The most common causes of insomnia are:

• Anxiety. Everyday anxieties as well as severe anxiety disorders may keep your mind too alert to fall asleep.
• Stress. Concerns about work, school, health or family can keep your mind too active, making you unable to relax.
• Depression is one of the most common causes of chronic insomnia.
• Learned insomnia (expecting to have difficulty sleeping and worrying about it). If you sleep poorly, you may worry about not being able to function well during the day. You may try harder to sleep at night, but unfortunately this effort can make you more alert, set off a new round of worried thoughts, and cause more sleep loss.
• Hormonal changes in women. Menstruation, menopause and pregnancy can trigger insomnia.
• Decreased melatonin. To feel sleepy your brain needs to produce a chemical called melatonin, a natural sedative.
• Physical health problems. These include sleep apnea (abnormal breathing while asleep), asthma, hyperthyroidism, tinnitus, arthritis, congestive heart failure, pain, prostate problems that mean frequent trips to the toilet at night, and indigestion.
• Pain. Some types of pain (muscle, bone, organ pain) can be key insomnia causes.
• Sleep related disorders. These include sleep apnea and periodic leg and arm movements during sleep (in which one's muscles excessively twitch or jerk). Sleep apnea, may affect people who breathe normally while they are awake. Breathing related sleep problems are most common in men, snorers, overweight people, and older adults.
• Jet lag. Air travel across time zones often causes insomnia.
• Working the night shift or long shifts. About 60-70% of all shift workers develop sleep disturbances.
• Medications. Drugs that may contribute to insomnia: corticosteroids, decongestants (pseudoephedrine), beta blockers, diuretics given at bedtime, oral contraceptives, antidepressants (Bupropion, Prozac), appetite suppressants (Meridia, Fastin), thyroid hormone, and amphetamines. Insomnia also may be the result of withdrawal from benzodiazepines (Valium, Librium, Ativan), antihistamines, amphetamines, cocaine, and marijuana.
• Caffeine intake. Caffeine blocks the chemical that promotes sleep.
• Nicotine use. Nicotine is a central nervous system stimulant that can cause insomnia.
• Alcohol consumption. Alcohol is a central nervous system depressant, so a "nightcap" may help some people to fall asleep initially, but it also contributes to frequent awakenings, nightmares and poor quality of sleep. A bedtime drink can also stimulate some people by raising epinephrine levels, thus making it harder to settle down to sleep. Alcohol can also worsen snoring and other breathing disorders.
• Noise. Excessive noise outside your bedroom, on the street or because of noisy neighbors.
• Light. Light affects your brainТs production of the hormones that regulate sleep rhythms. Too much light in the bedroom can keep your body from deep sleep.
• Extreme temperatures.
• Napping. Daytime napping will affect nighttime relaxation.
• Eating too much too late in the evening. Eating heavy, spicy, or high-sugar foods at night may cause indigestion.
• Sedentary lifestyle.

How to Improve Sleep Without Sleeping Pills

Insomnia is usually treatable whether it is a symptom of a disease or a condition itself. Strategies to improve sleep:

• Establish a regular sleep schedule. Go to bed and wake up at the same time every day, including weekends, even if you didn't get enough sleep. This will help train your body to sleep at night.
• Develop sleep rituals. Follow the same bedtime routine, such as having a warm drink or a light snack, reading something soothing or listening to relaxing music. Let your body know you're getting ready to sleep.
• Don't spend too much time in bed. Once you wake, get out of bed. An excess of time in bed rather than sleep time may cause poor sleep in the future.
• Don't eat a heavy meal late in the day. If you eat a heavy meal before bedtime, it can interfere with sleep.
• Bedtime snacks. Have a light snack before bed. If your stomach is too empty, that can interfere with sleep. Dairy products and turkey contain tryptophan, which acts as a natural sleep inducer. Tryptophan is probably why a warm glass of milk is sometimes recommended.
• Avoid or limit caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Although alcohol can make you relax and fall asleep, the relaxed feeling wears off, making you wake up in the early hours of the morning, feeling alert. Alcohol can also cause snoring which can disturb your sleep and that of others.
• Don't drink fluids just before bedtime.
• Gradually decrease mental and physical activity before going to bed.
• Sleep environment. Proper sleep environment can contribute to a good night's sleep. Keep the bedroom cool, well ventilated, quiet, and dark. An ideal environment for sleep is free of computers, fax machines and work projects.
• Associate your bed and bedroom with sleep. Don't watch TV or read in bed. Although these things help some people sleep, they can also give your brain the idea that bed isn't just for sleeping - and this can keep you awake.
• Don't go to bed until you are sleepy. If you can't sleep, get up, go into another room and do something relaxing until you feel sleepy. If you can't fall asleep for more than 15-20 minutes get up and read or do something that is not overly stimulating until you feel sleepy.
• Light. Keep lights low before bedtime. To feel sleepy your brain needs to produce a chemical called melatonin, a natural sedative. Being in a brightly lit room or in front of the computer makes it harder for your brain to produce melatonin, and this delays the drowsy feeling that helps you sleep.
• Naps. Try not to nap, especially in the evening, because naps may make you less sleepy at night.
• Do not look at the alarm clock or watch during the night.
• Get regular exercise. Exercising during the day encourages drowsiness at bedtime. The best time to exercise is in the daytime - particularly late afternoon or early evening. Exercising later than this may disturb your sleep.
• Relax before going to bed. Follow a routine to help relax and wind down before sleep, such as reading a book, listening to music, or taking a bath.

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