Eyes Wide Open

 By Erika Jonietz
For the many insomniacs who need more than NPR or a good bodice ripper, the classic approach is behavioral modification. Experts prescribe an arsenal of lifestyle adjustments that help patients practice what's known as good sleep hygiene, for example avoiding stimulating conversation, books, or television shows before bedtime. Bains also tells patients not to turn on the light or to look at the clock when insomnia strikes.

If gentle modifications don't work, some sleep experts practice various forms of tough love, such as depriving a patient of sleep until she's so tired that her sleep drive overcomes her tendency to wake up. Sometimes the best solution is medication—one doctor sometimes prescribes hormone replacement therapy for newly menopausal patients who are suffering from significant sleep problems.

In many cases, insomnia experts prefer the strategic use of new, short-acting prescription sleep drugs in conjunction with behavioral changes. Sonata, which lasts about three hours, and Ambien, which lasts about six hours, can be especially helpful for women who have trouble falling or staying asleep, because they won't feel groggy in the morning. But Bains points out that both drugs are for short-term use only, generally no more than a couple of weeks. For ongoing sleep troubles, he suggests addressing behavioral factors rather than continuing to take medication.

Snooze Control
Sleeping pills do not have a great rep. But when all else fails, isn't there some dreamy little thing you can pop for a good night of slumber? Here's how the nocturnal drugs and natural remedies stack up, along with their risks and side effects.