Solve Your Sleep Problems

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You Wake Up and Can't Fall Back to Sleep

Lifestyle changes: Eliminate dead-of-night disturbances that rouse you: Shut the bedroom door so the cat can't jump on you or place twin-size top sheets and blankets side by side so your husband takes only his covers when he rolls over. Also, avoid alcohol before bed: It may help you fall asleep faster but will likely make you wake up a few hours later and have problems going back to sleep.

Prescription help: Zaleplon (the generic form of Sonata) works in less than half an hour, then lasts less than four. A study from St. Luke's Hospital in Chesterfield, Missouri, found zaleplon didn't cause daytime sleepiness in patients given it in the middle of the night, then awakened three and a half hours later.

The downside of zaleplon is that if you wake up in the wee hours, you then have to decide whether to take the pill and wait for it to work. If you awaken almost nightly, a low dose of trazodone (the generic form of the brand drug Desyrel) may be better. This antidepressant is rarely used to treat mood disorders today (other drugs are more efficient), but it is the most-often prescribed drug for problems falling and staying asleep. "People do not have to be depressed for it to work," explains Dr. Esther, who says trazodone is safe for most healthy adults to take, even for years. Side effects of the low doses used to promote sleep may include dizziness, next-day drowsiness, headache, and weight gain. If hot flashes are what's waking you in the middle of the night, discuss the pros and cons of hormone therapy with your doctor, including whether it might help you sleep.

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