A first step is to eliminate all caffeine-containing drinks, such as tea, coffee and colas, even if taking tea or coffee late in the evening has not been the cause of the problem. (See Routines, below.)

It is important to ensure quiet surroundings. This is a particular problem for shiftworkers, especially where someone wants to burn the candle at both ends, or resents having to be on shiftwork. Further shiftwork-related difficulties are outlined under Body awareness, below.

Relaxation exercises, particularly progressive muscular relaxation, are useful in their own right but are not particularly sleep-inducing in the short term. They also require considerable patience and regular practice to master, as a great part of how they work depends on building up associations between relaxation and sleep. With regular practice, subjects find they drift off halfway through their exercises. Recordings or relaxation programmes promising sleep, however, rarely mention the fact that considerable hard work and patience are required. The failure of these methods to deliver a short-term result leads many to feel frustrated and to abandon what is a useful skill.

There is a regular cycle, operative in all of us, called the basic rest–activity cycle. ² This produces alternating peaks and troughs in arousal at regular intervals. This rhythm can be seen most clearly in infants, who wake and sleep on a 3–4-hour cycle. In later life this cycle continues so that we have our mid-morning and mid-afternoon dips. The same cycle also underlies the stages of sleep. In normal sleep we progress regularly through a series of stages of sleep called stages 1, 2, 3 and 4 of non-REM sleep and then REM sleep. In this process we sink deeper into sleep and come back to the surface before sinking again, several times during the night.