Sleep and Insomnia

Causes, Symptoms, Cures, Treatments, and Remedies

Of Sleeplessness and Insomnia

How To Sleep Well

Sleep Is a Basic Human Need!

Sleep is a natural part of everybody's life, but many people know very little about how important it is, and some even try to get by with little sleep. Sleep is something our bodies need to do; it is not an option. Even though the exact reasons for sleep remain a mystery, we do know that during sleep many of the body's major organ and regulatory systems continue to work actively. Some parts of the brain actually increase their activity dramatically, and the body produces more of certain hormones.

Sleep, like diet and exercise, is important for our minds and bodies to function normally. In fact, sleep appears to be required for survival. Rats deprived of sleep die within two to three weeks, a time frame similar to death due to starvation.

An internal biological clock regulates the timing for sleep. It programs each person to feel sleepy during the nighttime hours and to be active during the daylight hours. Light is the cue that synchronizes the biological clock to the 24-hour cycle of day and night.

Problem Sleepiness Has Serious Consequences

Sleepiness due to chronic lack of adequate sleep is a big problem in the United States and affects many children as well as adults. Children and even adolescents need at least 9 hours of sleep each night to do their best. Most adults need approximately 8 hours of sleep each night.

When we get less sleep (even one hour less) than we need each night, we develop a "sleep debt." If the sleep debt becomes too great, it can lead to problem sleepiness – sleepiness that occurs when you should be awake and alert, that interferes with daily routine and activities, and reduces your ability to function. Even if you do not feel sleepy, the sleep debt can have a powerful negative effect on your daytime performance, thinking, and mood, and cause you to fall asleep at inappropriate and even dangerous times.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children's performance in school, on the playground, in extracurricular activities, and in social relationships.

Inadequate sleep can cause decreases in:

• Performance
• Concentration
• Reaction Times
• Consolidation of Information Learning

Inadequate sleep can cause increases in:

• Memory Lapses
• Accidents and Injuries
• Behavior Problems

• Mood Problems

Signs of Sleep Disorders
A child who has not obtained adequate nighttime sleep is at high risk for symptoms of physical and/or mental impairment. The child may fall asleep in school, have difficulty concentrating in school and other activities, and/or exhibit behavioral problems.

Some children who are sleepy become agitated rather than lethargic and may be misdiagnosed as hyperactive. Not getting enough sleep is one cause of problem sleepiness. Undiagnosed/untreated sleep disorders can also cause problem sleepiness. Children as well as adults can suffer from sleep disorders. Parents should talk to their pediatrician about a possible sleep disorder if their child has any of the following:

• Snoring
• Breathing Pauses During Sleep
• Problems with Sleeping at Night
• Difficulty Staying Awake During the Day

• Unexplained Decrease in Daytime Performance

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NORMAL SLEEP

What is sleep?

Sleep is a behavioral state characterized by little physical activity and almost no awareness of the outside world. Most scientists think that sleep does something important -- something vital for life, although research has not yet identified specifically what sleep does.

Nevertheless, we all know when we need to sleep -- we can feel this need.

We also know when sleep has done its work -- we feel rested and that we have slept enough. Another important feature of normal sleep is that it can end quickly. Although a sleeper may appear to be unconscious; unlike someone who is actually knocked-out, anesthetized or in a coma; a sleeping person can be easily awakened and can resume normal waking activity within a minute or two.

Sleep Stages

Sleep is an active, highly organized sequence of events and physiological conditions. Sleep is actually made up of two separate and distinctly different states: 'non-rapid eye movement sleep' (NREM sleep) and 'rapid eye movement sleep' (REM sleep) or dreaming sleep. The NREM and REM types of sleep are as different from one another as both are different from wakefulness.

NREM sleep is further divided into stages 1 - 4 based on the size and speed of the brain waves generated by the sleeper. Stages 3 and 4 of NREM sleep have the biggest and slowest brain waves. These big, slow waves are called delta waves and stages 3 and 4 sleep combined are often called 'slow-wave sleep' or 'delta sleep'.

During REM sleep you can watch the sleeper's eyes move around beneath closed eyelids. Some scientists think that the eyes move in a pattern that relates to the visual images of the dream. We are almost completely paralyzed in REM sleep -- only the heart, diaphragm, eye muscles and the smooth muscles (such as the muscles of the intestines and blood vessels) are spared from the paralysis of REM sleep.

Deep Sleep

Doctors have tried to determine what type of sleep is the deepest sleep. To do this, they measure how much noise or other alerting stimulation is required to awaken a sleeper from the various types of sleep. It is always possible to awaken someone who is sleeping, as opposed to, say, someone who is in a coma.

However, people in stages 3 and 4 sleep require the most stimulation to awaken. Therefore, this phase of sleep is often thought of as 'deep sleep'. Also, large spurts of growth hormone are secreted during stages 3 and 4 NREM sleep. Consequently, these stages of sleep are thought to restore the body from the wear and tear of waking activity.

REM or Dream Sleep

People in REM sleep also tend to be quite difficult to awaken, but this finding is variable -- sometimes even the slightest noise can awaken a person in REM sleep. Nevertheless, because it is often difficult to awaken a person from REM sleep, many doctors think also of REM sleep as a 'deep' phase of sleep.

There are many theories about the function of REM sleep and dreaming -- ranging from 'safe, socially acceptable, wish fulfillment' to 'consolidation of memories' to 'providing necessary stimulation to the entire nervous system during development'.

Researchers used to think that REM sleep was necessary for normal psychological function, because experimental REM deprivation caused some subjects to behave strangely. The notion that we need REM sleep for our mental health is not accepted now, because, among other reasons, people have uneventfully withstood long and almost complete REM deprivation.

Some experiments have shown that REM deprivation improves depression. However, REM sleep must still do something, because rats will die after 2 - 3 weeks if they are deprived of REM sleep by a special experimental computer that wakes them up each time REM sleep is achieved.

Whatever REM sleep does, it is clear that every aspect of existence, from the body's manufacture of proteins to sexual arousal including orgasm, is influenced by REM sleep. It is likely that the ultimate explanation of REM sleep will be very broad -- not simply focused on one physiologic function.

Why do we sleep?

We sleep because we get sleepy and we cannot work if we get too sleepy. That is the simplest and yet the most profound answer to this question. The scientific truth is, however, that we do not yet know why we get sleepy.

We know that all mammals as well as some birds and reptiles sleep. Many doctors think sleep comes in order to get rid of certain chemicals that build up in our bodies during the day's activities.

Brain research in the 1960's and 1970's has identified several molecules involved in cell-to-cell communication within the brain as being important for sleep. More recent work has isolated products of the body's immune system that seem to be sleep-inducers.

Circadian Rhythm or Our Biological Clock

Feeling sleepy is not the whole story of our sleep-wake cycle. Some timing mechanism is also involved. We know that every living thing composed of cells with a nucleus has a daily cycle of activity and inactivity (if not actual wakefulness and sleep). The timing and control of the wakefulness-sleep cycle depends on one or more biological clocks in our bodies.

These clocks are sensitive to light and have evolved over the ages in close approximation to the 24-hour light-dark cycle of our world. Thus, sleep seems to be an unavoidable part of human behavior. In humans, sleep is physiologically programmed to come each day, either in one long bout (about 6 - 8 hours each night) or in two shorter bouts (a 5 - 6 hour sleep at night and a 1 - 2 hour nap in the afternoon).

The timing of sleep and wakefulness is controlled to a great extent by our exposure to the natural light and dark cycles of the earth. All humans tend to sleep in the dark and move about in the light. It takes the human body several days to change to a different light-dark schedule such as when one flies from New York to New Dehli. In fact, the influence of light on the timing of sleep is so powerful that doctors are now using exposure to bright light as a treatment to reset the sleep clock of people who have somehow disrupted their schedule.

In the extreme, sleep does seem to be necessary for life. Experimental rats die if they are completely deprived of sleep for longer than 1 - 4 weeks. However, do not worry. The experimental deprivation was done by means of special computers and alarm systems -- it is not possible for even the poorest of human sleepers to lose so much sleep that life is threatened.

The figure illustrates this interplay and shows over a period of 48 hours, a two-peak pattern for each day. There is a period with markedly increased sleep tendency in the early morning hours between 3 and 6 AM and a smaller but reliable afternoon peak between 1 and 3 PM. This is the so-called siesta effect or afternoon slump.

Both periods of increased sleep tendency can be exaggerated by sleep promoting factors such as alcohol consumption and sleep deprivation. Errors and reduced productivity peak at the times of maximum sleep tendency.

How much sleep do we need?

There is no 'normal' amount of sleep. The average amount of sleep for adults is 7 - 8 hours. But the range of nighttime sleep duration must be expanded to between 6 - 9 hours in order to include the large majority of people. Therefore, a few people feel fine with as little as 5 hours of sleep, while others require more than 10 hours to feel refreshed and alert throughout the day.

The amount of sleep you need is that optimum amount which allows you to function throughout the day without feeling drowsy when you sit quietly and try to pay attention to something.

We cannot, for very long, force ourselves to sleep much less or much more than this optimum amount. Several nights of sleeping an hour less than our usual amount will leave us sleepy and ineffective in the day. Conversely, several nights of staying in bed and trying to sleep an hour more than our optimum amount will leave us sleeping poorly with more awakenings -- particularly in the early morning.

Doctors believe that the optimum amount of sleep each person needs to remain alert during the day is biologically different from person to person. To a great degree, our optimum sleep need is determined by heredity. Scientists have found, for instance, that strains of mice can be selectively bred to sleep considerably more or considerably less than the average mouse.

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Sleep and Aging

Many people believe we need less sleep as we get older. This is probably not true. It seems that during infancy and in adolescence there are increases in sleep need, perhaps brought on by developmental changes. However, the best research available indicates that healthy elderly people sleep about as much as they did when they were young adults.

