• First, it is important to realize that people differ as to how much sleep they need each night to feel rested. Some seem to need at least 9 or 10 hours a night while others can get by with as little as 4 or 5 hours a night.
• Second, you need to come to grips with the fact that we cannot directly control the sleep process. In fact, you may have discovered that the harder you try to fall asleep, the more tense, frustrated, and wide awake you become. All we can do is create conditions in which sleep is more likely to occur.
• Third, it is important to understand that some medications which are used to bring about sleep can actually contribute to sleep difficulties when used over a long period of time. In a similar manner, use of alcohol can create sleep difficulties in the long run. Many of these chemicals interfere with natural sleep rhythms and so in a sense, your body forgets to sleep naturally. If you are not sure about the effects of sleep medications which you are taking, be sure to ask your doctor.

Although no one has to learn how to sleep, many people develop bad sleep habits which interfere with effective sleep. Like all bad habits, they need to be replaced with healthy habits.

Following are nine rules for establishing healthy sleep habits:

• Do not go to bed until you are drowsy and ready to sleep.
• Get up at approximately the same time each morning irrespective of how much sleep you got that night. If necessary, use an alarm clock to wake up at the desired time.
• Minimize use of daytime naps. The more you nap during the day, the less need you have for sleep at night.
• Do not drink alcohol later than two hours prior to bedtime. Although it is obvious that alcohol facilitates the onset of sleep, it can contribute to restless sleep and a tendency to awaken during the night
• Do not consume caffeine after about 4 pm., or within 6 hours prior to bedtime. Learn all the foods, beverages, and medications that contain caffeine.
• Do not smoke within several hours prior to your bedtime. Remember that nicotine, like caffeine, is actually a stimulant.
• Exercise regularly. However, you should avoid strenuous physical exertion in the hours before bedtime.
• Use common sense to make your sleep environment more conducive to sleep. Arrange for a comfortable temperature and minimum levels of sound, light, and noise.
• If you are accustomed to it, have a light carbohydrate snack before bedtime (e.g., crackers, graham crackers, milk, or cheese). Do not eat chocolate or large amounts of sugar. Avoid excessive fluids. If you awaken in the middle of the night, do not have a snack then or you may find that you begin to wake up habitually at that time feeling hungry.

Since it is impossible to make yourself go to sleep, the major question you should ask yourself is, what is the best use of my time while I am awake? Keep in mind that one of the major functions of sleep is to give your body and mind rest. You might then consider other ways to give your mind and body some needed rest, short of sleep itself.

Unfortunately, what often occurs for people who have trouble sleeping at night is the very opposite of rest. For many, it is a time of considerable tension, frustration, worry, and negative thinking. The negative thoughts may pertain to struggles over the sleep situation itself, or you may have negative thoughts about various problems in your life. It is a common fact that negative thoughts during the night tend to be magnified and blown out of proportion. It is frequently a time of greatest cognitive distortion and loss of perspective.

These negative thoughts typically act like repeating tape loops that play over and over again in your mind, with no constructive resolution. Certainly these repetitive cycles of negative thinking interfere with rest and perpetuate the sleep problem. Pain also is often magnified while lying awake at night. With the lights out and everyone else in your household sound asleep, there are no external distractions available. Consequently, it is much easier for your mind to become totally consumed by your pain.

Since it is impossible to directly force negative thoughts and pain out of your mind, the goal should be to redirect your mind to something else. Therefore, while lying in bed, either before going to sleep or if you awaken during the night, a better use of your time is to do a relaxation procedure, listen to a relaxation tape, or engage in pleasant mental imagery. While doing so, the goal of relaxation is not necessarily to fall sleep, but rather to relax and give your body and mind some rest. If you happen to fall asleep, great. If you stay awake relaxing, that's okay too. At least you are getting rest. Any number of different relaxation approaches can be used. It also may be an especially useful time to get involved in enjoyable mental imagery. Such imagery does not have to include traditional relaxation scenes. You can use any form of enjoyable fantasies or pleasant memories, e.g., fantasies of success and recognition, exciting romantic encounters, heroic deeds, thoughts about loved ones, etc. The idea here is to do your best to prolong the enjoyable fantasy. Using a form of reverse psychology, you should actually try not to fall sleep so you can enjoy the relaxation or pleasant fantasies.

If it is not possible for you to engage your mind in some form of relaxation or enjoyable imagery, then the next alternative is to get out of bed, leave the bedroom, and do some other activity that is relaxing, positive, or constructive. The ideal is to have some predetermined activities already lined up (e.g., reading, watching tv or a video, doing crossword puzzles, write a letter, working on a hobby etc.). You should only return to bed when you feel drowsy and sufficiently tired. This whole process can be repeated as often as necessary during the night. Remember, irrespective of the amount of sleep you actually get, try to wake up at around the same time.

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