Most of us are familiar with the basic tenets of sleep hygiene…. keep a regular bed time and wake time, no caffeine after lunch, don’t exercise or use electronics close to bedtime, don’t nap, don’t do anything in your bed besides sleep (and….) These standards have been around for the last few decades but recent advances in sleep medicine have led to better advice and better treatments. I’ve created an updated list of tips to help you fall asleep more easily - without a prescription.

1. Use a weighted blanket. Target sells one for about $40. For a more stylish option, check out Bearaby’s blankets. We use the “Tree Napper” in our clinic.

2. Use a weighted eye pillow. Both the weighted blanket and the weighted eye pillow stimulate the parasympathetic nervous system, and covering your eyes releases melatonin.

3. Eat a small snack (I like Zone Perfect bars) and a glass of milk before bed. This diverts blood flow to the stomach and helps quiet the mind.

4. Learn Transcendental Meditation (TM.) . TM has been in existence for over 5000 years, and the benefits are scientifically-proven to help a variety of medical conditions. TM is easy to learn, easy to maintain, and the most well-studied of all the meditation methods. The Beatles were big believers and today, Jerry Seinfeld, Paul McCartney, Dr Oz and Tom Brady are among the many advocates. A 20 minutes session of TM reduces the body’s oxygen consumption by 16% (compared to 10% during sleep) and dips your brain into alpha 1 activity, lowering cortisol levels and releasing stress from all over your body. To learn how to do TM, find a local TM center near you, or try it at home using this self-help guide.

5. Get an air filter for your bedroom - cleans the air and provides white noise.

6. OTC Medications:

   1. Tylenol PM is just Tylenol + Benadryl. Benadryl is safe and non-habit-forming. I tell my patients to take 2 Benadryl and a melatonin if their insomnia is a moderate to severe problem. When choosing a dose of melatonin, lower is better.. higher doses create an imbalance in the brain’s sleep-wake system.

   2. Magnesium can also be very helpful to take before bed, especially if you’re pregnant. It’s a natural muscle relaxer and what is used to treat pre-term labor. I took it nightly with all my pregnancies - stopped my leg cramps, helped me sleep and kept me regular.

   3. CBD helps with anxiety, is non-habit-forming and has been shown to promote sleep. When buying CBD, look for “THC-free”… the THC is what gives people the high.. and the positive drug test!

7. Prescription Medications:

   1. Avoid benzodiazepines at all cost as they are strongly habit-forming.

   2. If you are struggling with insomnia, in addition to the above measures, exercise more, eat better, get a massage, treat yourself. Only when all else fails, should you think about taking a prescription drug.

   3. There are a slew of prescription sleep medications out there. The newest one, Belsomra, has a unique method of action that sets it apart from the others by targeting orexin receptors in the brain. Orexin is a neuropeptide that increases wakefulness; it was first discovered in narcolepsy patients who have insufficient amounts of it. Belsomra is safe, effective and unlike most other medications for sleep, has no hangover effect. Insurance companies, of course, usually won’t pay for it ($$$$) unless other, less expensive, medications have been tried first.

8. If you wake up and can’t go back to sleep….. the best trick I know, because it happens to me frequently, is to have a small snack and a glass of milk. Blood is immediately diverted to your stomach, the parasympathetic nervous system is stimulated by digestion, and your mind will quiet down.

What have you found helpful for insomnia? Please leave your comments below!