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However, when treatment of medical or behavioural factors does not improve the insomnia or when there is no apparent underlying cause (as in primary insomnia), your doctor may recommend other treatment methods.

Home treatment to prevent insomnia

Many sleep problems can be overcome by simple, commonsense measures:

• Cut down on late-night snacks and late-evening heavy dinners. Some experts recommend that you should not eat at least three hours before bedtime.
  Protein promotes alertness and carbohydrates calm and drowsiness, so eat a light, high-protein, low-carbohydrate lunch. This will decrease early afternoon drowsiness, and make an afternoon nap less tempting.
  Conversely, a high-carbohydrate, low-protein supper should help encourage sleepiness closer to bedtime.
• Exercise - even moderate exercise helps control stress and releases natural stimulants, decreasing the need for external stimulants such as caffeine. An exercise routine should help regulate your sleep cycles and make you feel sleepier in the late evening.
  However, avoid exercising vigorously too close to bedtime.
• Don't use your bedroom, even less your bed, as a place for activities other than sleep and intimacy. Get into bed when you are ready to sleep and leave it when you wake, to avoid sending your body conflicting cues about sleep and waking life.
  If you wake up in the middle of the night and can't fall asleep within half an hour, get up and rest or read in a comfortable chair until you become sleepy.
  Establish a bedtime ritual of cues for going to sleep. These could include having a bath or drinking a glass of warm milk (milk contains an amino acid that is converted into a sleep-enhancing compound in the brain).
  Many people feel relaxed after sex. Relaxation techniques (see above) may also be useful.
• Cut down on daytime napping if it starts to affect your regular sleep patterns. Avoid napping within seven or eight hours of bedtime.
• Avoid alcohol in the late evening.
• If your insomnia persists, keep a diary of your sleep history. This may be helpful later in diagnosing an underlying cause.

(Prof M. Simpson, MB., BS. (London ); MRCS, LRCP; MRCPsych, DPM).

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