Addiction and Substance Abuse

Insomnia: How to Get a Better Night's Sleep

Insomnia is the inability to get the amount of sleep you need to feel good and function during the day. Many factors contribute to insomnia: Substance abuse, medical illnesses, stress and anxiety, internet use, television, caffeine, and work schedules all contribute to a decline in the number of hours of sleep you get at night. Americans have reduced their sleep by 20% in the past century.

Recommendations for improved sleep hygiene:

Establish a regular bedtime and wake up time and continue this on weekends. Make your sleeping environment comfortable, quiet, dark, cool and well ventilated.
Use your bed for sleep and sex, not watching TV or eating.
Place your clock out of sight to avoid anxiety about the time. Use an alarm clock to ensure a scheduled wake up time.
Take time to relax before bedtime. Engage in quiet activity: read, journal, practice focused breathing and progressive muscle relaxation.
Take a warm bath or shower 30 - 60 minutes before bedtime.
Avoid beverages with caffeine for at least 6 hours before bedtime. Caffeine is a strong stimulant and its effect lasts hours.
A light protein snack before bedtime may be helpful.
Limit fluids just before bedtime.
Avoid alcohol in the evening. Alcohol is a poor sedative.
Avoid naps in the daytime.
Exercise regularly. It’s best to exercise early in the day, before dinner.
Stop smoking. This eliminates the stimulating effects of nicotine.
If you do not fall asleep after 30 minutes, get up and do something relaxing with low impact lighting, such as listening to music or looking at a magazine, or something totally boring, such as reading a book about something that does not interest you. Return to bed when you feel sleepy.
Consider synthetic Melatonin 1 mg. about 30 minutes before bedtime. Look for the USP marking on the label. Contact your physician if you are considering this option.

If you feel you are practicing good sleep hygiene but continue to have problems getting a good night’s sleep, discuss your problems with your physician. Referral to a sleep specialist or a neurologist may help in evaluating and treating this condition.

This material was developed by Addiction Services at Talbot Hall, University Hospitals East, The Ohio State University, and adapted for use on NetWellness with permission, 2006.

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Last Reviewed: May 05, 2008

Tom Hartwell Pepper, MD
Medical Director
University Hospital East - Talbot Hall
Department of Psychiatry
College of Medicine
The Ohio State University

Dennis Auckley, MD
Director, MetroHealth's Center for Sleep Medicine
Assistant Professor
Division of Pulmonary, Critical Care and Sleep Medicine
MetroHealth Medical Center
School of Medicine
Case Western Reserve University

Deborah L. Hoy, CNS
Clinical Nurse Specialist
University Hospital East - Talbot Hall
The Ohio State University

Edna M. Jones, MD, MRO
Clinical Assistant Professor
Department of Family Medicine
College of Medicine
The Ohio State University