>Who's At Risk?

>Hazards of Sleeplessness

>Improving Sleep Hygiene

>Sidebar: Defining Insomnia

>Sidebar: Signs of Inadequate Sleep

>Sidebar: Insomnia and Age

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It's 2 a.m., and despite a grueling day at work you're still wide awake. You stare at the ceiling as your mind replays everything that went wrong during the day and the various problems you'll be facing tomorrow. "If I fall asleep now," you tell yourself, "I can still get five hours of rest." But no matter how hard you try, sleep remains frustratingly elusive. In the dark, your alarm clock tick-tick-ticks away the minutes of another sleepless night.

Like the common cold, insomnia is a problem that afflicts nearly everyone at one time or another. In most cases it's a temporary ailment caused by situational anxiety—worry over an upcoming business meeting, for example, or perhaps difficulties at home. But for nearly 35 percent of American adults, an inability to initiate or maintain sleep is a daily nightmare that affects almost every aspect of their lives, reports the National Sleep Foundation.

Thankfully, insomnia is almost always treatable, say sleep experts. In fact, sometimes the solution is as simple as buying a new bed.

Who's At Risk?

Insomnia is a condition that doesn't discriminate, though women are nearly twice as likely as men to report sleep difficulties, notes Susan Zafarlotfi, PhD., clinical director of the Institute for Sleep/Wake Disorders at Hackensack University Medical Center in Hackensack, N.J. Type-A personalities-those chronic worriers who always have to be in control—are another high-risk group.

"Insomnia also runs in families," Dr. Zafarlotfi reports. "When I interview patients, quite often they will say, 'I remember my grandmother never slept,' or 'Dad was always an insomniac.'" So if your parents or siblings have trouble sleeping, don't be surprised if you do too.

Stress is one of the most common causes of chronic insomnia. Often the resulting anxiety prevents the brain from "shutting off" at bedtime, making sleep all but impossible, explains Joyce Walsleben, PhD., a sleep researcher and clinician at the New York University Sleep Disorders Center. But other factors can also contribute to sleeplessness. They include:

* Health problems—especially those that result in chronic pain such as arthritis and fibromyalgia. "Asthma can also cause insomnia," notes Dr. Walsleben. "So can allergies, especially when they cause a stuffed nose, and restless legs syndrome, in which the patient just can't settle down to get to sleep."

* Certain prescription and over-the-counter drugs, including medications for the treatment of asthma and depression, can trigger insomnia.

* Lifestyle is another factor. "Daytime activities can impact how well we sleep at night," observes Walsleben. An office worker who downs cup after cup of coffee over the course of the day, for example, should not be surprised if he has difficulty sleeping when he finally goes to bed. And coffee isn't the only food containing this popular stimulant—caffeine can also be found in tea and chocolate.

Alcohol and tobacco consumption also are known to affect sleep. So is exercise if performed too close to bedtime.

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