The idea that the elderly sleep less probably comes from the fact that elders often have medical conditions that interfere with their sleep. This is why most elderly people are 'light sleepers' at night, yet they frequently dose-off during the day.

This type of light sleep and dozing pattern is what sleep researchers would expect if a person is awakened again and again while they try to sleep. In fact, research on repetitive sleep disruption, called 'sleep fragmentation', has shown that the rate of sleep disruptions determines whether or not the sleep is felt to be satisfactorily restorative, and whether or not there is proper alertness the next day.

These kinds of studies show that disruptions every minute will greatly reduce the restorative value of sleep. However, disruptions every five minutes will affect restoration much less -- even when total sleep time is the same for the one-per-minute and five-per-minute rates of disruption. Thus, scientists believe that for refreshing sleep, it is not just the total amount of sleep that is important. Sleep must be continuous as well.

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Napping and "Siestas"

Certain cultures use the siesta very successfully. However, siesta cultures are relatively consistent in napping. In most western cultures, napping is not consistent day after day. If you want to nap, nap at the same time each day and for the same duration, particularly if you are prone to insomnia. Many people complain about Sunday-night insomnia. What usually happens in these cases is that the person napped on Sunday from, say, 2 to 5 in the afternoon and then could not get to sleep at the usual time Sunday night. That is why keeping a consistent schedule is the best strategy.

With respect to occasional napping, one important advantage is that even a 30 - 60 minute nap greatly helps a person counter sleep loss. Studies have shown that the first hour or so of sleep is most potent in relieving the effects of missing a night's sleep.

What should I do if I am not sleeping well?

Try and identify the nature of your sleep problem. Is it difficulty sleeping or excessive sleepiness? There are a number of screening tests that can help you determine if you have normal sleep or might have a sleep problem. Take a sleep screening test and see if you fit in to one of the categories identified. Then you can get more information about that problem and how to help yourself or how and where to obtain professional help if needed.

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Sleep Dos & Don'ts

'Sleep Hygiene' Solutions for Better Sleep

From having occasional difficulty sleeping to insomnia, there is a lot you can do to get a better night's sleep, feel refreshed when you awake, and remain alert throughout the day. It's called "sleep hygiene" and refers to those practices, habits, and environmental factors that are critically important for sound sleep. And most of it is under your control.

There are four general areas important to sleep hygiene:

·         Our circadian rhythm, or 24-hour cycle

·         Aging

·         Psychological stressors -- those factors can cause difficulty falling asleep and disturb the quality of your sleep

·         Common social or recreational drugs like nicotine, caffeine, and alcohol

Circadian Rhythm

We all have a day-night cycle of about 24 hours called the circadian rhythm. It greatly influences when we sleep and the quantity and the quality of our sleep. The more stable and consistent our circadian rhythm is, the better our sleep. This cycle may be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light (from traveling across time zones to staring at that laptop in bed at night).

Aging

Aging also plays a role in sleep and sleep hygiene. After the age of 40 our sleep patterns change, and we have many more nocturnal awakenings than in our younger years. These awakenings not only directly affect the quality of our sleep, but they also interact with any other condition that may cause arousals or awakenings, like the withdrawal syndrome that occurs after drinking alcohol close to bedtime. The more awakenings we have at night, the more likely we will awaken feeling unrefreshed and unrestored.

Psychological Stressors

Psychological stressors like deadlines, exams, marital conflict, and job crises may prevent us from falling asleep or wake us from sleep throughout the night. It takes time to "turn off" all the noise from the day. No way around it. If you work right up to the time you turn out the lights, or are reviewing all the day's events and planning tomorrow (sound familiar?), you simply cannot just "flip a switch" and drop off to a blissful night's sleep.

One must develop some kind of pre-sleep ritual to break the connection between all the stress and bedtime. This is perhaps even more important for children. These rituals can be as short as 10 minutes or as long as an hour.

Some find relief in making a list of all the stressors of the day, along with a plan to deal with them, as it serves to end the day. Combining this with a period of relaxation, perhaps by reading something light, meditating, or taking a hot bath can also help you get better sleep. And don't look at that clock! That tick-tock will tick you off.

Social or Recreational Drugs

Social or recreational drugs like caffeine, nicotine, and alcohol may have a larger impact on your sleep than you realize. Caffeine, which can stay in your system as long as 14 hours, increases the number of times you awaken at night and decreases the total amount of sleep time. This may subsequently affect daytime anxiety and performance. The effects of nicotine are similar to those of caffeine, with a difference being that at low doses, nicotine tends to act as a sedative, while at high doses it causes arousals during sleep.

Alcohol may initially sedate you, making it easier to fall asleep; however, as it is metabolized and cleared from your system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated. These arousals disturb sleep, often causing intense dreaming, sweating, and headache. Smoking while drinking caffeine and alcohol can interact to affect your sleep dramatically. These sleep disturbances may be most apparent upon awakening, feeling unrefreshed, groggy, or hungover.

It is important to realize that not getting the proper amount of and the best quality sleep may have serious short-term and long-term consequences. Many studies have shown that sleep deprivation adversely affects performance and alertness.

Reducing sleep by as little as one and a half hours for just one night reduces daytime alertness by about one-third. Excessive daytime sleepiness impairs memory and the ability to think and process information, and carries a substantially increased risk of sustaining an occupational injury. Long-term sleep deprivation from sleep disorders like apnea have recently been implicated in high blood pressure, heart attack, and stroke.

All that said, here are some sleep hygiene tips to help you relax, fall asleep, stay asleep, and get better sleep so that you wake up refreshed and alert.

1. Avoid watching TV, eating, and discussing emotional issues in bed. The bed should be used for sleep and sex only. If not, we can associate the bed with other activities and it often becomes difficult to fall asleep.

2. Minimize noise, light, and temperature extremes during sleep with ear plugs, window blinds, or an electric blanket or air conditioner. Even the slightest nighttime noises or luminescent lights can disrupt the quality of your sleep. Try to keep your bedroom at a comfortable temperature -- not too hot (above 75 degrees) or too cold (below 54 degrees).

3. Try not to drink fluids after 8 p.m. This may reduce awakenings due to urination.

4. Avoid naps, but if you do nap, make it no more than about 25 minutes about eight hours after you awake. But if you have problems falling asleep, then no naps for you.

5. Do not expose your self to bright light if you need to get up at night. Use a small night-light instead.

6. Nicotine is a stimulant and should be avoided particularly near bedtime and upon night awakenings. Having a smoke before bed, although it may feel relaxing, is actually putting a stimulant into your bloodstream.

7. Caffeine is also a stimulant and is present in coffee (100-200 mg), soda (50-75 mg), tea (50-75 mg), and various over-the-counter medications. Caffeine should be discontinued at least four to six hours before bedtime. If you consume large amounts of caffeine and you cut your self off too quickly, beware; you may get headaches that could keep you awake.

8. Although alcohol is a depressant and may help you fall asleep, the subsequent metabolism that clears it from your body when you are sleeping causes a withdrawal syndrome. This withdrawal causes awakenings and is often associated with nightmares and sweats.

9. A light snack may be sleep-inducing, but a heavy meal too close to bedtime interferes with sleep. Stay away from protein and stick to carbohydrates or dairy products. Milk contains the amino acid L-tryptophan, which has been shown in research to help people go to sleep. So milk and cookies or crackers (without chocolate) may be useful and taste good as well.

10. Do not exercise vigorously just before bed, if you are the type of person who is aroused by exercise. If this is the case, it may be best to exercise in the morning or afternoon (preferably an aerobic workout, like running or walking).

11. Does your pet sleep with you? This, too, may cause arousals from either allergies or their movements in the bed. Thus, Fido and Kitty may be better off on the floor than on your sheets.

Good sleep hygiene can have a tremendous impact upon getting better sleep. You should wake-up feeling refreshed and alert, and you should generally not feel sleepy during the day. If this is not the case, poor sleep hygiene may be the culprit, but it is very important to consider that you may have an unrecognized sleep disorder. Many, many sleep disorders go unrecognized for years, leading to unnecessary suffering, poor quality of life, accidents, and great expense. Since it is clear how critical sound sleep is to your health and well-being, if you are not sleeping well, see your doctor or a sleep specialist.

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Mattress guidelines for sleep comfort

Mattresses impact sleep quality
The right mattress can significantly contribute to having a good night’s sleep and waking up feeling rested and refreshed; and sleeping on the wrong mattress can cause sleeplessness, back pain, and overall aches and pains. For people with a back condition, sleep can aggravate the pain if the mattress isn’t a good fit.

Mattresses are a personal choice
When searching for the best mattress, perhaps the most important thing to remember is that mattresses are largely a matter of personal preference. There is no single type of mattress or bed that works well for all people, and there is no best mattress for back problems. Likewise, there is no single sleep position known to be best for all people. This is due to several factors:

·         There are many causes of back problems, and different back conditions may respond better to specific types of beds, mattresses and sleep positions

·         There is a high degree of personal preference for mattresses, and what works well for one person may not work well for another

·         There is very limited scientific study published on mattresses and back pain, and findings from the studies that have been completed are inconclusive

·         Overall, the causes of back pain can be quite complex, and it’s difficult to isolate whether or not a person’s mattress has played a significant role in improving the pain or making it worse.

The bottom line is that the type of mattress that is best for any particular person is really a matter of personal preference. That being said, there are a number of useful guidelines when selecting a mattress or bed - as well as suggestions for sleep positions - that are discussed in this article. These guidelines can be especially important to help people with back conditions sleep more comfortably.

