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     If you are a teenager or college student and can’t sleep, we need to know if you can’t fall asleep or you can’t stay asleep.  There is a difference.  Of course, you could have both problems.

     If you are young, or old for that matter, and have difficulty falling asleep, either you are worrying too much, have anxiety, or you are playing on electronic devices too late in the evening.  It has been shown that the back-lighting from the computer or smart phones or tablets can delay the time to going to sleep by a couple to a few hours.  If that is you, perhaps you should get away from them two-hours before going to bed.  If you have anxiety and can’t fall asleep, you might need help with the anxiety to fix the problem.

     Generally, if you are younger and can’t stay asleep, or have early morning awakenings where you can’t go back to sleep, you might have a form of depression.  This is true for older patients as well.  To fix this, the depression might need to be treated.  Early morning awakenings might be the only symptom you have of depression.

     As we age, sleep comes harder, and there are genetic differences in how much sleep an individual might need.  If you are getting up in age and don’t seem to sleep well, you might be normal.  If you have restless sleep, are overweight and snore, you might have sleep apnea, a potentially deadly disorder if not treated.

     Sleep hygiene is important for some.  What we mean by this is the prep work that goes into getting a good night’s sleep.  If you sleep during the day, or get up around noon, the odds are that you will stay up late, or have difficulty going to sleep.  Fixing this will require some discipline to stay awake during the day to break the cycle.

     If you are accustomed to using alcohol to fall asleep, it won’t work for long.  Too much alcohol interrupts restorative sleep, called REM sleep.  REM stands for Rapid Eye Motion sleep.  That is when you get your best sleep.  Anxiety medications can do the same thing.

     If you drink or eat caffeine before bed, or take stimulants, sleep will be difficult.

     Other medications you chronically take might affect your ability to sleep.  Check the side-effects of your medications, especially if you are taking them at night.

     After you have limited caffeine, fixed your sleep hygiene, treated the anxiety and depression and cut off the electronics, if you still can’t sleep, try sleeping in a totally dark room.  Try to grey-out your mind and think of something pleasant.  Perseverating over your problems will only make it more difficult to sleep and will not fix them.

     Benadryl, also known as diphenhydramine, can help you go to sleep.  And these medications, though over-the-counter, can cause you to have restless legs, and make you groggy in the morning.  Prescription sleep medications are for sparse use.  If you use them all the time, you might get dependent on them, though some newer ones, not so much.

There are other nutritional sleep aids on the market that go by various names.  Most are harmless, and some really help.