Common Culprits

The first step in addressing your sleeplessness is to rule out a more serious underlying problem that requires medical attention. One common sign of depression, for example, is an inability to get back to sleep after waking in the early morning. Loud snoring may be linked to sleep apnea, a potentially life-threatening condition in which people actually stop breathing for short periods. Or your insomnia could be related to hormonal changes, unrelieved pain or "restless legs syndrome"--discomfort combined with a strong desire to move the limbs. In all of these instances, it’s best to seek treatment for the underlying cause.

After ruling out an underlying medical condition, think about what you're ingesting for clues to what’s keeping you awake. Avoid caffeine--found in obvious places like coffee and soft drinks but also in chocolate and some nonprescription pain relievers--for several hours before bed (and longer if you're particularly sensitive to its effects). Cold formulations and over-the-counter diet pills may contain phenylpropanolamine, pseudoephedrine or the herb ephedra, all of which can interfere with sleep and should be avoided before bedtime. Prescription medications including blood pressure pills, asthma drugs and newer antidepressants like Prozac can all contribute to insomnia, and the same is true for many recreational drugs from cocaine to marijuana. Nicotine is another common culprit, as is alcohol--a glass of wine with dinner may not affect your shut-eye, but a nightcap or two can contribute to early morning waking and less-than-refreshing sleep.

Next: Bedtime Rituals