Factors in addition to mattresses that affect sleep comfort
It is important to remember that the type of mattress one uses is not the only factor for patients with pain and sleep difficulty. Many other factors need to be considered that may affect sleep, including:

·         Medication side effects

·         Irregular sleep patterns

·         Caffeine/alcohol/tobacco use

·         Sleep apnea

·         Anxiety/stress

If comfort is not the only thing making sleep difficult, it is advisable for the patient to consult his or her family physician to discuss other possible causes and treatments for sleeplessness. And if anyone experiences significant or persistent back pain, there may be an underlying back condition that has nothing to do with the mattress. It is always advisable for people with back pain to consult with a health care provider for a thorough exam, diagnosis and treatment program.

As a final reminder, sleep comfort is first and foremost a matter of personal preference. No one should expect that switching mattresses or beds will cure their lower back pain, and changes in the type of bed or mattress used should be made solely for the sake of comfort when choosing Mattresses for back conditions

The only time during which the muscles, ligaments and other structures in the spine can completely relax is while sleeping. And when a person suffers from a back injury or disorder, it’s especially important to sleep well in order to help the healing process.

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General sleeping guidelines
While there are no absolute rules, there are a few general guidelines about sleeping positions that are most comfortable for the spine:

·         In general, the best sleeping position is to lie on your back with a small pillow tucked underneath the back of the knees. This position completely unloads the stress on the spine and allows for the natural curve of the lower back.

·         For people who prefer sleeping on their side, it is helpful to place a pillow between the knees to help keep stress off the hips and lower spine.

·         For people who sleep best on their stomach, placing a flat pillow beneath the stomach and hips can reduce stress on the spine.

While these guidelines are true in general, the position that is most comfortable to sleep in is again largely dependent individual preferences and on the type of back pain one has.

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Mattresses and sleep positions for back conditions
An important factor that can influence individual preferences for mattresses, beds and sleeping positions is the specific back condition a person has. For example:

·         Osteoarthritis. Patients with pain from osteoarthritis of the facet joints may prefer to sleep on their sides with their knees curled up (in the fetal position). This helps open up the facet joints in the spine and can relieve any corresponding pressure. Alternatively, sleeping in a reclining chair or an adjustable bed that allows the head and knees to be elevated can also relieve pressure on the facet joints.

·         Degenerative disc disease. Patients with pain from degenerative disc disease may prefer to sleep on their stomach as this can relieve pressure on the disc space. Patients may feel most comfortable using a relatively firm mattress and placing a flat pillow under the stomach and hips, which can further reduce stress on the lower back.

·         Spinal stenosis. People with pain from spinal stenosis may prefer to sleep on their sides with their knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Sleeping in a reclining chair or an adjustable bed that allows the head and knees to be elevated can also relieve pressure on the nerve.

·         Bursitis. Patients who have inflammation of the bursa over their hips (greater trochanteric bursitis) can be especially susceptible to pain from a mattress that is too firm. If the mattress is too hard, a new mattress with thick padding on top, or placing an egg crate foam mattress cover over the old mattress, can help provide some relief from the firmness.

·         Hip pain. Patients with hip pain who sleep on their sides can usually find some pain relief by placing a pillow between their knees. This decreases stress across the hip.

·         Herniated lumbar disc. The most comfortable sleep position depends on the position of the disc. For a paracentral disc herniation (most common), patients will tend to do better lying on their stomach. For a foraminal herniated disc, sleeping on the side in a fetal position is usually better tolerated.

In general, elevating the knees slightly by placing a pillow under them while lying on the back can help many general forms of low back pain. Many patients also find that this is the most comfortable way to sleep after spine surgery.

Sleeping in a reclining chair, or an adjustable bed that allows one to put the head and knees up (the semi-Fowler position), can also help people with lower back pain sleep better. Specifically, patients who suffer from conditions in which the pain feels worse when standing up straight and better when bending forward may benefit from a reclining chair or adjustable bed.

Selecting the best mattress

Finding the right mattress for the back
While individual preference is probably the most important factor in determining the best mattress for each person, there are some general rules of thumb in what constitutes a good mattress.

·         In general, most people prefer a firmer mattress that gives the spine more support. While there is no definitive literature that absolutely supports this claim, it makes sense that it is beneficial to have support for the spine while sleeping. It is thought that a mattress should provide support for the spine at all points (along the spine’s natural curves), and keep the spine in the same body position as good standing posture.

·         While a firm mattress is usually good, if the mattress is too hard it can cause aches and pains in pressure points, such as the hips. Patients who have inflammation of the bursa over their hips (greater trochanteric bursitis) can be especially susceptible to aches from a mattress that is too firm. People who sleep on their sides - with pressure points at their hips and shoulders pressed against the mattress - may also feel more sensitive to a firmer mattress.

·         There are no significant external forces on the spine while one is sleeping, so even a firmer mattress, although it probably gives more support, is not absolutely necessary. If one feels more comfortable on a softer mattress, or even a waterbed, it is quite reasonable to sleep on a softer mattress.

As an overall rule of thumb, any mattress that helps a person sleep well, so that he or she wakes feeling rested and refreshed, and without pain and stiffness, is the best mattress for that individual.

Tips on buying a high-quality mattress
Before buying a mattress, it is best to try sleeping on it. People may try different beds in hotels, at other people’s houses, etc. and when they find the best mattress for them, then they buy the same make/model. If it’s not possible to sleep on a mattress first, it’s advisable to at least lie on the mattress in the store until feeling sure that it is a comfortable fit.

There are two main factors that comprise a mattress:

·         Support: The coils or inner springs in the mattress provide support for the spine. A mattress should have enough coils to provide adequate support and allow for the natural curves of the spine.

·         Comfort: The padding on top of the mattress primarily provides the comfort (thick padding may be called “pillow top”). This is really a matter of personal preference - some people prefer thick padding and some thin.

In general, the higher number of coils and the thicker the padding, the higher quality (and more expensive) the mattress. However, this does not mean that it’s necessary to buy the mattress with the highest number of coils and/or thickest padding. As noted on the previous page, mattress preference is dictated by a number of factors, including a person’s specific back condition.

While it is important that a mattress provide an adequate level support for the spine, personal preference and comfort level is the bottom line when selecting a mattress.

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FAQS ABOUT SLEEP AND INSOMNIA CAUSES, SYMPTOMS, CURES, TREATMENTS AND REMEDIES

1. What is sleep?
Sleep is a behavioral state characterized by little physical activity and almost no awareness of the outside world.

Most scientists think that sleep does something important -- something vital for life, although research has not yet identified specifically what sleep does. Nevertheless, we all know when we need to sleep -- we can feel this need. We also know when sleep has done its work -- we feel rested and that we have slept enough. Another important feature of normal sleep is that it can end quickly.

Although a sleeper may appear to be unconscious; unlike someone who is actually knocked-out, anesthetized or in a coma; a sleeping person can be easily awakened and can resume normal waking activity within a minute or two.

Sleep is an active, highly organized sequence of events and physiological conditions. Sleep is actually made up of two separate and distinctly different states: 'non-rapid eye movement sleep' (NREM sleep) and 'rapid eye movement sleep' (REM sleep) or dreaming sleep. The NREM and REM types of sleep are as different from one another as both are different from wakefulness.

NREM sleep is further divided into stages 1 - 4 based on the size and speed of the brain waves generated by the sleeper. Stages 3 and 4 of NREM sleep have the biggest and slowest brain waves. These big, slow waves are called delta waves and stages 3 and 4 sleep, combined, are often called 'slow-wave sleep' or 'delta sleep'.

During REM sleep you can watch the sleeper's eyes move around beneath closed eyelids. Some scientists think that the eyes move in a pattern that relates to the visual images of the dream. We are almost completely paralyzed in REM sleep -- only the heart, diaphragm, eye muscles and the smooth muscles (such as the muscles of the intestines and blood vessels) are spared from the paralysis of REM sleep.

Doctors have tried to determine what type of sleep is the deepest sleep. To do this, they measure how much noise or other alerting stimulation is required to awaken a sleeper from the various types of sleep. It is always possible to awaken someone who is sleeping, as opposed to, say, someone who is in a coma. However, people in stages 3 and 4 sleep require the most stimulation to awaken.

Therefore, this phase of sleep is often thought of as 'deep sleep'. Also, large spurts of growth hormone are secreted during stages 3 and 4 NREM sleep. Consequently, these stages of sleep are thought to restore the body from the wear and tear of waking activity. People in REM sleep also tend to be quite difficult to awaken, but this finding is variable -- sometimes even the slightest noise can awaken a person in REM sleep. Nevertheless, because it is often difficult to awaken a person from REM sleep, many doctors think also of REM sleep as a 'deep' phase of sleep.

There are many theories about the function of REM sleep and dreaming -- ranging from 'safe, socially acceptable, wish fulfillment' to 'consolidation of memories' to 'providing necessary stimulation to the entire nervous system during development'.

Researchers used to think that REM sleep was necessary for normal psychological function, because experimental REM deprivation caused some subjects to behave strangely. The notion that we need REM sleep for our mental health is not accepted now, because, among other reasons, people have uneventfully withstood long and almost complete REM deprivation.

Some experiments have shown that REM deprivation improves depression. However, REM sleep must still do something, because rats will die after 2 - 3 weeks if they are deprived of REM sleep by a special experimental computer that wakes them up each time REM sleep is achieved.

Whatever REM sleep does, it is clear that every aspect of existence from the body's manufacture of proteins to sexual arousal, including orgasm, is influenced by REM sleep. It is likely that the ultimate explanation of REM sleep will be very broad -- not simply focused on one physiologic function.

The following chart is called a hypnogram. Hypnograms are made to summarize sleep laboratory recordings. This particular hypnogram shows how a typical night's sleep for a young, healthy adult is organized. Notice how the night is structured into the various stages of NREM sleep alternating with REM sleep, with most slow-wave sleep occurring in the first part of the night and most REM sleep occurring in the last part.

2. Why do we sleep?
We sleep because we get sleepy and we cannot work if we get too sleepy.

That is the simplest and yet the most profound answer to this question. The scientific truth is, however, that we do not yet know why we get sleepy. We know that all mammals as well as some birds and reptiles sleep.

