I have had insomnia off and on all my life, but my stroke brought this problem to a new level. I had a stroke in the brainstem which contains the reticular formation that puts us to sleep and wakes us up. Since my stroke I have repeatedly had nights where I get only two hours of sleep per night. In February I did not sleep for two days. What FREAKED ME OUT was that I did not feel sleepy for
2 days so I got aggressive about addressing this problem. If you want to read about what sleep deprivation does to your brain read Dean's posts.
Daytime routine. I avoid caffeine after 10 in the morning and exercising and eating late at night.
Bedroom environment. I sleep in a dark bedroom with no TV. The alarm clock is placed where I cannot see it. Sometimes I wake up and find I am sweating. After my February freak out I lowered the room temperature because a lower body temperature tells the brain to sleep.
Preparing for bed. If I am sleepy at 10 p.m. I go to bed. If I wake up in the middle of the night at least I have slept for 4 or 5 hours because I went to bed early. If I am still wide awake at 10 p.m. I go to war. (1) I turn off the TV, wash my face and brush my teeth, and come back to the living room to listen to a calming CD (e.g. sounds of the ocean) for as long as it takes for me to feel sleepy.
(2) While I listen to the CD I assess my body. If my knee hurts I take Tylenol. If the constant burning in my foot bothers me I provide a competing sensation by taking a warm gel pack to bed.
Back up plans. (1) If I lay in bed and cannot fall asleep, I get up and eat a banana. Bananas have tryptophan that helps the body make the melatonin that makes us sleepy. This strategy works only when I realize how long I have been lying awake AND I have the fortitude to get out of bed.
(2) If I wake up at 3 a.m. to go to the bathroom I do not wait to see if I will fall asleep again.
Before I get back into bed I start a calming CD at a low volume or turn on a fan for a low
background noise. This often helps me fall asleep again.