We can’t really control when we fall asleep since falling asleep is a passive activity. What we can control is how to set up our bedroom environment to be more conducive to getting good sleep.

We do this by improving our sleep hygiene. Neurology at NorthShore, shares some examples:

• Eliminating bright lights, noises and electronic devices from the bedroom
• Using the bedroom for sleep and sex only (not work or answering emails)
• Ensuring the room temperature is on the cool side, but extra covers are available within reach
• Avoiding heavy meals or exercise within two hours of bedtime
• Planning for consistent bedtimes and wake times that ensure at least seven hours of sleep per night

What if following good sleep hygiene does not help? What should I do next?

Ask yourself whether you are having more difficulty falling asleep or staying asleep or both. If you are having trouble falling asleep, something may still be alerting you. You may have had too much residual caffeine or other stimulating substance in your system, you may be tormented by racing thoughts, or perhaps your circadian rhythms are stuck on a different clock than your current schedule. If you are having racing thoughts or just can’t get your mind to turn off, you may want to learn some mindfulness meditation exercises or listen to an audio podcast that can turn your mind away from the alerting thoughts. If you watch TV to turn off your mind, make sure it has an automatic timer to turn off after 40-60 minutes.

If you wake up in the middle of the night, you may have a primary sleep disorder such as a sleep breathing disorder or limb movement disorder, and often times it is difficult to fall back to sleep. If you are experiencing this, you will likely need to obtain a sleep study to ensure that you don’t have a primary sleep disorder.

Do I just have to deal with insomnia?

Insomnia can be defined in different ways but is most often described as feeling unrefreshed upon awakening – not accounted for by lack of sleep – and is typically correlated with daytime impairment. That is to say that some people can get by on less sleep than others without any daytime drowsiness, cognitive effects or performance deficits. If the insomnia is persistent, a more sophisticated treatment plan may be needed.

Is it safe to take a sleeping pill every night?

Prescription sleep medications have been evolving for a long time with the goal of reducing side effects such as daytime drowsiness, respiratory suppression, memory difficulties, dependency and unwanted behaviors during sleep such as sleepwalking, sleep paralysis, nightmares, sleep-eating. Even the newer sleep hypnotics may still cause these effects in a small fraction of patients. For more discussion of the safety of sleep aids, is recommended to talk with your physician.

Are there any over-the-counter solutions or dietary changes that will help me sleep better at night?

There is limited efficacy data for antihistamines (e.g., Tylenol PM or Benadryl) and melatonin, however antihistamines are more likely to give a side effect in most patients and are not recommended for long-term use. Melatonin, typically taken in 0.5 mg – 6 mg size tabs, helps regulate your circadian rhythm when taken in the evening at consistent times but the effects may be subtle. It is most effective at improving sleep efficiency in the elderly, particularly because they can be melatonin deficient. The herbal substance, valerian root, may also help.

Alcohol use may cause drowsiness to help promote initial sleep onset, but will typically cause middle-of-the-night awakenings and therefore should be avoided. Similarly, foods containing high caloric content should be avoided in the evening as well.