Many doctors think sleep comes in order to get rid of certain chemicals that build up in our bodies during the day's activities. Brain research in the 1960's and 1970's has identified several molecules involved in cell-to-cell communication within the brain as being important for sleep. More recent work has isolated products of the body's immune system that seem to be sleep-inducers.

However, feeling sleepy is not the whole story. Some timing mechanism is also involved. We know that every living thing composed of cells with a nucleus has a daily cycle of activity and inactivity (if not actual wakefulness and sleep).

The timing and control of the wakefulness-sleep cycle depends on one or more biological clocks in our bodies. These clocks are sensitive to light and have evolved over the ages in close approximation to the 24-hour light-dark cycle of our world.

Thus, sleep seems to be an unavoidable part of human behavior. In humans, sleep is physiologically programmed to come each day, either in one long bout (about 6 - 8 hours each night) or in two shorter bouts (a 5 - 6 hour sleep at night and a 1 - 2 hour nap in the afternoon). The timing of sleep and wakefulness is controlled to a great extent by our exposure to the natural light and dark cycles of the earth.

All humans tend to sleep in the dark and move about in the light. It takes the human body several days to change to a different light-dark schedule such as when one flies from New York to New Dehli. In fact, the influence of light on the timing of sleep is so powerful that doctors are now using exposure to bright light as a treatment to reset the sleep clock of people who have somehow disrupted their schedule.

In the extreme, sleep does seem to be necessary for life. Experimental rats die if they are completely deprived of sleep for longer than 2 - 4 weeks. The cause of death is not at all clear.

The animals undergo multiple organ failure and lose weight despite eating greater than normal amounts of food. The experimental deprivation in rats was done by means of special computers and alarm systems -- it is thought to be impossible for even the poorest of generally healthy human sleepers to lose so much sleep that life is threatened.

However, even moderate sleep loss may not be harmless. Findings from Dr. Eve Van Cauter's lab at the University of Chicago on the effects of sleep restriction give a striking new perspective. She and her collaborators report that after as few as 6 days of restricting sleep to 4 hours per night, normal volunteers show altered metabolism of carbohydrates.

Tests on insulin and leptin levels indicate that the sleep restriction down to 4 hours per night can cause a metabolic pattern best described as prediabetic with increased appetite for foods rich in carbohydrates.

3. How much sleep should I get?
There is no 'normal' amount of sleep. The average amount of sleep for adults is 7 - 8 hours. But the range of nighttime sleep duration must be expanded to between 6 - 9 hours in order to include the large majority of people.

Therefore, a few people feel fine with as little as 5 hours of sleep, while others require more than 10 hours to feel refreshed and alert throughout the day. The amount of sleep you need is that optimum amount which allows you to function throughout the day without feeling drowsy when you sit quietly and try to pay attention to something.

We cannot, for very long, force ourselves to sleep much less or much more than this optimum amount. Several nights of sleeping an hour less than our usual amount will leave us sleepy and ineffective in the day. Conversely, several nights of staying in bed and trying to sleep an hour more than our optimum amount will leave us sleeping poorly with more awakenings -- particularly in the early morning.

Doctors believe that the optimum amount of sleep each person needs to remain alert during the day is biologically different from person to person. To a great degree, our optimum sleep need is determined by heredity. Scientists have found, for instance, that strains of mice can be selectively bred to sleep considerably more or considerably less than the average mouse.

4. Is it true that we need less sleep as we get older?
Probably not. It seems that during infancy and in adolescence there are increases in sleep need, perhaps brought on by developmental changes. However, the best research available indicates that healthy elderly people sleep about as much as they did when they were young adults.

The idea that the elderly sleep less probably comes from the fact that elders often have medical conditions that interfere with their sleep. This is why most elderly people are 'light sleepers' at night, yet they frequently dose-off during the day.

This type of light sleep and dozing pattern is what sleep researchers would expect if a person is awakened again and again while they try to sleep. In fact, research on repetitive sleep disruption, called 'sleep fragmentation', has shown that the rate of sleep disruptions determines whether or not the sleep is felt to be satisfactorily restorative, and whether or not there is proper alertness the next day.

These kinds of studies show that disruptions every minute will greatly reduce the restorative value of sleep. However, disruptions every five minutes will affect restoration much less -- even when total sleep time is the same for the one-per-minute and five-per-minute rates of disruption. Thus, scientists believe that for refreshing sleep, it is not just the total amount of sleep that is important. Sleep must be continuous as well.

5. What is yawning?
Most vertebrate animals exhibit yawning. A yawn consists of widely opening the mouth with a slow inspiration at the beginning and a quick expiration at the end. Yawning is a reflex behavior that can be only partially controlled by our own volition.

The behavior occurs most often when we feel sleepy, bored, and, perhaps, physically fatigued. Yawning can also be triggered by drugs and has been used as a medical index because there are changes in the frequency of yawning in certain disease states.

Scientists have not identified a function of yawning, but, at least in humans, it does seem to be contagious since observers are more likely to yawn when they watch someone else yawn. In this sense, yawning is a type of social behavior that is largely involuntary and controlled by the brain.

6. What about bedroom temperature and sleeping position? Can these things affect sleep?
People sleep best when they are comfortable, physically and mentally.

There is no universal formula for physical and mental comfort. It is best to explore bedroom temperatures, bedclothes, etc. until you find bedroom conditions under which you feel that you sleep the best.

Again, there is no single ideal sleeping position. Most people move through many sleeping postures in the course of a normal night's sleep. Scientists think such movement is good because it prevents pressure-related restriction of circulation.

However, some medical conditions will obviously exclude certain sleeping positions with no ill effects. Furthermore, avoiding some sleeping postures can be helpful. For example, people with breathing problems associated with airway obstruction breathe irregularly and sleep poorly when lying on their backs. Such people often sleep sitting-up as a matter of preference until the condition is effectively treated.

7. Can we make up for lost sleep?
Yes, we can make up for lost sleep, but only to a certain extent. Suppose a man, who usually sleeps 7 hours a night, loses 2 nights of sleep. He will not sleep 21 hours (14 hours longer than usual) on the third night, when he is able to sleep.

After significant sleep loss, we may have more slow-wave sleep for the next couple of nights, but we rarely sleep more than 2 - 4 hours longer than usual. This is because our wakefulness-sleep cycle depends on both our sleep need and our internal timing mechanisms.

Furthermore, experiments with shift work have shown that people who stay awake for a single night and then go to bed at 8 AM, instead of their usual 11 PM, will not simply move their normal sleep to an interval 9 hours later. Rather, their sleep beginning at 8 AM will be shorter and more broken because it is occurring at a biological time when activity usually occurs.

This inability to sleep during certain periods of the day is due to the alerting influences of the biological clock located in the brain’s hypothalamus. What our ancestors previously thought of as a ‘second wind’, is now understood by sleep scientists as clock-dependent alerting.

It is because of complex interplay between sleep deprivation and clock dependent alerting, that sleep losses or shifts in sleep time will have effects for several days.

The figure illustrates this interplay and shows over a period of 48 hours, a two-peak pattern for each day. There is a period with markedly increased sleep tendency in the early morning hours between 3 and 6 AM and a smaller but reliable afternoon peak between 1 and 3 PM.

This is the so-called siesta effect or afternoon slump. Both periods of increased sleep tendency can be exaggerated by sleep promoting factors such as alcohol consumption and sleep deprivation. Errors and reduced productivity peak at the times of maximum sleep tendency.

8. Are there any advantages to taking a nap?
Certain cultures use the siesta very successfully. However, siesta cultures are relatively consistent in napping. In most western cultures, napping is not consistent day after day.

If you want to nap, nap at the same time each day and for the same duration, particularly if you are prone to insomnia. Many people complain about Sunday-night insomnia.

What usually happens in these cases is that the person napped on Sunday from, say, 2 to 5 in the afternoon and then could not get to sleep at the usual time Sunday night. That is why keeping a consistent schedule is the best strategy.

With respect to occasional napping, one important advantage is that even a 30 – 60 minute nap greatly helps a person counter sleep loss. Studies have shown that the first hour or so of sleep is most potent in relieving the effects of missing a night’s sleep.

9. Does meditation change sleep?
Meditation probably will not affect sleep in any significant way. In its most common forms, meditation involves the practice of sitting in some prescribed position with the eyes closed and 'saying' (either audibly or only mentally) a prescribed word or set of words, called mantras.

There are a variety of meditation techniques that are taught by trained individuals for the purpose of improving waking functioning as well as spiritual and physical well-being. These meditation techniques are also claimed to have various effects on sleep such as 'improving sleep', 'reducing the need for sleep' and being an 'alternative to sleep'.

However, scientific studies on meditators have found that most meditation is characterized by the brain wave pattern of quiet, relaxed wakefulness with occasional bouts of NREM sleep.

Thus, the best current studies suggest that any meditation-related shortening of nocturnal sleep probably occurs because the meditator is getting daytime sleep (i.e. is napping) during the act of meditation. There is no evidence that meditation will reduce a person's overall need for sleep. 

10. Can we learn better during sleep?
No. There is no study that shows efficient learning during sleep.

The brain needs to be awake in order to learn, as learning is usually defined. When new information is presented to someone while they sleep, the amount of information that they remember the next morning depends on how long and how many times they were awake during the night -- not on how well they slept.

11. Do we dream during our deepest sleep?
The answer is yes, but only partially yes. The experience which we would all agree constitutes dreaming involves a good deal of action and several senses such as vision, hearing and touch. This type of experience occurs most often in REM sleep.

Here is why the answer is only partially yes: First, some dreamlike experiences can occur during other phases of sleep besides REM sleep. Second, REM sleep cannot really be considered our 'deepest sleep'.

