1. Go to bed and get up at the same time every day.
   
2. Make sure your sleep environment is as comfortable as possible.
   
3. Keep your bedroom as dark and as quiet as possible.
   
4. Avoid caffeine -- in coffee, tea and soft drinks -- in the evening.
   
5. Don't drink alcohol or smoke before going to bed.
   
6. Get some exercise every day -- but not in the late evening.
   
7. Don't nap in the daytime.
   
8. Develop a sleep ritual -- a nightly routine that eases you down from the day's activity.
   
9. Use your bedroom for sleeping instead of working, worrying or watching television.
   
10. If you can't sleep, get out of bed and do something relaxing, like reading, deep breathing or yoga.

A recent onset of insomnia is usually related to a current problem such as health concerns, marital troubles, dilemmas at work, etc., and as such usually last less than three weeks. If no such mental/emotional reason can be uncovered, then physical causes should be investigated. It is important to "rule out" obvious causes of insomnia such as anemia, hypertension (high blood pressure) or prescription drugs. Insomnia that does not respondto simple measures is often due to an emotional upset, especially depression.

The results of prolonged insomnia can be very discomforting: chronic fatigue; anxiety about sleeping; lack of concentration, etc. The conventional treatment is sedative hypnotics if over-the-counter (OTC) drugs fail to help.

Can I Use Physical Medicine to Treat insomnia?
If there is any panacea (cure-all) in medicine it must be a clean diet and regular aerobic exercise that makes you happy. Treating insomnia is no different. Regular aerobic exercise that you enjoy is crucial to getting a good night's sleep, every night, without fail. Find an exercise buddy in your neighborhood and make a pact to exercise together 3 or 4 times weekly, doing something you both enjoy like briskly walking for an hour, playing tennis, joining a water aerobics class, whatever. Just do it!

You can also make a habit of taking a NEUTRAL temperature bath before bed. This is about body temperature. Both cool and hot baths are too stimulating to both nervous and vascular systems to be of use in insomnia before bed. Some people find it helpful to use a cupful of 3% hydrogen peroxide in the neutral bath water. You can also give yourself a deep foot massage, especially concentrating on the soles of the feet, while in the bath, or just before turning out the light.

What about Botanical Medicine to help with sleep?
Herbal medicine has a long tradition of being able to induce peaceful sleep. A word of caution, however. Many of the botanicals listed below affect the central nervous system, and must be taken with the supervision of a qualified herbalist or naturopathic physician. Please consult with one of these health care professionals to determine the correct dose and form of the potential toxic herbs.

• Anenome pulsatilla (Wind, or Pasque, flower -- can be toxic)

• Avena sativa (Oat straw). Yes, this is the familiar kitchen item frequently eaten as oatmeal. In fact, oats are one of the most universally used medicinal foods to soothe the nerves. You may want to eat your oats in the evening instead of breakfast, but not too close to bedtime, to ensure a restful sleep. No food should be taken closer than 2 hours to bedtime to make sure your digestive workings don't keep you awake. Oats may be used as a soothing bath: put a handful in an old sock and let the bath water run through the sock so the bath water becomes slightly slimy. Bathe in this gentle brew to allow the mildly sedative qualities to seep in through your skin. You could also take oats in a tincture form, using frequent doses at short intervals beginning after dinner.

• Matricaria recucita (German chamomile, or any chamomile species) for sleep disturbed by anxiety or irritability. This herb is especially good for children. Take note: if you are using the chamomile in a tea (infusion) form, don't let it steep more than 3-5 minutes. A strong chamomile tea can actually be mildly stimulating.

• Gelsemium sempervirens (Yellow Jasmine, can be toxic)

• Humulus lupulus: (Hops, a popular flavoring for beer) can allay irritation or anxiety, thus promoting sleep. This doesn't necessarily endorse beer drinking! A better approach would be to rest your head at night on a pillow filled with dried hops leaves.

• Hyoscyamus niger (Henbane, may be toxic) works well for insomnia due to irritability, unrest, fright, or terror. This herb has the power to subdue excitement and induce sleep, especially in sleeplessness due to pain. Great for both the aged and infants.

• Lavendula officinalis (Lavender flowers) works primarily through the sense of smell. It is extremely soothing to simply sniff a small opened bottle of the volatile oil made from these redolent blossoms. Many health food stores will carry some brand of Lavender oil. Keep it next to your bed or add a few drops to the bath water before retiring.

• Leonurus cardiaca (Motherwort) is particularly useful for lack of sleep due to heart problems, including a "broken heart." This herb is known traditionally to "gladden the heart."

