"Having a regular routine that you do every night helps signal to the body that it's time to go to bed."

"Having a regular routine that you do every night helps signal to the body that it's time to go to bed."(LAWRENCE EPSTEIN)

Lawrence Epstein, MD, is the regional medical director for the Harvard-affiliated Sleep HealthCenters, an instructor at Harvard Medical School, and past president of the American Academy of Sleep Medicine. He is coauthor of The Harvard Medical School Guide to a Good Night's Sleep.

Q: My wife wants to put a nightlight in our room, but I think that even a tiny bit of light keeps me awake sometimes. Is it my imagination?

A: No, it may not be your imagination. Light is a stimulant that can keep some people from falling asleep. The optimal bedroom is dark, quiet, and comfortable. Ideally, you'll get rid of all light sources in your room. Digital clocks and other electronics have LED displays that commonly light up people's bedrooms, so get rid of them or turn clocks to the wall when you sleep. You want to create an environment that's most conducive to sleep, and for you, that may mean complete darkness.

Q: My dad says I should put a sheet of plywood under my mattress to make it more comfortable, but I think that makes it feel worse. Is that really a good tip for everyone?

A: Part of the equation of getting a good night's sleep is having a bed that's comfortable. But there isn't a lot of data available about firm versus soft or what makes a good mattress. It's personal preference. If the bed isn't comfortable with plywood, you're not going to sleep well, so opt for something else.

Q: I sleep a lot better during the winter, when the house is colder. Is this just a coincidence, or is it really harder to fall asleep if you're warm?

A: People seem to fall asleep better in a narrow range of temperatures on the cool side, rather than the warm side. The low 70s are generally preferred. During very hot or cold weather, the temperature in your room can interfere with your ability to fall asleep. If you find this to be the case, keep your room in the comfortable range by adjusting your heat or air-conditioning accordingly.

[ pagebreak ] Q: I'm looking for a new mattress and want to choose a model that will help me sleep the best. What sort of features should I look for?

A: Again, this is a matter of personal preference. There isn't a lot of data available about firm versus soft or what makes a good mattress. Just be sure to shop for mattresses in person (rather than online or over the phone) and lie down on various models to see how comfortable they are.

Q: My husband falls asleep in about two minutes, but it takes me a long time because I'm stuck listening to him snore. I've heard about white noise machines but don't know what they do. Could one help me?

A: Yes, something that will reduce your exposure to unwelcome noise can improve your sleep, including white noise machines (which play calming background sounds to drown out other noise), earplugs, or thicker window coverings if the disturbance is external.

If your husband's snoring is the issue, address the problem head-on: He should see a doctor. Snoring can be a marker for obstructive sleep apnea—especially if you notice that your husband gasps in his sleep or pauses in his breathing at night. Even if the snoring isn't caused by sleep apnea, though, there are several strategies your husband can try to eliminate his snoring, if he's interested.

Q: What should I do when I wake up in the middle of the night and find myself staring at the clock? This happens at least once a week, but I need my alarm to wake up for work.

A: Waking up during the night is a normal occurrence; everyone does it several times per night. We don't all become aware of it, though. Often we just roll over and fall back asleep. Night wake-ups only become a problem when we get annoyed and frustrated while looking at the clock and can't go back to sleep.

Finding a way not to look at the clock is helpful. Try putting a cover over the front or turn it around 180 degrees. Or tell yourself that if you wake up during the night and the alarm hasn't gone off, it means that it's time to go back to sleep; it doesn't matter what time it is.

Q: Is it true that I'll fall asleep easier if I only use my bed for sleep and sex? Right now, I also read and watch TV in bed.

A: Using your bed for sleep and sex only can be helpful if you've made bad associations with your sleep environment. Ideally, you'll associate your bed as a place to go for sleep. If you think of it as a place to go for entertainment or for getting frustrated because you have trouble sleeping, then it becomes harder for you to relax there, making the problem worse. If that's the case, you should limit the bedroom to sleep and intimacy only. Do other things elsewhere. Your bed should not be a place of entertainment, worry, or anxiety.

[ pagebreak ] Q: What's the best way to relax before bed? A bath or shower? Dimming the lights? Something else?

A: This is really a matter of personal preference, but warm baths or showers before bed are common routines, as is watching TV, listening to music, and reading. Having a regular routine that you do every night helps signal to the body that it's time to go to bed, so that can also be relaxing (and it can incorporate activities like a bath).

There are some activities that should be avoided before bed, namely work and exercise. Exercise is a stimulating activity, so don't do it during the last few hours before bedtime. And work isn't relaxing, so don't do it up until the minute that you go to sleep.

Q: Could dust or pet hair in the bedroom be making it harder for me to fall asleep?

A: If your allergies flare when your pet is in the bedroom, yes, it could be a problem. The logical solution: If you have allergies and you have pets, get rid of your pets—or at the very least, don't let them in your bedroom. If you have dust allergies, you'll want to keep your bedroom as clean as possible.

It may be helpful to avoid having carpet under the bed, since it can trap a lot of dust. Allergies can interfere with your sleep, so be rigorous about keeping an allergen-free environment, and see your allergist regularly and take any allergy medications he or she prescribes.

Q: How should I pick out the most sleep-conducive sheets and pillows? There are too many choices in the stores, and I feel overwhelmed.

A: I don't have any specific suggestions or recommendations; it's a matter of personal preference. Pick bedding materials that feel comfortable to the touch and are within your budget.

Q: My sister has mentioned that relaxation techniques have made it easier for her to fall asleep at night. What's involved, and can they help me?

A: Relaxation techniques can be very helpful, because the primary problem in insomnia is a hyperarousal response. Anything to help you relax is beneficial, such as meditation, breathing exercises, and cognitive-behavioral therapy. Relaxation is a precursor to falling asleep.

All of the techniques require practice; they need to be part of your daily routine. You can't do them every now and then and expect them to be effective. And you can't expect results the first night that you try them. There are a variety of ways to learn the techniques. You can take a class in meditation and yoga, read a book for breathing exercises, or take lessons from a professional.