The depth of a particular phase of sleep is best defined in terms of how difficult it is to awaken someone when they are in that particular phase of sleep. What phase of sleep requires the loudest noise, for example?

The two phases of sleep that are 'deepest' -- that is the hardest to wake up from -- are 'slow wave sleep' (stages 3 and 4 of NREM sleep combined, is called 'slow wave sleep' because of the big, slow brain waves seen then) and REM sleep. Dreams rarely occur in slow wave sleep and frequently occur in REM sleep.

12. Do people in other countries and cultures sleep differently?
The basic physiology of human sleep does not seem to vary much from race to race or culture to culture. However, there are effects of culture and climate.

For example, many equatorial cultures have the institution of an afternoon siesta which breaks sleep into a short afternoon bout and a longer nighttime bout. People in siesta cultures seem to sleep about the same amount as those in other cultures.

There also are studies showing profound seasonal changes in sleep. The largest seasonal changes occur in the polar regions, where there are great changes over the year in the length of the light interval in the day with long light periods increasing the tendency for the daily schedule to have two sleep bouts.

13. Does your body size affect your sleep?
There seems to be no direct effect of body size on sleep. Assuming that the length and width of the sleeping surface is of appropriate dimensions, small people sleep just as much as, and just as well as, large people of comparable ages.

However, if body size restricts the normal body movements during sleep or the ability of the diaphragm to move during respiration, such as is common with extremely overweight people, then sleep can be profoundly disturbed.

14. What are the best ways for most of us to get a good night's sleep?

Here are ten sensible rules for a good night's sleep:

1. Stick to a regular schedule of going to bed and getting up at the same time every day.

2. Be consistent about taking naps. Take one every afternoon or none at all. People who take a nap once in while usually find they do not sleep well that night.

3. Exercise regularly in the morning or early afternoon, but do not engage in strenuous physical activity just before bedtime.

4. Stay away from caffeine-containing drinks after about 4 p.m.

5. Avoid alcohol after the dinner hour. Instead of promoting sleep, a nightcap actually disturbs sleep patterns and can cause early morning awakenings.

6. Be careful about sleeping pills. These medications should not be taken for more than four weeks. Longer use leads to increased insomnia.

7.  Find the right room temperature for you and maintain it throughout the night.

8. Try to relax before going to bed. Take a warm bath, read a light novel, listen to music, avoid stressful thoughts.

9. Do not eat heavily just before going to bed.

10.  If you cannot sleep at night, do your best to preserve your usual 24-hour cycles of activity-rest and exposure to light and dark. For example, do not get up, turn on bright lights and read or exercise. It is best to remain reclining in the dark and listen to music or an audio book.

Insomnia

• What is insomnia?
• What are the different types of insomnia and what causes them?
• Do women suffer from insomnia more than men?
• How is insomnia diagnosed?
• How is insomnia treated?
• What can I do to sleep better?

What is insomnia?

Insomnia is too little or poor-quality sleep caused by one or more of the following:

• Trouble falling asleep
• Waking up a lot during the night with trouble returning to sleep
• Waking up too early in the morning
• Having un-refreshing sleep (not feeling well rested), even after sleeping 7 to 8 hours at night

Insomnia can cause problems during the day, such as excessive sleepiness, fatigue, trouble thinking clearly or staying focused, or feeling depressed or irritable. It is not defined by the number of hours you sleep every night. Although the amount of sleep a person needs varies, most people need between 7 and 8 hours of sleep a night.

What are the different types of insomnia and what causes them?

Insomnia can be:

• Transient (short term) insomnia lasts from a single night to a few weeks.
• Intermittent (on and off) insomnia is short term, which happens from time to time.
• Chronic (on-going) insomnia occurs at least 3 nights a week over a month or more.

Chronic insomnia is either primary or secondary:

• Primary insomnia is not related to any other health problem.
• Secondary insomnia can be caused by a medical condition (such as cancer, asthma, or arthritis), drugs, stress or a mental health problem (such as depression), or a poor sleep environment (such as too much light or noise, or a bed partner who snores).

Do women suffer from insomnia more than men?

Women are twice as likely to suffer from insomnia than men.

Some research suggests that certain social factors, such as being unemployed or divorced, are related to poor sleep and increase the risk of insomnia in women. Also, insomnia tends to increase with age.

Sometimes perimenopausal (the time leading up to menopause) women have trouble falling asleep and staying asleep; hot flashes and night sweats often can disturb sleep. Pregnancy also can affect how well a woman sleeps.

How is insomnia diagnosed?

If you think you have insomnia, talk to your doctor. It might be helpful to complete a sleep diary for a week or two, noting your sleep patterns, your daily routine, and how you feel during the day.

Discuss the results of your sleep diary with your doctor. Your doctor may do a physical exam and take a medical history and sleep history. Your doctor may also want to talk to your bed partner to ask how much and how well you are sleeping. In some cases, you may be referred to a sleep center for special tests.

How is insomnia treated?

If insomnia is caused by a short-term change in the sleep/wake schedule, as with jet lag, your sleep schedule may return to normal on its own.

Treatment for chronic insomnia includes:

• Finding and treating any medical conditions or mental health problems.
• Looking for routines or behaviors, like drinking alcohol at night, that may lead to the insomnia or make it worse, and stopping (or reducing) them.
• Possibly using sleeping pills, although controversy surrounds the long-term use of sleeping pills. You should talk to your doctor about the risks and side-effects.
• Trying one or more methods to improve sleep, such as relaxation therapy, sleep restriction therapy, and reconditioning.

1. Relaxation Therapy. This type of therapy aims to reduce stress and body tension. As a result, your mind is able to stop "racing," the muscles can relax, and restful sleep can occur.
2. Sleep Restriction. Some women suffering from insomnia spend too much time in bed trying to fall asleep. They may be helped by a sleep restriction program under the guidance of their doctor. The goal is to sleep continuously and get out of bed at the desired wake time. This treatment involves, for example, going to bed later or getting up earlier and slowly increasing the amount of time in bed until the person is able to sleep normally throughout the night.
3. Reconditioning. This means using your bed only at bedtime when sleepy or for sex. Avoid other activities in your bed, such as reading or watching TV. Over time, your body will relate bed and bedtime with sleep.

What can I do to sleep better?

Try to go to sleep at the same time each night and get up at the same time each morning. Do not take naps after 3 p.m.

Avoid caffeine, nicotine, and alcohol late in the day or at night.

Get regular exercise. Exercise during the day--make sure you exercise at least 5 to 6 hours before bedtime.

Make sure you eat dinner at least 2 to 3 hours before bedtime.

Keep your bedroom dark, quiet, and cool. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a "white noise" machine to cover up the sounds.

Follow a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath.

If you can't fall asleep within 20 minutes or don't feel drowsy, get up and read or do something that is not too active until you feel sleepy. Then try going back to bed.

If you lay awake worrying about things, try making a to-do list before you go to bed.

Use your bed only for sleep and sex.

For some more information...

Call the National Women's Health Information Center at 1-800-994-9662 or contact the following organizations:

National Center on Sleep Disorders Research
NHLBI Health Information Center
Phone Number(s): (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov/sleep

American Insomnia Association
Phone Number(s): (708) 492-0930
Internet Address: http://www.americaninsomniaassociation.org/

National Sleep Foundation
Phone Number(s): (202) 347-3471
Internet Address: http://www.sleepfoundation.org/

ANOTHER POSSIBLE CAUSE OF INSOMNIA: DELAYED SLEEP PHASE SYNDROME

What is Delayed Sleep Phase Syndrome (DSPS)?

It is a disorder in which the major sleep episode is delayed by 2 or more hours of the desired bedtime. This causes difficulty awakening at the desired time.

What are the symptoms?

• Complaint of insomnia or excessive sleepiness
• inability to fall asleep at the desired time
• inability to wake up at the desired time
• Depression may be present
• This sleep pattern has been present for 3 months

Associated features:

The DSPS patients are usuall perplexed that they cannot find a way to fall asleep more quickly. Their efforts to advance the timing of sleep onset such as going to bed early, having a friend or family member get them us in the morning, trying relaxation techniques or using sleeping pills is not permanently successful.

They often describe sleeping pills in normal doses as having little or no effect in helping them fall asleep. Sometimes the pills only aggravate the daytime symptoms of difficulty awakening and sleepiness.

DSPS patients typically are "owls" or "night people" and say they feel and function best and are more alert during the late evening and night hours.

If a sleep-wake log is kept, it usually shows a pattern of bedtime later than 2 a.m., few or no awakenings once they fall asleep, shorter sleep periods during the work/school week and lengthy (9-12 hour) sleeps with late morning to mid-afternoon wake up times on the weekend.

Depression or other psychiatric problems are present in about half of the adult DSPS patients, which is about the same for people that suffer from other forms of insomnia.

At what age does DSPS begin to show up?

Many DSPS patients report that their difficulties began after a period of late night studying or partying, or after employment on the evening or night shift. Following these activities, they found it impossible to sleep on a normal schedule even when they resumed normal work or school hours. Adolescence appears to be the most common period of life for the onset of DSPS, but childhood cases have been reported. It is rare for it to begin after age 30.

Adolescents and DSPS

• In adolescents, failure to cooperate with a plan to reschedule the patient's sleep may be a sign of clinical depression.
•  
• Adolescence seems to be a particularily vulnerable life stage for the development of the syndrome.
• One study of adolescents suggested a 7% prevelance in this age group.

How can it be treated? Some ideas are:

• Improve sleep hygiene habits
• Bright Light Therapy
• Chronotherapy
• Melatonin or other natural sleep inducers

EXTRA TIPS ON HOW TO SLEEP WELL

      CAN'T SLEEP?

Nothing is more frustrating than not being able to sleep. Tossing and turning. Your mind is racing, going over everything that happened today. Night noises keep you awake. What can you do? There ARE things you can do! Read on and learn some new tricks to sleep well. These tips are also known as "Sleep Hygiene."

