Having trouble drifting off? Perhaps try some of these alternatives to prescription drugs first. Sometimes, sleep comes easier if you make preparations before you put on your pajamas:

What to leave out of the bedroom

• Don't watch TV in bed. TV viewing is not conducive to calming down.
• Don't do computer work in bed, in fact, put the computer away at least an hour before going to bed.

What you can do to make yourself comfortable before bed

• Stop working or doing strenuous housework at least two hours before going to bed. The best preparation for a good night's rest is to unwind and relax.
• Forgo alcoholic or caffeinated beverages for at least three hours before going to bed.
• Pass up big meals late at night, especially if you are prone to indigestion or heartburn. Allow at least two hours between dinner and going to bed.
• Don't smoke for at least 3 hours before going to bed. (Better yet: quit!)
• Regular exercise during the day or early in the evening helps you get to sleep and stay asleep. But don't exercise for at least 3 hours before going to bed. It revs up your metabolism, making falling asleep more difficult.
• Going to sleep at widely varying bed times – 10 p.m. one night and 1 a.m. the next – disrupts optimal sleep. It's best to go to sleep at around the same time every night, even on the weekends.
• Likewise, the best practice is to wake up around the same time every day (with not more than an hour's difference on the weekends).
• Solving insomnia by spending too much time in bed is usually counter-productive; you'll become only more frustrated. Don't stay in bed if you are awake, tossing and turning. Get up and do something else until you are ready to go to sleep.
• Naps can be wonderful but don't take one after 3 p.m., since it can disrupt your ability to get to sleep at night.

Still awake?
If it's habitually hard to drift off to sleep, there's a non-drug treatment that has proven quite effective to treat intermittent or chronic insomnia: cognitive behavioral therapy or CBT. Behavioral therapy involves getting help from a therapist trained in CBT to learn a new set of behaviors around sleep.

For example, you may be prohibited from watching TV in bed, be directed to get up at the same time everyday, or have your actual time in bed restricted while you "relearn" to associate being in bed with sleep. You may also learn relaxation techniques and mental tricks to help you get to sleep. And behavioral therapy usually also involves correcting your poor sleep habits. (Generally, CBT involves three to six one-hour sessions with a therapist, who may or may not be a doctor, plus lots of direction for at-home activities.)

Studies have found behavioral therapy to be effective (helping 70 to 80% of people with chronic insomnia) and several studies have found it more effective than sleeping pills. In other studies, a combination of the two has helped most. Behavioral therapy also has the advantage of yielding long-lasting benefits, which differs from pills, whose effects are only limited to when they are being taken.

Said another way, behavioral therapy – for some people, anyway – may produce a "cure" while sleeping pills continue to treat the symptoms but don't produce a cure. So, behavioral therapy is absolutely an alternative to sleeping pills for people with intermittent or chronic insomnia. If you see a primary care doctor or therapist for chronic insomnia and the doctor prescribes pills without mentioning the behavioral therapy option, you should ask why. If they don't know anything about behavioral therapy, we advise finding someone who does. Behavioral therapy costs more than pills in the short-term, but probably less in the long run. One diffculty with behavioral therapy, however, is finding a doctor or therapist properly trained in the CBT techniques. For that, you may have to do some serious searching.