Solve Your Sleep Problems

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It Often Takes You an Hour or More to Fall Asleep

Lifestyle changes: Avoid caffeine for at least six hours before bedtime and cut out stimulating activities, such as answering e-mails, housecleaning, or watching TV, a habit shared by 90 percent of people who report sleep problems, according to a poll by the National Sleep Foundation. (The bright flashing images and sounds from TVs and computers actually wake up your brain, notes Marcel Hungs, MD, PhD, director of the Center for Sleep Medicine at the University of California, Irvine.) Instead, shift gears and slow down for about 20 minutes before bed: Take a warm bath, write in a journal, or listen to soothing music. A ritual of relaxing pre-bedtime activities is an automatic cue to become sleepy, making it more likely you'll fall asleep, says Helene A. Emsellem, MD, medical director of the Center for Sleep and Wake Disorders, in Chevy Chase, Maryland.

Prescription help: Zolpidem tartrate (the generic form of Ambien) acts quickly to put you to sleep within 15 to 30 minutes on average and, as a benefit, may help you sleep longer and awaken less, according to a recent University of Rochester study of almost 200 men and women. And because it doesn't appear to cause rebound insomnia, it shouldn't prevent you from falling asleep on the nights you don't take it. Since it lasts only four to six hours, there's a low risk of next-day drowsiness.

Side effects can include headaches and dizziness, but what is more worrying are reports that this drug can cause sleepwalking, sleep-driving, night eating, and short-term amnesia. It turns out that these can be problems with other prescription sleep medications as well, "especially if not taken as directed," says Dr. Emsellem. Many side effects occur because people take extra doses or mix the drug with alcohol. Report any unusual reactions to your doctor.

Continued on page 3:  You Wake Up and Can't Fall Back to Sleep


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