• Sleep only when sleepy

This reduces the time you are awake in bed.

• If you can't fall asleep within 20 minutes, get up and do something boring until you feel sleepy

Sit quietly in the dark or read the warranty on your refrigerator. Don't expose yourself to bright light while you are up. The light gives cues to your brain that it is time to wake up.

• Don't take naps

This will ensure you are tired at bedtime. If you just can't make it through the day without a nap, sleep less than one hour, before 3 pm.

• Get up and go to bed the same time every day

Even on weekends! When your sleep cycle has a regular rhythm, you will feel better.

• Refrain from exercise at least 4 hours before bedtime

Regular exercise is recommended to help you sleep well, but the timing of the workout is important. Exercising in the morning or early afternoon will not interfere with sleep.

• Develop sleep rituals

It is important to give your body cues that it is time to slow down and sleep. Listen to relaxing music, read something soothing for 15 minutes, have a cup of caffeine free tea, do relaxation exercises.

• Only use your bed for sleeping

Refrain from using your bed to watch TV, pay bills, do work or reading. So when you go to bed your body knows it is time to sleep. Sex is the only exception.

• Stay away from caffeine, nicotine and alcohol at least 4-6 hours before bed

Caffeine and nicotine are stimulants that interfere with your ability to fall asleep. Coffee, tea, cola, cocoa, chocolate and some prescription and non-prescription drugs contain caffeine. Cigarettes and some drugs contain nicotine. Alcohol may seem to help you sleep in the beginning as it slows brain activity, but you will end end up having fragmented sleep.

• Have a light snack before bed

If your stomach is too empty, that can interfere with sleep. However, if you eat a heavy meal before bedtime, that can interfere as well. Dairy products and turkey contain tryptophan, which acts as a natural sleep inducer. Tryptophan is probably why a warm glass of milk is sometimes recommended.

• Take a hot bath 90 minutes before bedtime

A hot bath will raise your body temperature, but it is the drop in body temperature that may leave you feeling sleepy. Read about the study done on body temperature below.

Trouble Sleeping? Chill Out! - A press release from the journal Sleep about the significance in body temperature before sleep

• Make sure your bed and bedroom are quiet and comfortable

A hot room can be uncomfortable. A cooler room along with enough blankets to stay warm is recommended. If light in the early morning bothers you, get a blackout shade or wear a slumber mask. If noise bothers you, wear earplugs or get a "white noise" machine.

• Use sunlight to set your biological clock

As soon as you get up in the morning, go outside and turn your face to the sun for 15 minutes.

Insomnia: More Causes And Cures

Twenty five percent of adults and 50% of senior citizens have insomnia problems. Insomnia is also a problem that is prevalent among people with HIV/AIDS.

The purpose of sleep is to allow the body to repair and rejuvenate. Sleep also reduces fatigue and stress. Dreaming helps to clear the nervous system.

There are five distinct stages of sleep. Stages 1 & 2 are considered light sleeping which takes place the majority of the night. Stages 3 & 4 are deep sleeping or "delta sleep " and rest and restoration. Stage 5 is the dream state which generally involves rapid eye movement or REM.

Patterns of sleep generally look like this: light sleep - deep sleep - REM - light sleep - deep sleep - rest and restoration. The first period of light sleep lasts about 45 minutes.

Insomnia problems include: You can't get to sleep. You wake up in the middle of the night, and can't go back to sleep. And waking up too early, between 3:00 and 5:00 a.m., and you can't get back to sleep.

The 24 hour cycle (12 on, and 12 off) is called "Circadian Rhythms ". When it gets dark, the body clock stimulates the Pineal gland which produces melatonin. Bright light or sunshine shuts off melatonin production.

Causes of chronic insomnia associated with psychological problems can be deeply rooted in stress, anxiety and/or depression. Insomnia associated with medical problems can be caused by a variety of things including: iron deficiency anemia, breathing disorders, kidney dysfunction, diabetes, and in the case of HIV, can be associated with a variety of medication side effects. Insomnia can also be due to poor eating habits, caffeine, & lack of exercise.

Open The Sleep Gate

Reduce intake of caffeine. More than 300 milligrams (about 3 cups of coffee) a day can lead to addiction. Caffeine is also found in colas, chocolates, and some medications. It can take a long time to clear caffeine from the body and side effects of headaches in the morning and urinating at night are common.

Limit intake of alcohol. Alcohol can cause fractured sleep, therefore reducing the total amount and quality of your sleep time. Eliminate or reduce cigarette smoking, nicotine is a stimulant to the brain. Increase daytime exposure to the sun and avoid bright lights at night.

Changes In Eating

You may want to try eating things that raise your melatonin production. Suggested intake includes: spirulina seaweed, soy nuts, cottage cheese, chicken, pumpkin seeds, turkey, and dried watermelon seeds. Melatonin rich foods include: oats, sweet corn, rice, ginger, tomatoes, bananas, and barley.

Some life-style changes can also help you to sleep better. For example cutting down your sleep time. Different people need varying amounts of sleep. If you only need 7 hours but are sleeping 9 hours, the 7 hour sleep spreads over 9 hours and becomes ineffective. You may try increasing daytime exposure to sunlight by getting out earlier. Often exercising can help or even spending time in meditation or prayer.

Often medications that are prescribed for sleep can disrupt or eliminate the sleep cycle as described. These include: Doral, Halcion, Restoril, Valium, and Xanax. Antihistamines can also cause sleep depravation.

Some vitamins and minerals such as B6, niacin amide, calcium, magnesium, or antioxidants may help. Other herbal remedies to consider are Valerian root, Skullcap, Passion flower, Wood betony, or California poppy.

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We spend about one third of our lives sleeping. But how many of us actually pay attention to how we're doing it?

If you've got neck or back pain, restless legs or have just had a hard day, you might be sleeping with the enemy. Making a few quick adjustments in your mattress, pillows and the way you position your body in bed, however, can make a big difference, doctors and sleep experts say.

"Most people don't know how poor their sleep is until they get a good mattress," says a spinal medical expert and chair of an orthopedics department in Vero Beach, Fla.

Underlying Problem of Sleep

Ignoring aches and pains caused by a worn-out mattress or poor sleeping habits can exacerbate the problem.

People who wake up with a stiff neck over time may end up with arthritis and can develop bony spurs that pinch the nerve roots reaching from the neck to the arms, a doctor says. He recommends for people who sleep in the fetal position to place a pillow between their knees, which takes the stress off their lower backs and hips. Those who sleep on their backs should place a pillow under their knees.

Resting your head on more than one pillow is a bad idea because it puts the neck in an awkward position.

Benjamin suggests using a contoured or cervical pillow, which supports the neck with a gentle C-shaped curve.

Be Choosy When It Comes to Sleep and Insomnia

When it comes to mattresses, the most important factors are support and comfort. The mattress should be as firm as you can tolerate, keeping your body in a better position.

"That's why when you go to your grandmother's house and the bed is older than you, your back ends up killing you," Benjamin says. "The mattress is worn out."

To choose a firm bed that's most comfortable, figure out whether you want a pillow top, an added layer of foam, cotton or wool.

An executive director of the nonprofit Better Sleep Council says people should reevaluate a mattress every five to seven years, depending on its quality. At that point, the mattress might start showing signs of wear and tear and it's likely your body has changed too.

"As you age, you tend to get extra aches and pains, maybe gain some weight [or] gain or lose a sleep partner," Shark says. "That could have an impact on the type of comfort and support you need."

Helpful Hints Regarding Sleep and Insomnia

One useful guide is the SLEEP test--select a mattress, lie down in your typical sleep position, evaluate its comfort and support, educate yourself about the selection and shop with your partner to make sure the bed suits you both.

But how much should you spend? As much as you want, it turns out, since spending more is no guarantee you're getting a better product. Just make sure its one you can live with for a long time.

"Sometimes people don't think twice--they'll go and enjoy a day at a spa or do a weekend getaway to relax," Shark says. "But for probably less money, they could get a mattress on which they could get a great night's sleep all-year round."

