Believe it or not, sleep — or the lack of it — is the most common health concern that I discuss with my patients. Whether they can’t fall asleep, stay asleep, or find time to sleep — sleep deprivation has an enormous impact on their health and well-being. We all have to deal with the fact that our culture is not “sleep-friendly.” In 1900, the average person slept 10 hours each night, falling asleep shortly after sunset and sleeping until sunrise. By 1950, with the broad use of electrical lighting, Americans slept an average of 8 hours. And in 2000, the average American slept 6.5 hours a night, dropping 3.5 hours from the amount of sleep required by humans for the last 10,000 years! Sleep deprivation causes irritability, anxiety, lack of concentration, depression and hormonal irregularities — and you wondered what was wrong with America! Shockingly, the average American needs sleep even more than exercise. Now that’s saying something!

Many of us, despite the desire to sleep, simply cannot fall asleep or stay asleep, which can make for long, frustrating nights and delirious days. Some of this is due to the large amounts of caffeine we consume in order to function on 6.5 hours of sleep, which makes for a vicious sleepless cycle. Unplugging our over-stimulating world and recreating our natural sleep environment can help us relax into the dream world and wake up refreshed.

· Make your bedroom a sleep sanctuary — dark, quiet, cool and without electronic devices (especially the T.V.). Ear plugs can be very helpful to reduce ambient noise.

· Do not do anything in bed except sleep or make love. Never work, do homework, or pay bills in bed. If you wake up and can’t go back to sleep within 15 minutes, get out of bed and do something relaxing. Train your body that the only thing that happens in bed is sleep.

· Taking a hot bath or shower before bed can be relaxing and also raises your body temperature. As your temperature cools, your body naturally gets sleepy.

· Dim the lights and quiet the sounds in your home for the hour or two before bedtime. Remember that our ancestors were awake by firelight, not fluorescent lights.

· Try to go to sleep by 10 pm. In the ayurvedic tradition (the Indian healing tradition), the most restful hours of sleep are those prior to midnight. Remember that we are accustomed to going to bed soon after sundown and waking with the sunrise.

· Kick the caffeine habit or at least avoid drinking caffeine after noon. and avoid excessive amounts of sugar before bedtime.

· Consider essential oils such as lavender or lemon balm in your bath, on your skin in a lotion or oil or dropped on to your pillow for their sleep inducing quality. You can get lavender and lemon balm plants from your local farmer’s market vendor.

Still sleepless? There are many natural remedies that can help.

· All types of meditation can help quiet the mind and heart before bed. I am particularly fond of a simple Taoist exercise where you lie in bed, take a deep breath and bring your hands over your head, palms facing your feet and elbows bent. Now exhale making the sound “HEEEEEEE” while you push your palms down your body toward your feet. Imagine that you are emptying your head of unnecessary thoughts and clearing them from your body. You can repeat this as many times as are necessary.

· Some foods are sleep inducing, including milk (thus grandma’s hot milk and honey before bed remedy) and foods high in l-tryptophan, such as turkey. The general rule is that a small snack is helpful. Whole grain bread and turkey or some of our fabulous seasonal fruits and cheese are great options, but a large meal close to bedtime can impede sleep. L-tryptophan or 5-hydroxytryptophan (5-HTP) are precursors to the neurotransmitter serotonin and are also available as supplements that can assist in sleep and anxiety. See your health care provider for guidance on these and other remedies.

· Many herbs are safe and effective for inducing sleep without the addictive quality of some prescription sleep medications. My favorite is valerian root, which can be taken in doses as high as 600mg, 45 minutes before bedtime. Other herbs are also safe and sleep inducing, whether in a tea, tincture or capsule form, such as chamomile, passionflower, hops, Jamaica dogwood and lemon balm. Especially for people with shifting sleep cycles (such as those doing shift work or traveling across time zones) melatonin at a dose of .4 mg before bed can be helpful for re-setting the internal clock.

· If sleep still eludes you, you may want to consider one of several sleep medications that can be prescribed by your physician. Remember that many of these are addictive and almost all of them disturb the sleep cycle, reducing the amount of restorative, deep sleep. They can be lifesavers during stressful short-term situations, but are not ideal for long-term use.

So get back to the quiet basics of human nightlife and create a sleep friendly home for yourself. You’ll be amazed at how good you feel and how much easier you will be to be around when you get your zzz’s!

Originally published at medium.com