Insomnia is a persistent difficulty going to sleep or maintaining sleep that results in daytime symptoms, such as fatigue, inattention, mood disturbances or impaired performance.

Insomnia is a persistent difficulty going to sleep or maintaining sleep that results in daytime symptoms, such as fatigue, inattention, mood disturbances or impaired performance. Everyone has trouble going to sleep or staying asleep at some time in their life, and the longer this trouble goes on, the more likely it is to result in insomnia. For these reasons you might consider saving this article for future reference, in the event that you or someone close to you begins to show a pattern of trouble with sleep.

The sleep-wake cycle (also known as circadian rhythm) is perhaps the most important element for avoiding or treating insomnia. It is maintained mostly by exposure to light, especially the blue part of the spectrum. It can be adjusted forward by only about 30 minutes per day, although it can easily fall back by 2 or more hours, as anyone who has ever slept late can attest. For this reason, I advise people to get lots of exposure to sunlight or other bright light in the first part of their day. In the last 2 or 3 hours of their day they should avoid very bright light and also the full spectrum lights of their smart phones, etc. When using a smartphone or similar screen device within 2 hours of bedtime you may utilize a feature or app that deactivates the blue pixels. Night Shift is a feature of the Apple IOS 9.3 and later which does just that, and the user can enable this feature with an automatic schedule. Android has a similar Night Mode, and there are other apps available.

Sleep Hygiene is the name for a set of behaviors which have been shown to help improve the quality of sleep. This is a fairly comprehensive list aimed at people who are having some trouble with their sleep:

Have a regular time to get up each morning, and get up within 30 minutes of that time every day of the week. (This is more important than keeping to a schedule in the evening.)

Napping is a complicated issue, but if you have insomnia, avoid napping during the day.

Have an established bedtime, plan to go to bed at that time, and establish a regular relaxing bedtime routine. Try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Don't dwell on, or bring your problems to bed.

Avoid stimulants such as caffeine too close to bedtime. For some people, 3 pm may be too close to bedtime.

Avoid nicotine and alcohol too close to bedtime. While alcohol can speed the onset of sleep, it disrupts sleep a few hours later as the body begins to metabolize the alcohol. Depending on a number of factors, nicotine can sometimes be a stimulant while at other times promoting relaxation.

Avoid strenuous exercise in the evening, after about 5 pm. Vigorous or moderate exercise taken in the morning or early afternoon can help to promote good sleep.

Food can be disruptive right before sleep; stay away from large meals close to bedtime.

Associate your bed with sleep. Don't watch TV, do homework or read in bed.

Make sure that the sleep environment is pleasant and relaxing. The bed should be comfortable; the room should not be too hot or cold.

If you have problems with allergies, do your best to eliminate allergens from your bedroom. Much more could be said, but 2 common offenders are feather pillows and down comforters.

Don't clock-watch, but if you find that you are not going to sleep after 20 to 30 minutes, get up and engage in some activity that does not entail a screen, is a little boring or tedious and that you can put down with little notice. Do this in a quiet setting with low light. When you feel sleepy, stop what you are doing and go to bed. Repeat if necessary.

This article is intended to provide general information only, and is not to be taken as medical advice. For advice about a particular case or situation, consult your own physician or other trusted health professional.

Bradly Bundrant, MD, MPH, D, ABSM is a Diplomat of the American Board of Sleep Medicine.

This column is a service of The Health and Wellness Coalition of Runnels County which now meets every second Thursday at 7 pm. The next meeting will be June 14 at 7 p.m. in the Conference Room at Keel Drug in Ballinger, and it will be devoted to Emergency Planning and Preparation for Healthcare Services and Facilities.