Avoid caffeine or nicotine close to bedtime. The Food and Drug Administration recommends not having caffeine or nicotine for four to six hours before bedtime. Sateia goes farther, advising insomniacs to restrict caffeine to small amounts in the morning. That means no more than a cup or two of coffee per day, and nothing after midday, he says.
Skip the glass of wine at bedtime. Alcohol can actually interfere with sleep—not improve it, as many people assume. Although it's sedating, Sateia says, it's also very short-acting. "What happens is it gets metabolized quickly, he says, and "sleep becomes lighter and more fragmented." That means you may wake up in the middle of the night and have trouble getting back to sleep.
Exercise and eat early. It's best to avoid exercising and eating large meals within two hours of bedtime, according to the FDA. And try to prepare yourself for bed by listening to music or reading in the half-hour just before bedtime. In addition, sleep experts advise that insomniacs use their beds only for sleep and sex.
Get out of bed. If you can't fall asleep quickly, get up. "If you're not able to get to sleep within about 20 minutes, remove yourself from bed and do something else relaxing until you're prepared to go back and try it again," advises Sateia. The same advice applies if you awaken in the middle of the night.
Create a supportive sleeping environment. Experts suggest having a bedroom environment that's conducive to sleep: dark and quiet, with a comfortable temperature, and preferably free of noisy pets, beeping cellphones or pagers, television, radio, and computers. "It's easy to get carried away with all of the technology we have available to us," Kline says, but he says it's a must to limit tech use close to bedtime if you want a good night's rest.
Restrict your "sleep window," which is the amount of time that you spend in bed. "So if you're only sleeping five hours a day, the rules of sleep restriction say you start out with the allotted five hours in bed," Sateia says. Gradually lengthen your time in bed, but only after you've trained yourself to actually sleep for 90 percent or more of the initially restricted sleep window.
The average sleep time is about seven hours for adults (eight hours is ideal), yet people with chronic insomnia "will spend 10, 12, 16 hours in bed because they haven't gotten enough sleep," Sateia says.
Maintain a sleeping routine. "We're creatures of habit, and every cell in our body has a rhythm," Kline says. "Generally speaking, it's a good idea to keep a regular sleep routine: going to bed at the same time, waking up at the same time. Keep it within 15 to 30 minutes of that routine." And that includes not sleeping in on the weekends.
Consider medication, but be careful with over-the-counter sleep aids, most of which contain antihistamines, which make you drowsy but may interact with certain other types of medications. The options for OTC sleep aids include various pills that contain diphenhydramine, a sleep-aiding ingredient. Among these are Benadryl, Tylenol PM (which contains acetaminophen plus diphenhydramine), Advil PM (ibuprofen plus diphenhydramine), Sominex and Nytol (both contain diphenhydramine as their primary active ingredient). Unisom (doxylamine) is another option, as are dietary supplements, including melatonin and valerian, but not much is known about the safety and effectiveness of these supplements, according to the Mayo Clinic.
If you are or were recently taking a prescription monoamine oxidase inhibitor (an antidepressant known as an MAOI), you should ask your doctor before taking OTC sleep aids or supplements. The same goes for anyone taking any medications for Parkinson's disease, depression, or any psychiatric or emotional problems. And be careful with the combination sleep aide Tylenol PM because it contains acetaminophen, which can be dangerous if consumed in high-enough doses and is also found in many pain relievers and combination cold, allergy, and sinus medications. And Advil PM, in a class of drugs called nonsteroidal anti-inflammatory medications, or NSAIDs, carries its own risks. Also, there's no evidence that OTC sleep aids are helpful to people when taken over long periods of time for insomnia, Sateia says.