The habit of sleep

Before you start taking Ambien or alongside a course of Ambien, you should change your habit patterns and practise relaxation techniques to help you get to sleep. The first step is to develop a sleep routine in a "sleep friendly" environment. Look at the temperature setting on your air-conditioning/home heating system. Try to find a cooler temperature that you find comfortable. You should also reduce distractions of light and noise. Heavier curtains may keep out flashing lights and reduce street noise.

Aim to go to bed and wake up at the same time every day. Try not to sleep during the day. If you feel tired, distract yourself until it is your "time" to go to bed. If you cannot avoid sleep, always take a nap at the same time every day and make sure that it is never for more than, say, thirty minutes. You want to "save" your tiredness until night. When you do go to bed, you should set your alarm for the morning and always get up at that time no matter how many hours of sleep you have had. If you can teach your body to work to a new set of rhythms, even on weekends, this will build up and reinforce the sleep habit.

Further, you have to avoid lifestyle choices that may make sleep more difficult. So, for example, you should not eat a heavy meal, particularly if it is spicy food, late in the day. Sleep can be elusive if you have indigestion. Drinking a significant volume of liquid is also a bad idea because you may keep waking up to go to the toilet. Caffeine in drinks close to your fixed bedtime should be avoided — stimulants do not mix with sleep.

You are more likely to fall asleep if you are tired. So did you exercise during the day? The more you lead the life of a couch potato, the more difficult it is to fall asleep at a specific time. Inactivity leads you to roll over the start of sleep until you feel tired. Because this can be at any time, this is a bad habit. You should establish a fixed routine of some exercise to tire yourself, read a book or listen to music to relax yourself, and then go to bed.

The combination of physical tiredness and a relaxed state of mind is the ideal. To be relaxed, you must reduce anxiety — particularly anxiety that you may not be able to sleep. There are a number of techniques to help you relax. These include:

• breathing and counting exercises where you exclude other thoughts in favour of producing even and controlled breathing, or simple stress-free progressions or combinations of numbers; and
• envisioning exercises where you picture yourself in calm and pleasant surroundings or produce mental images that you find peaceful.

One really important new rule is that you should get out of bed if you cannot sleep. You want a clear association in your mind between bed and sleep. Lying in bed when you are unable to sleep is bad therapy, particularly if you are watching an alarm clock slowly mark the passing of the minutes. Get up and practise the relaxation techniques you have found most useful until you feel tired. Always reinforce the link between bed and sleep. This means that you should not do other things in bed like watch TV, read a book or send SMSs — leave your BlackBerry at the bedroom door.

How does cognitive behavioural therapy help? One of the best alternatives to simple reliance on a drug like Ambien is cognitive behavioural therapy (CBT). CBT teaches you a new set of behaviours around the "activity" of sleep. You have to "relearn" the association between going to bed and falling sleep.

The habit of sleep Before you start taking Ambien or alongside a course of Ambien, you should change your habit patterns and practise relaxation techniques to help you get to sleep.