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What to Do When You Can't Sleep
American Academy of Family Physicians
Peer Review Status: Externally Peer Reviewed by the American Academy of Family Physicians
Creation Date: January 1995
Last Revision Date: January 1995


Most people have trouble sleeping sometimes. However, some people have trouble more often. They find it hard to fall asleep, don't sleep soundly, or wake up early and can't go back to sleep. If you do this, you have insomnia.

What causes insomnia?

The most common cause of insomnia is a big change in daily routine. For example, traveling, starting a new job, going into the hospital or moving into a new home may cause sleep problems. This type of insomnia usually doesn't last for more than a few days.

Insomnia that lasts for more than a few days may be related to a more serious problem. Chronic insomnia may result from illnesses that cause pain, nausea or shortness of breath. Depression or anxiety may also cause chronic insomnia. If you have insomnia that lasts for more than a few days, talk to your family doctor.

Will insomnia go away on its own?

Sometimes. Insomnia related to things going on in your life may go away on its own. But chronic insomnia, which may be a sign of another illness such as depression or anxiety, may require special treatment. Proper treatment of the depression or other illness often helps the insomnia go away.

Even if the exact cause of insomnia can't be identified, treatment for your insomnia may help. Treatment may consist of doing certain things that will help you improve your sleep habits and help you sleep better, or it may include sleeping pills prescribed by your doctor.

What are the things that I can do that will help me sleep better?

Some ideas that may help you sleep better are listed below:

•Go to bed at the same time each day.
•Get up at the same time each day.
•Get regular exercise each day.
•Keep the temperature in your bedroom comfortable .
•Keep the bedroom quiet when sleeping. •Keep the bedroom dark enough. Use dark blinds or wear an eye mask if needed.
•Use your bed only for sleep and sex.
•Take medicines only as directed.
•When you go to bed, relax your muscles, beginning with your feet and working your way up to your head.

There are some things that you should avoid because they may make your insomnia worse:

•Don't exercise just before going to bed.
•Don't engage in stimulating activity just before bed. Examples include playing a competitive game of cards or watching an exciting program on television.
•Avoid caffeine. Remember that caffeine is present in chocolate, as well as regular coffee or tea, and caffeinated sodas.
•Don't read or watch television in bed.
•Don't use alcohol to help you sleep.
•Don't take another person's sleeping pills.
•Don't lie in bed awake for more than half an hour. Instead, get up, do some quiet activity, then return to bed when you are sleepy. Do this as many times in a night as you need.

You will get the best results if you try these things over a period of time. Usually, you'll need two to four weeks to see the best results.

What about sleeping pills?

Sleeping pills are mainly used to treat the short-lasting insomnia that may occur as a result of things going on in your life. Sleeping pills that you can buy at the store are not always effective. If you are older, taking over-the-counter sleeping pills may be risky, because they can cause confusion.

If your doctor decides to prescribe a sleeping pill for you, use it only as directed. Don't take more pills than your doctor tells you to take. Usually, sleeping pills can be taken for no more than two weeks, because they may actually make insomnia worse after this time.

Are there any precautions I should take when using sleeping pills?

Sleeping pills cause drowsiness and poor balance, so be careful about driving or doing other activities that may be dangerous. Don't drink alcohol when taking sleeping pills.

If you're older, you're more likely to fall if you are taking sleeping pills. If you have to get up at night to go to the bathroom, get up slowly, sit on the side of the bed for a minute, and then walk carefully to the bathroom. Use good light. Either turn on the lights or use a bright flashlight.


This information provides a general overview on insomnia and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

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