These solutions can help

Consistently getting a good night’s sleep isn’t a luxury — it’s essential to your health. Insufficient sleep not only leaves you feeling tired and irritable but also weakens your immune system and puts you at risk for depression, weight gain and chronic headaches. To get the full health benefits of sleep, most adults should aim for at least seven hours of uninterrupted sleep a night.

Many of my patients have trouble sleeping. I often help them determine the nature of their sleep problem — and what might help.

Choose your specific sleep problem below — and try one solution at a time for up to two weeks. If the problem persists, try a second solution in combination with the first. (Don’t try three solutions at once.) Once you find the remedies that work for you, you can use them indefinitely. Before starting, check to make sure that your sleep problem is not caused by any prescription medication you might be taking.

Trouble Falling Asleep

For any reason when you first go to bed, try…

Sublingual melatonin. Melatonin, the hormone produced in the pineal gland in the brain, helps to control sleep and wake cycles. Sublingual melatonin supplements (lozenges placed under the tongue) generally work better than either capsules or tablets. Start with 1.5 milligrams (mg) of sublingual melatonin, 30 to 45 minutes before bedtime. (If this doesn’t help within three nights, try 3 mg.) Do not take melatonin if you are pregnant, breast-feeding or taking oral contraceptives.

If you have feelings of anxiety, depression or stress, start with…

5-Hydroxytryptophan (5-HTP). The body uses this amino acid to manufacture the “good mood” neurotransmitter serotonin. Taking a 5-HTP supplement increases the body’s serotonin production, promoting a sense of well-being and better resistance to stress. Start with 100 mg one hour before bedtime. (If symptoms don’t improve within three nights, try 200 mg.) Don’t take 5-HTP if you are pregnant, breast-feeding or taking an antidepressant or antianxiety medication.

If 5-HTP (above) doesn’t help and you need a more aggressive approach to anxiety and depression, add…

SedaLin. This formula, manufactured by Xymogen (health-care professionals can order it at 800-647-6100, www.xymogen.com), can help relax the nervous system. It contains Magnolia officinali extract, from the bark of a type of magnolia tree, to relieve anxiety… and Ziziphus spinosa extract from a shrub to treat irritability and insomnia. Take one capsule at bedtime for a minimum of two weeks to allow your hormone levels to adjust. (SedaLin also can be used on its own to relieve anxiety and nervousness during waking hours. Since its main role is to calm the nervous system, it won’t make you drowsy.) It is not recommended for women who are pregnant or breast-feeding.

If you are over age 60, try…

Calcium and/or magnesium. These supplements can help seniors, who are most likely to be deficient in these minerals, fall asleep by relaxing the nervous system. Take 500 mg of calcium with 250 mg of magnesium one hour before bedtime. Some people are helped by taking either the calcium or the magnesium alone. Find what works best for you.

If you are menopausal, try…

Natural progesterone. This bioidentical hormone (not to be confused with the pharmaceutical progestin) has a natural sedating effect for women with sleep problems related to low progesterone.

Best: Have your hormone levels tested. If progesterone is low, apply a total of one-quarter to one-half teaspoon of progesterone cream to the inner forearm and wrist or the inner thighs 30 minutes before bedtime.

One over-the-counter brand to try: Emerita Pro-Gest (800-648-8211, www.emerita.com). For a stronger effect, take a progesterone capsule (100 mg to 150 mg), available by prescription.

Waking in the Night

If you have trouble getting back to sleep…

Eat a light snack before bedtime. Some people wake up in the night because their blood sugar dips, triggering the adrenal glands to produce adrenaline — exactly what you don’t want while sleeping.

Solution: Eat a small snack before bedtime, such as six ounces of organic yogurt.

If you consistently wake up between midnight and 2 am, try…

Balancing stress hormones. Many people wake up in the wee hours and are unable to fall back to sleep quickly because of an imbalance in stress hormones. Melatonin can help. In addition, try…

Walking after dinner. Exercise of any kind decreases the production of stress hormones. Exercise as early as possible in the evening, at least three hours before bedtime.

Listening to relaxing music. One study showed that listening to relaxing music (such as classical) for 45 minutes before bedtime resulted in better-quality and longer sleep.

If you consistently wake up between 2 am and 4 am, try…

Balancing other hormones. Waking between 2 am and 4 am can be related to hormone imbalances, including estrogen deficiency in menopausal women (note that this is a different sleep problem than that caused by progesterone deficiency described above)… testosterone deficiency in men age 50 and older… and/or growth hormone deficiency in people age 60 or older. Have your hormone levels tested — and if they are low, get a prescription for a bioidentical hormone.