Do you wake up refreshed in the morning without the use of an alarm clock and feel energetic all day? If you don't, you may not be sleeping enough (adults need between 7.5-8.5 hours a night of sleep) or you may suffer from a sleep disorder that affects 60 million Americans: insomnia. If you have insomnia, you probably experience difficulty falling asleep, waking up too early, waking up during the night and having trouble going back to sleep, or un-refreshing sleep. During the day, you may have difficulty concentrating or feel sleepy, fatigued, or irritable.

Obviously a significant life stress (losing a job or a loved one, divorce, or moving), illness, or environmental factors (noise, change of bed, the neighbor's late night party) can throw off your normal sleep schedule, and health conditions (depression, heartburn, cancer, asthma, arthritis, etc.) can cause insomnia as well. Once these situations resolve themselves, your sleep schedule should improve. However, if these problems are not present, and you still cannot sleep, perhaps some of your daily, and nightly, routines contribute to your sleeplessness. Diet, environment, and routine are three areas that commonly affect sleeping success. Here are some healthy tips that many experts agree can improve the amount and quality of your sleep.

1. Don't go to bed hungry! Have a light, early dinner or a light snack, but avoid a heavy meal before bed, as going to bed with a full stomach can disturb sleep. Warm milk, dairy products, carbohydrates, and foods high in tryptophan (an amino acid) like turkey or bananas may help you sleep. Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime. Spicy foods may cause heartburn, which leads to difficulty falling asleep and discomfort during the night. Try to restrict fluids close to bedtime to prevent nighttime awakenings to go to the bathroom, though some people find milk or herbal, non-caffeinated teas to be soothing and a helpful part of a bedtime routine.

2. Avoid caffeine! This includes chocolate, caffeinated sodas and teas, and coffee. Caffeine delays sleep and increases the number of times you awake during the night. It generally remains in your body from 3-5 hours, but can affect you for up to 12 hours.

3. Give up smoking! Nicotine is a stimulant that can cause difficulty falling asleep and waking in the morning, and even nightmares. If that's not bad enough, smokers experience withdrawal symptoms for nicotine while asleep and experience sleep disturbances.

4. Forego that "night cap!" Alcohol may help you to get to sleep, but it will cause you to wake up throughout the night, even if you aren't aware of it. Alcohol also contributes to snoring and sleep apnea symptoms. Although you may consider alcohol as a sedative, it actually disrupts sleep, causing nighttime awakenings.

5. Is your room an inviting place to sleep? Make your sleeping environment a place for healthy sleep - cool, quiet, comfortable, attractive, and orderly. Use clean, comfortable, and allergen-free bedding and pillows and a quality mattress. Keep the temperature cool, but not cold, and the room dark, quiet, and well ventilated for a restful sleep environment. If light is a problem, invest in blackout curtains, eye shades, or a sleeping mask. Install dimmer switches in bedroom and bathroom, keep them low at night and high in the morning. Experiencing bright light at a regular time in the morning should help you wake up and then feel sleepy at the same time every night. If noise is a problem, invest in earplugs, a fan, or a white noise machine to cover up interruptive sounds.

6. Don't balance your checkbook right before bedtime! Avoid activities that cause excitement, stress, or anxiety. Quiet bedtime routines like reading, listening to music, or taking a bath are helpful to relax and wind down before sleep. Conduct these activities in dim light to signal the brain that it is time to relax and get sleepy.

7. No pushups right before bed! Although daily exercise is a desirable asset to wellness, try not to exercise during the 3 hours before bedtime to avoid stimulation that could make falling asleep more difficult. Exercise also raises your body temperature, causing it to take longer to reach the cooler temperature associated with sleep onset.

8. Sex or sleep only! The bedroom is not an office! Using your bedroom only for sleep and sex strengthens the association between bed and sleep. Your body needs to "know" that the bed is associated with sleeping. Do not engage in activities that cause you anxiety and prevent you from sleeping. If you associate a particular activity or item with anxiety about sleeping, omit it from your bedtime routine. For example, if looking at a bedroom clock makes you anxious about how much time you have before you must get up, turn it to the wall. Avoid TV or laptop computers, and if you find reading helpful, make sure to use a very small wattage bulb to read by. Train your body to understand that this is the place and time to rest.

9. Early to bed, early to rise! Limit daytime naps to 30-45 minutes. Your sleep-wake cycle is regulated by a "circadian clock" in your brain and the body's need to balance both sleep time and wake time. A regular waking time in the morning strengthens the circadian function and can help you get sleepy at night. That is also why it is important to keep a regular bedtime and wake-time, even on the weekends when there is the temptation to sleep-in. 10. Count sheep, not problems! If you have trouble lying awake worrying about things, try making a to-do list before you go to bed, and then put those problems to bed for the night. If you can't fall asleep for over 30 minutes and don't feel drowsy, get up and read or do something boring in dim light until you feel sleepy. Stressing over whether or not you are getting enough sleep will just make matters worse. Relax, and you will eventually fall asleep.

11. No middle of the night TV! If, after awakening in the middle of the night, you cannot get back to sleep within 15-20 minutes, leave the bedroom and read, have a light snack, or do some quiet activity (not TV). Return to bed after 20 minutes or so. Avoid looking at the clock if you wake up as this can make you anxious. As I said, turn it to the wall!

12. No weekend sleep binges! Because of the high-paced lifestyle most of us lead, you may have difficulty getting enough sleep. Ongoing lack of sleep causes sleep deprivation, which runs up a sleep debt that you must pay back or your sleepiness will continue to worsen. However, avoid trying to pay up by weekend sleep binges as this will result in the disruption of your circadian rhythm.

Make quality sleep a priority! Follow these guidelines and develop your own bedroom environment and regiment for healthy, restful sleep. Happy dreams!

Copyright 2006 Dr. Eileen Silva