41 More Tips for Getting to Sleep, including some I'm quite sure you've never seen before. They're all designed to help you deal with tension, stress and anxiety, and to enjoy a good night's sleep. Not every one of these techniques alone will get you to sleep, but a few of them at least should prove successful. Needless to say, there's no guarantee, and no attempt to provide medical advice. With that caveat out of the way, I can only wish you good luck. And a good night's sleep. Techniques you've probably already tried but are still worth trying again. See a Doctor Insomnia can be a symptom of physical disorders, although for most of us it's the result of tension, stress and anxiety -- and of course the more anxious we get about our insomnia, the worse it gets. If your doctor pronounces you a "healthy" insomniac, he might suggest some of the techniques provided here. Or she might prescribe drugs to help you get to sleep. We suggest you try all these methods first, and use drugs only as a last resort. The decision, of course, is yours. Take a Warm Bath It's a great way to relax your body. Don't overdo it, however. You merely want to relax your body, not exhaust it. Too long in hot water and your body is drained of vitality. Use bath salts, or throw in Epsom salts and baking soda -- one cup of each. These will relax you and also help remove toxins from your body. Get a Massage Have your spouse (or whoever) give you a massage just before going to sleep. If you can convince them to give you a full body massage, great. If not, even a short backrub and/or a face and scalp massage can be a big help. Have them make the massage strokes slow, gentle, yet firm, to work the tension out of your muscles and soothe you to sleep. Listen to Music Play some soft, soothing music that will lull you to sleep. There are even cassettes and records designed for that very purpose. Some are specially composed music, others simply have sounds of waves rhythmically breaking, or the steady pattern of a heartbeat. Of course if you don't have a record, cassette or CD player that will automatically turn off, we don't suggest this. If you have to get up and turn it off at the end, you've obviously lost its effect. Drink Warm Milk A glass of warm milk 15 minutes before going to bed will soothe your nervous system. Milk contains calcium, which works directly on jagged nerves to make them (and you) relax. Drink Herb Tea If you don't like milk - or are avoiding dairy products - try a cup of hot camomile, catnip, anise or fennel tea. All contain natural ingredients which will help you sleep. Most health food stores will also have special blends of herb tea designed to soothe you and help you get to sleep. Eat a Bedtime Snack A small, low protein, high carbohydrate bedtime snack, such as juice and cookies, eaten about an hour before bedtime, can help you fall asleep sooner. (Pizza does not qualify.) On the other hand: Studies indicate that foods with large amounts of the amino acid L-tryptophan help us sleep better. These include warm or hot milk (but not cold milk), eggs, cottage cheese, chicken, turkey and cashews. Try both food theories, and see which works best for you. Avoid Caffeine, Alcohol and Tobacco It should be obvious, but some people forget that coffee is not the only drink containing caffeine. Tea (black, not herbal), chocolate and cola drinks are also high in caffeine. Alcohol may feel like it's soothing you, but all it's doing is stupefying you. Research has shown that alcohol upsets sleep, preventing a deep rest. Same with tobacco. Avoid them all. Sleep in a Well-Ventilated Room Fresh air (we know - it's hard in the wintertime) and a room temperature between 60-65 degrees will give you the best sleeping conditions. Any warmer and you'll toss and turn from the discomfort of being too warm. Keep the thermostat down and do your temperature-adjusting inside the bed -- with more or fewer blankets. Sleep on a Good Firm Bed A firm bed will give your entire body the support it needs to really relax. It's better for your spine, too. Sleep on Your Back It's the best position for relaxing, and allows all your internal organs to rest properly. If you must sleep on your side, do it on your right side, not your left. Sleeping on the left side causes your lungs, stomach and liver to press against your heart, causing stress on an organ that most of us find quite useful. Never -- ever -- sleep on your stomach. It causes pressure on all your internal organs -- including your lungs, which results in shallow breathing. It can also, as you've no doubt discovered, cause a stiff neck and upper back problems. Get Some Physical Exercise During the Day People with "mental" jobs, like office workers, have far more trouble with insomnia than do people who work physically hard all day. Even 15 minutes a day of exercise (at least half an hour before going to bed so your body will have a chance to slow down) will give your body the activity and oxygen it needs to help you relax more and sleep better. Keep Regular Bedtime Hours Your body likes regular routines, whether you do or not. It likes to know that it's going to get up at the same time each day, eat at the same times, and go to bed at the same time. Not very exciting, maybe, but comfortable. So pick a reasonable and regular time to go to bed each night. And stick to it. Even if you don't think you're tired when the time comes. Your body will appreciate it. And after a while when it feels it can rely on the routine, it will begin to repay the favor by letting you get to sleep when you want. If You Can't Sleep, Get Up Don't lie awake trying to get to sleep any longer than 30 minutes. If it goes that long, get up. Do something quiet and non-stimulating. When you feel tired again, go back to bed. Don't Sleep In Get up at the same time every day, even on weekends and holidays. Once you've awakened, get up. Don't lie in bed awake, thinking about getting up. Just do it. Get Up Earlier in the Morning At least try this when you're trying to set up your new regular bedtime routine. As much as you may hate getting up one-half hour earlier (or even more) than you really have to, you'll be that much more tired at night and more apt to get to sleep. Once you and your body have the confidence that you can get to sleep when you want at night, you can go back to your preferred wake-up-in-the-morning time. Keep Your Bed a Place for Sleep Okay, and maybe for one other thing. But not for working, reading, watching television, doing crossword puzzles, or whatever else occupies you in the evening. Let your mind and body identify bed with sleeping. Avoid Naps Sure, they're nice to do during the day, and if you couldn't sleep at night, you're grateful for any chance to sleep. But if you're really having trouble sleeping at night--and you're not a senior citizen who sleeps for small periods of time, skip naps. You'll be more tired at bedtime and more able to fall asleep. Avoid Illuminated Bedroom Clocks Try to keep your bedroom as dark as possible. An illuminated bedroom clock is a source of light that can be extremely annoying if you're having a hard time getting to sleep. If you can't replace the clock, at least block its light with something. Of course there's the standard technique that everyone knows (although it never worked for us) Counting Sheep We finally figured out why it never worked for us. The old wives' cure for insomnia is to count bouncy little sheep leaping over a fence. No wonder it doesn't work. Bouncy sheep are hyperactive and wide awake. They're the last thing you need to dwell on when you want to go to sleep. So try the variation that worked for us. Count sleeping sheep. Imagine a beautiful green meadow stretching to infinity. Every ten feet or so, right in a row, lies a peaceful, sleeping sheep. Imagine that you're just gliding by, almost floating. And that you pass by a sheep every 3 or 4 seconds (experiment to find which time interval works best for you -- it varies from person to person). Count the sheep and glide on to the next, and the next, and so on. Take it from us. Sleeping sheep are much more effective. Some techniques you probably haven't seen before Sleep with Your Head Facing North And, obviously -- unless you have a particularly unusual body -- your feet facing south. This aligns your body with the magnetic field of the planet, bringing your own energies into harmony with those of the Earth. Sound like a pretty bizarre theory? Try it. You'll see what a difference it makes. Don't Watch TV or Read Before Going to Bed Wait at least one-half hour (preferably longer) before going to bed after reading or watching television. We know; some people say that reading a detective story or some such escapist book helps put them to sleep. If it works for them, great. But it seldom worked for us. And it probably hasn't worked for you either. The reason is that no matter how passively we watch television, or how innocuous the book we read is, our minds are still being stimulated. And an overstimulated mind -- along with anxiety and stress -- is what keeps us awake. It's all those thoughts in our head we have to get rid of before we can get to sleep. The last thing we need is more input into our heads from television or books. Toe Wiggling A relaxed body is essential for a sound sleep. This may sound like we're contradicting what we just said about our minds keeping us awake, but it's no contradiction. Eastern sciences (such as yoga) have known for thousands of years that the mind and body are connected (actually they're not just connected, they're one, but the idea that they're connected is sufficient for our purposes here.) So if the mind is not relaxed, the body is not relaxed. Conversely, the body has to be relaxed for the mind to be relaxed. It's a package deal. So how do you relax your body? We've already mentioned milk, herbal teas, exercise, and avoiding caffeine. But there are techniques you can do directly with your body. Toe Wiggling is one of them. Lie on your back (where you should be in the first place) and wiggle your toes up and down 12 times, wiggling the toes of both feet at the same time. This will relax your entire body, inside and out. How does it work? According to the science of Reflexology -- which has been around in other cultures for thousands of years -- your feet are a kind of master control panel for the rest of your body. "Meridians" in the body -- which are those channels of energy treated by acupuncture -- end up in the feet. So the ends of those meridians in your feet connect with every organ and every part of your entire body. When you wiggle your toes, you are stimulating -- and thus relaxing -- your entire body. (Incidentally, this is a good place to mention that you can be energized and relaxed at the same time. It's a matter of the quality of that energy. If it flows freely and smoothly, you will be relaxed. If the energy flow in your body is restricted or blocked, you will be tense. And toe wiggling helps to bring about a relaxing, free-flowing energy.) Note: This same exercise is also great first thing in the morning before getting out of bed in order to energize the body. Stomach Rub This soothes down the digestive system and helps to bring about a deeper relaxation. An extra benefit is that it will help you to lose weight by improving the functioning of the digestive system. Simply lie on your back and place your hand on your navel. Begin to make small circles in a clockwise direction as you gently glide your hand over your stomach. Let your circles gradually become bigger and bigger. When your circles reach the outside of your stomach, gradually reduce their size until you are back at your navel again. Then reverse the direction (to counter-clockwise) and do the same thing again. Repeat this whole series with your other hand. Do this several times. Note: Food material moves through the colon in a clockwise direction. If you have trouble with constipation, make all your circles clockwise. If troubled by diarrhea, make all your circles counter-clockwise. Clockwise circles will alleviate the blockage, counter-clockwise circles will help solidify fecal material. Progressive Relaxation This exercise is most effective when you tape record the instructions in advance, preferably in your own voice. This way you don't have to concentrate on remembering the instructions. We'll give you the instructions here. You tape record them, with a short pause after each sentence to allow yourself time to actually do the sensing and relaxing. Lie on your back, close your eyes, and begin to listen to the tape. 1. Feel your feet. Feel the weight of your feet. Feel your feet relax and sink into the bed. 2. Feel your lower legs. Feel the weight of your lower legs. Feel your lower legs relax and sink into the bed. 3. Feel your knees. Feel the weight of your knees. Feel