly pink toward evening, so the blue of your monitor doesn't keep you awake later.

Try using progressive relaxation. You may want to memorize the following, or even say it into a tape recorder, and play it back:

"Take a comfortable position, sitting or lying down, remove ear rings or contacts, loosen your belt or tie, and close your eyes.

Just imagine your toes beginning to relax, and the relaxation moving across the soles of your feet ...into your heels. Then imagine the relaxation penetrating through... to the tops of your feet, and moving into your ankles. (Actually think the words, in order to engage the left brain, too.)

Imagine your calves relaxing, and even your shins relaxing. The relaxation moves into your knees, and into your thighs. The long muscles of your thighs relax in the front, the back, the insides and the outsides... of your thighs. Your hips relax. The relaxation moves into your lower back, and up through your middle back... and your upper back. Your shoulders relax.

You feel the relaxation in your upper chest, your lower chest, your upper abdomen, your middle abdomen, and your lower abdomen. The muscles in your sides relax, and the sides of your ribs relax.

With your shoulders relaxed, you feel the relaxation moving into your upper arms, both biceps and triceps, your elbows, your forearms, your wrists, your hands your fingers, and you even imagine your fingernails... relaxing.

You feel the relaxation move from your shoulders up the sides of your neck, the back of your neck, and across the back of your scalp, the top of your scalp, and your forehead. The relaxation moves through your temples, your cheeks, and into your chin. You feel your lips... relax. Your nostrils ...relax.

The tiny muscles across the bridge of your nose... just let go. You can feel your eyes relax, and the muscles all around your eyes... relax. Your eyebrows relax. Your cheeks relax. The tiny muscles of your eyelids... relax, as well as the muscles... behind your eyes.

Your whole face is relaxed. Your head is relaxed. Your brain relaxes. Your left brain, and your right brain. Your forebrain... relaxes. Your center brain... relaxes. Your brain stem relaxes... deeply, deeply... relaxed.

Your thoughts relax. Your thinking relaxes. Your feelings relax... deeper and deeper relaxed. Your attitudes... relax. Your past... relaxes, with all... of your memories, just relax. Your present... relaxes. Your future... relaxes, together with all of your expectations... and anticipations."


Before you have got this far, you will probably be sound asleep.

If you do this in the daytime, the relaxation effect will last 24 hours. Do it sitting up so you won't fall asleep. You may notice a more "laid back" attitude for the rest of the day. If you intend to be awake after a hypnotic session, add the following at the end, especially if you are recording it:

"Now, I am going to count to ten. When I reach the count of ten, you will be wide awake, fully alert, feeling grand, feeling wonderful, in every way. Counting for you now:

One. Feel new energy entering your body, through the soles of your feet. Two. More and more new energy, sweeping up through your feet, your legs, your body your arms, and head.

Three. More and more new energy, filling you up, faster and faster, and faster. Four. Almost halfway up. Five. Halfway there.

Six. Feel more and more new energy filling you faster and faster. Seven. Only three to go. Eight. Nine. Almost there. Ten. Wide awake, full of energy, completely alert, feeling grand, feeling wonderful in every way."

Do not play a hypnotic tape or CD in a moving automobile. It may put the driver to sleep.

People with high blood pressure may notice their HBP returning to normal for a full day after a session of progressive relaxation. Tape the session, and listen to the tape. In the daytime, include a suggestion at the end, that after you count to 10, your consciousness and alertness will have returned to normal. If you use a tape at night, or as you prepare to sleep, it should have an automatic cutoff device on the tape player.

For a rapid self-hypnosis technique, go to More and scroll down to "A Self Hypnosis Technique." It will be at the bottom of the page.

Try using meditation. That can be slow, deep breathing, as you count your breaths. Notice the place where your feel your breathing the most, and count that feeling as it repeats. Or, it can simply be thinking a word over and over, such as "peace," or "calm."

Try taking 3 mg. of melatonin 30 minutes before bedtime. Or sipping a cup of chamomile tea (in Spanish, "manzanilla.") Or taking 1,000 mg. of magnesium at bedtime. (Avoid valerian root or chamomile if you are taking prescription anti-anxiety medications.) Even under ordinary conditions, valerian can leave you with "morning drowsiness" (not to mention its smell, which is a little like a damp cellar, and a little like spaded earth.)

Niacin at bedtime can help you to sleep, but don't take more than 2,000 mg per day, or it could damage your liver. One type of niacin (nicotinic acid or niacinamide) can cause a "flush," or a few minutes of red skin and itchiness, but that type also reduces cholesterol.

Niacin metabolizes to 5-HTP, which metabolizes to tryptophan, which metabolizes to seratonin, which has a sedative effect (and a temporary anti-depressive effect, too.)

Use your bed only for sleeping and lovemaking, not watching TV or doing your taxes. Let lying in bed create an association in your inner mind, which is conducive to sleep.

Other herbs with a sedative effect are two to four 400 mg. capsules of Gotu Kola, or two capsules of freeze-dried hops extract. (Hops is the herb used in flavoring beer.)