• Melissa officinalis: (Lemon Balm). This tasty plant can soothe a nervous heart or a nervous stomach and therefore aid in insomnia which presents as difficulty falling asleep.

• Nepeta cataria (Catnip). It works for humans too!

• Passiflora incarnata: (Passion flower) is a relaxing nervine, indicated for sleep disturbed from mental worries or anxiety, and for geriatric cases where the insomnia is due to fear.

• Piscidia erythrina (Jamaican dogwood, can be toxic in somewhat high doses). This plant was originally used to mildly "stun" fish in a pond to make them easier to catch. It is great as a gentle pain reliever and for general nervousness.

• Scutellaria lateriflora: (Skullcap) is another sweet tasting herb to help alleviate nightmares or restless sleep. Combines well with Passiflora incarnata.

• Valeriana spp. (Valerian) has an active ingredient from which the medication Valium was first derived. It can both relax and stimulate the central nervous system. Don't use this botanical for more than 3 weeks at a time. It combines well with Hops.

Another sedative tea formula contains:
Angelica root, 20 g.
Rosemary leaf, 10 g.
Lemon balm leaf, 30 g.
Lavender flower, 10 g.
Hops leaves, 20 g.
Yarrow flowers, 10 g.
1-2 tsp. to 1 cup boiling water. Infuse. Drink 1-2 cups before going to bed. Use regularly over a period of time.

Can my diet effect getting a good night's sleep?
It certainly can. There is one amino acid (from protein breakdown) that is a potent biochemical inducer of serotonin, the major sleep neurohormone. This amino acid is Tryptophan. Tryptophan is high in turkey meat, eggs, fish, dairy products, bananas, pineapples, whole wheat toast and walnuts. If you decide to supplement with Tryptophan: make sure to also take the cofactors which will facilitate the conversion to serotonin. These are Vitamins B3, B6, and C.
Other therapeutic food suggestions include:

• increase foods high in Vitamin C (all tart fruits, dark leafy greens and red peppers) and Vitamin B-complex such as Brewer's yeast.
  
• Traditional Chinese Medicine food recommendations for deeper sleep include chicken, duck, oysters, celery, sesame seeds, and walnuts.

• lettuce and celery
  
• carrot and spinach
  
• carrot and celery

• myo-inositol (a high quality fat, usually derived from soy bean) 500 mg daily

• niacinamide (buffered Vitamin B3) 1000 mg at bedtime (if you can fall asleep readily but cannot return to sleep after waking)

• L-Tryptophan 1-4 g 30-45 minutes before bedtime with carbohydrates, no protein

• Calcium 500 mg before bedtime

• Avoid B-complex after 5 PM, especially B6 which is known to cause prolific dreaming

• Vitamin B12 injected intra-muscularly (IM) 2 cc weekly until your deep sleep is restored. This can be administered at home, but get your doctor to show you or your spouse the correct injection technique.

• Corydalis Yanhusus Analgesic Tablets (patent) for insomnia due to pain

• Ginseng and Longan C. (Gui Pi Tang) (available as patent)

• Bai Zi Yang Xin Wan (patent) for Heart Blood Deficiency with Spleen Qi Deficiency) for poor appetite and memory, pale face, anemia

• Miao Xiang San, a patent combination, for Heart Qi Deficiency with symptoms of forgetfulness, spontaneous sweating, anxiety, restlessness

• Ginseng and Zizyphus F. (Tian Wang Bu Xin Dan)

• An Mian Pian (patent): Heart Yin Xu (Deficiency) for exhaustion due to excessive mental work; tossing and turning; also for patients on tranquilizers or sleeping pills for so long that they no longer have an effect

• Coptis and Gelatin C. plus cinnamon bark (rou gui) (Huang Lian E Jiao Tang): Kidney and Heart Not Communicating: strong patient, so irritable they cannot even lie down in bed, dizziness, tinnitus

• Baked Licorice C. (Zhi Gan Cao Tang) minus linum (huo ma ren) plus zizyphus (suan zao ren) for Qi Deficiency with Blood Deficiency for slow, irregular or thin pulse, palpitations, shortness of breath, emaciation, dry mouth and throat, pale shiny tongue

• Licorice and Jujube C. (Gan Mai Da Zao Tang) for "Shen" (Spirit) Disturbance, which presents as absentmindedness, moodiness, crying spells, restless sleep

• Ci Zhu Wan (patent): Kidney and Heart not Communicating.