In this article: When to see a doctor about your sleep habits Links about sleep

As you count those sheep, consider your habits.

Most of us may grumble next weekend when we have to "spring forward" into daylight saving time and skip an hour of sleep.

But every night, millions of Americans lose serious time because of sleep disorders. For these people, daytime is plagued by lack of energy, difficulty concentrating and irritability. Fortunately, doctors are getting better at diagnosing and treating sleep disorders. So listen up if you're watching infomercials at 3 in the morning.

Most of us have difficulty sleeping on occasion, and it's important to note that individual sleep needs vary greatly. What really matters isn't the quantity of sleep, but the quality.

Insomnia is officially defined as the perception or complaint of inadequate or poor-quality sleep because of one or more of the following: difficulty falling asleep, waking up frequently during the night with difficulty returning to sleep, waking up too early in the morning or feeling unrefreshed by sleep.

Fortunately, most of these common difficulties are short-lived and sporadic, and people can "catch up" with a good night's rest. But chronic insomnia can last months, even years. Sufferers are left with constantly low batteries, which can lead to health problems.

The good news: If you can improve other habits, your sleep probably will improve, too. Consider whether you should modify any of the following 10 factors.

Stress. Work, family and community activities are the spice of life. But whether stress is "good" (soccer games, charity balls) or "bad" (unpaid bills, teenager trouble), the effects on sleep can be the same. Stress is harder to treat than to identify. Some experts recommend relaxation therapy, which usually requires counseling and lots of practice but can be effective.

The environment. A friend I camp with snores like a buzz saw. On our first trip, he tossed me a pair of foam earplugs without a word. I looked at him, bewildered. He smiled and said, "Trust me -- you'll need them." Boy, was he right! Bottom line: The environment makes a difference in how soundly you sleep. A quiet, cool (but not cold), dark room with a comfortable, familiar bed is your best bet.

Jetlag. If you travel a lot, crossing times zones, it helps to get on the new schedule right away. Some experts recommend taking melatonin, the "dark hormone," a substance our bodies produce so we can tell daytime from night. Our clinic's policy on melatonin: for jetlag, OK; for chronic insomnia, no.

Medications. Many people who use decongestants for allergies find that the medicine affects their sleep. I recommend that my patients with allergies and sleeping difficulty take the decongestant early in the day.

Caffeine. As a nation, we consume so much caffeine I'm surprised we aren't all named Juan Valdez! We wake up after disturbed slumber, bleary-eyed and tired, but we have a meeting we must be cheery for, so what do we do? Put on a pot of coffee! We then drink coffee all day for stimulation. That evening, the caffeine disturbs us and we don't get rejuvenating sleep. I recommend my patients limit caffeine to 200 milligrams daily. That's two small cups of weak coffee or four cans of soda.

Alcohol before bed. A drink can relax you, but it also can disturb your sleep pattern. Never have more than two drinks within two hours of bedtime.

Tobacco. Nicotine is a stimulant. The best thing for your health: Don't smoke. If you do smoke, abstain for a few hours before bed.

Irregular schedules. Physicians and shift workers certainly identify with this! Waking up throughout the night for phone calls from patients, or working where "graveyard" shifts alternate with daytime shifts, can take a toll. Try to minimize these types of disruptions.

Napping. An occasional nap on a lazy Saturday afternoon is fine, but regular napping can affect your ability to rest at night.

Exercise. Moderate workouts help you sleep by "purging" adrenaline. But vigorous exercise an hour or two before bed can disturb sleep. So exercise moderately, and not just before you hit the sack.

So, what help is available? Fortunately, losing a night or two of sleep doesn't require special treatment.

Sleeping pills often are prescribed for people with excessive daytime somnolence (EDS). But use them with caution; they have side effects and can be habit-forming. If your sleep is disturbed more than occasionally, see a doctor. Remember the saying "We have seen the enemy, and he is us!" That's fairly accurate for most who can't sleep. Resolve to be a buddy to yourself and get a good night's sleep.

WHEN TO SEE A DOCTOR

You may want to see a sleep specialist if you regularly have any of these symptoms:

Trouble getting to sleep
Frequently waking up throughout the night
Excessive daytime sleepiness
Inability to concentrate in the daytime
Feeling a need to move your legs at night in bed
"Air hunger" (gasping for air on waking up)
Loud snoring or pauses in breathing while sleeping

Contributing Editor Tedd Mitchell, M.D., directs the Wellness Program of the Cooper Clinic in Dallas.

Sleep links

Sleep information and referrals from the National Institutes of Health.
www.nhlbi.nih.gov/health/public/sleep/index.htm

Publications, research and forums from the Sleep Home Pages.
www.sleephomepages.org

Information and referrals on women and sleep disorders from the National Sleep Foundation.
www.sleepfoundation.org/whatsnew/woman_sleep.html

Research and resources on adolescents and sleep from the National Sleep Foundation.
www.sleepfoundation.org/publications/teensleep.html

Referrals and publications from the American Sleep Apnea Association.
www.sleepapnea.org/pubs.html

Questions and answers about narcolepsy from the Narcolepsy Network.
www.narcolepsynetwork.org/faq.htm

Online publications from the Restless Legs Syndrome Foundation.
www.rls.org/frames/home_frame.htm

The Better Sleep Guide from the Better Sleep Council.
www.bettersleep.org/sleep_guide/sleep_guide.html

Clarification: The Jan. 26-28 Health Smart column recommending aspirin for the fever and aches of a cold was directed toward otherwise healthy adults. Children should be given acetaminophen or ibuprofen.