your knees relax and sink into the bed. 4. Feel your upper legs. Feel the weight of your upper legs. Feel your upper legs relax and sink into the bed. 5. Feel your hands. Feel the weight of your hands. Feel your hands relax and sink into the bed. 6. Feel your lower arms. Feel the weight of your lower arms. Feel your lower arms relax and sink into the bed. 7. Feel your elbows. Feel the weight of your elbows. Feel your elbows relax and sink into the bed. 8. Feel your upper arms. Feel the weight of your upper arms. Feel your upper arms relax and sink into the bed. 9. Feel your buttocks. Feel the weight of your buttocks. Feel your buttocks relax and sink into the bed. 10. Feel your back. Feel the weight of your back. Feel your back relax and sink into the bed. 11. Feel your pelvic and belly area. Feel the weight of your pelvic and belly area. Feel your pelvic and belly area relax and sink into the bed. 12. Feel your chest. Feel the weight of your chest. Feel your chest relax and sink into the bed. 13. Feel your shoulders. Feel the weight of your shoulders. Feel your shoulders relax and sink into the bed. 14. Feel your neck, both front and back. Feel the weight of your neck. Feel your neck relax and sink into the bed. 15. Feel your skull. Feel the weight of your skull. Feel your skull relax and sink into the bed. 16. Feel your mouth. Feel any tension in your mouth. Feel your mouth relax and any tension slide off into the bed. 17. Feel your eyes. Feel any tension in your eyes. Feel your eyes relax and any tension slide off into the bed. 18. Feel your entire face. Feel any tension in your face. Feel your face relax and let any tension slide off into the bed. 19. Mentally scan your body. If you find any place that's still tense, relax it and let it sink into the bed. Deep Breathing One of the main reasons many of us are tense is our breathing. Most people breathe very shallowly, using only the top part of their lungs. Deep Breathing allows us to use our entire lungs, providing more oxygen to our bodies, and energizing and rejuvenating every organ and cell in our bodies. It is probably the most effective and beneficial method of relaxation we've seen. 1. Lie on your back. 2. Slowly relax your body, starting with your feet and moving through every part of your body until you have reached -- and relaxed -- your face and scalp. 3. Do a quick check to see if you've missed any place. If so, relax it. 4. Slowly begin to inhale, first filling your lower belly, then your stomach area, and then your chest and the top of your lungs almost up to your shoulders. Hold for a second or two, then begin to exhale. Empty the very bottom of your lungs first, then the middle, then finally the top. 5. Continue this breathing for 4 or 5 minutes. Don't force your breathing; it's not a contest to see how much air you can take in. Just do it in a relaxed, peaceful manner. 6. After a while, imagine that you are resting on a warm, gentle ocean. The sun is shining peacefully on your body. Imagine that you rise on the gentle swells of the water as you inhale, and that you slowly descend as you exhale. 7. Continue this relaxing breathing as long as you wish (hopefully until you fall asleep). Note: This is particularly effective when you do it after Progressive Relaxation -- if you haven't already fallen asleep! Visualize Something Peaceful Just lie there with your eyes closed and imagine you're in your very favorite, most peaceful place. It may be on a sunny beach, swinging in a hammock in the mountains or your back yard, or all alone in a cave in the Himalayas. Wherever it is, imagine you are there. You can see your surroundings, hear the peaceful sounds, smell the fragrance of the flowers, and feel the warmth of the sun or whatever sensations are there. Just relax and enjoy it -- and drift off to sleep. Once you've found a place that's especially peaceful and effective, you'll find that the more you use it, the more you can count on it to help you relax and get to sleep. Its comfort and familiarity will make it more and more effective. Visualize Something Boring We like this one in particular. The beauty of it is you can turn a negative into a positive. Just visualize that you are someplace that you have always found extremely boring. It could be listening to a particular teacher who was so boring that he or she almost always put you to sleep. Perhaps it's some friend or acquaintance whose incessant talk and theories put you to sleep. Maybe it's your work, maybe it's your commute each day. Whatever it is, visualize it. And recapture that bored, tired, heavy, sleepy feeling that you always experience. Let that feeling spread through your mind and all through your body till you're filled with complete tiredness and sleepiness. It works. Imagine It's Time to Get Up This is a neat one too. Kind of a variation on the previous technique. Imagine that you're not allowed to go to sleep. Imagine that your morning alarm has gone off and it's time to get up and go to work. You know how delicious that feeling is in the morning when it's time to get up but you're so tired and your eyes are very heavy and you shouldn't do it but you just want to fall right back to sleep for a few minutes more? Well, we find you can often bring that about just by imagining as fully and realistically as possible that it's morning, that you have to get up, put your feet on a cold floor, stagger around the house, take a cold shower, and do whatever unpleasant things you associate with getting up in the morning. The more unpleasantly you can imagine it, the more you won't want to do it. And the more you'll just want to stay in bed and sleep. Try it. You'll be surprised how tired and sleepy your mind can make your body. Quiet Ears This technique is an ancient Eastern meditation as well as a great way to fall asleep. 1. Lie on your back with your hands behind your head, fingers interlocked, and your palms cupping the back of your head. Get as relaxed as possible (This position make take a little while to get used to). 2. Place your thumbs in your ears so that you are pressing the outer flap of your ear and blocking the entrance to the ear canal. 3. Lie quietly and listen for a high-pitched sound that you will gradually hear inside your head. 4. Lie there for 10 to 15 minutes and concentrate on that sound. Then put your arms to your sides and go to sleep. (Don't worry about all the stories of people who have ringing in their ears. This is different -- and natural.) And some new suggestions from readers Not Thinking "I have one method that never fails to put me to sleep. As long as I'm 'decently' tired, i.e., not trying to overdo it, it's bedtime, etc., I just lie down, close my eyes, and concentrate on 'not thinking'. This often becomes a competition of my strength of will versus my instinct to think. Occasionally a pinprick of an idea strikes you, but you just have to ignore it, and it always puts me to sleep in about two minutes. It's better then just lying there. "- Lance Yawning "Force yourself to yawn two or three times. This followed by the relaxation exercises you discuss will help signal your mind that it is time for sleep. Thanks for the good advice." - Joaquin Backwards Counting / Mental Computer "Even though I am only a kid, I still have problems falling asleep sometimes. Usually, all I have to do is count backwards from 1,000, taking a deep breath in between each number, as far as it takes to get to sleep." Another mental exercise to use is to mentally 'type' in your worries onto a mental computer, such as 'fear', 'stress', and 'anxiety'. Then hit the delete key until the entire "screen" is blank." I know many adults often say, 'I wish I was as carefree as a kid,' but it really isn't that easy to be a kid! Thank you so much for the suggestions!" - Anonymous South, Not North "I suggest you amend the tip on "sleeping with the head pointing North". It has long been known in India that sleeping this way is damaging to mind and body, and that burying the dead with the head pointing northward makes the body decay more quickly. The premise is that the body can be seen as a large magnet, with the head as the north pole and the feet as the south pole. Since unlike poles attract, it is best to have the feet (south pole) facing North. This results in minimal blood circulation and low activity in the brain, and therefore more restful sleep."- Ron Earplugs "How about plain old-fashioned earplugs? I finally figured out that the reason I couldn't relax into sleep was that I was being kept irritated and awake by the crickets chirping outside my window. Earplugs work! And they're inexpensive, too." - Vanessa Secure Place "A technique that I have found most useful is to envision myself in some ideal spot: a house, say, that is perfectly secure and warm while a blizzard rages outside. I picture a window next to my bed, with snow striking against it. Then I work out the layout of the house, the heating system, the surroundings; and I make them all ideal so that the idea of security and no disturbing thoughts can intrude."- Edward Bedtime Routine "It helps to develop a bedtime routine. Have a series of things that you always do when going to sleep. For example, before going to bed, feed the dog, fold laundry, check the locks. Humans are creatures of habit. Remember the guy with the dogs? He rang a bell and they knew it was dinnertime. It's the same theory. Doing this will 'program' your body to know that it's bedtime." - Erinn Hot Water Bottle "To help you sleep after a high stress day, lie down with a hot water bottle on your stomach, close your eyes and breath deeply, so the bottle rises and falls. We carry a lot of tension there and the weighted heat releases it." - Elaine Green Cows—and Other Animals of Color "Actually, I feel a little silly passing this along since I'm up right now with, well, insomnia. But, a technique I've generally had good success with is to visualize animals in the wrong colors. For example, blue cat, green cow, red elephant, and so on. After coming up with a color/animal combination I try to actually visualize it and then I move on to the next one. Coming up with the combinations and then trying to picture the animal seems to keep my mind occupied and distracted from whatever stressful thoughts were keeping me awake and it gets boring enough that I can generally fall asleep pretty quickly. I've shared this with two coworkers with insomnia and they've reported that it helped them as well." - Candace "What is the secret to getting a solid 7 to 8 hours of sleep? Head for the kitchen and enjoy one or two of these 10 foods. They relax tense muscles, quiet buzzing minds, and/or get calming, sleep-inducing hormones - serotonin and melatonin - flowing. Yawning yet? Bananas. They're practically a sleeping pill in a peel. In addition to a bit of soothing melatonin and serotonin, bananas contain magnesium, a muscle relaxant. Chamomile tea. The reason chamomile is such a staple of bedtime tea blends is its mild sedating effect - it's the perfect natural antidote for restless minds/bodies. Warm milk. It's not a myth. Milk has some tryptophan - an amino acid that has a sedative - like effect - and calcium, which helps the brain use tryptophan. Plus there's the psychological throw-back to infancy, when a warm bottle meant "relax, everything's fine." Honey. Drizzle a little in your warm milk or herb tea. Lots of sugar is stimulating, but a little glucose tells your brain to turn off orexin, a recently discovered neurotransmitter that's linked to alertness. Potatoes. A small baked spud won't overwhelm your GI tract, and it clears away acids that can interfere with yawn-inducing tryptophan. To up the soothing effects, mash it with warm milk. Oatmeal. Oats are a rich source of sleep - inviting melatonin, and a small bowl of warm cereal with a splash of maple syrup is cozy - plus if you've got the munchies, it's filling too. Almonds. A handful of these heart-healthy nuts can be snooze-inducing, as they contain both tryptophan and a nice dose of muscle-relaxing magnesium. Flaxseeds. When life goes awry and feeling down is keeping you up, try sprinkling 2 tablespoons of these healthy little seeds on your bedtime oatmeal. They're rich in omega-3 fatty acids, a natural mood lifter. Whole-wheat bread. A slice of toast with your tea and honey will release insulin, which helps tryptophan get to your brain, where it's converted to serotonin and quietly murmurs "time to sleep." Turkey. It's the most famous source of tryptophan, credited with all those Thanksgiving naps. But that's actually modern folklore. Tryptophan works when your stomach's basically empty, not overstuffed, and when there are some carbs around, not tons of protein. But put a lean slice or two on some whole-wheat bread mid-evening, and you've got one of the best sleep inducers in your kitchen.