by Sergio Silva, M.D.

Created on: August 20, 2009   Last Updated: August 21, 2009

How to Maintain Good Sleep Hygiene

Insomnia is a common complaint in any doctor's office and by far one of the most common complaints in psychiatry. While there are various medical conditions to be ruled out (such as obstructive sleep apnea), the vast majority of cases are either mood- or stress-related, or else have no obvious cause. Many cases are chronic. Likewise, while there are many medications available to treat this condition, medications are not without their side effects and, for chronic sufferers, even the most effective sleeping pills lose their efficacy over time.

Regardless of whether or not you choose to submit to pharmacological or other medical treatments for insomnia, a good starting point is what health care providers call good "sleep hygiene." These are important tips that should be followed by everyone, whether you suffer from clinical insomnia or just the occasional fitful night of sleep (or the lack thereof). Sleep hygiene refers to one's habits concerning sleep.

Avoid caffeine and other stimulating substances before bedtime. Not only will caffeine keep you alert, but it is a diuretic. Diuretics promote the excretion of water by the kidneys, making middle-of-the-night trips to the bathroom more necessary. This is already a problem for many older adults.

Avoid excessive use of alcohol. Alcohol of course is itself sedating (it's one of the principal ingredients in NyQuil), but taken during the day or early evening, alcohol can actually lead to a rebound state of wakefulness at bedtime or in the middle of the night, greatly exacerbating insomnia. It's also a potent diuretic.

Avoid going to bed on a full stomach immediately after eating a heavy meal. If you suffer from acid indigestion, remember that lying down tends to aggravate reflux; bedtime is one of the best times to take an antacid.

Avoid a heavy workout before bed. Adrenaline and other stress hormones that are released during vigorous exercise will keep you wide awake. Schedule your workouts for the early afternoon, or better yet, start your day off right and exercise first thing in the morning; it will set a great mood and energy level for the whole day!

Ensure the right sleeping environment: for most people, a dark, quiet, cool room. If you sleep better with a little "white noise," try an oscillating fan (which works nicely to keep you cool as well), or invest in a sound machine. The TV's sleep function works as well, but turn the volume down low and

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