Dr vinod rai

Frequently Asked Questions

Epilepsy is a common neurological disorder characterised by recurrent epileptic seizures (mostly sudden jerking, tingling or loss of consciousness) caused by abnormal or excessive electrical discharges from brain cells.

What are some of the causes of epilepsy?

About 65 percent of new epilepsy cases have no obvious cause. Of the rest, the more common reasons include stroke, congenital abnormalities (those we are born with), brain tumors, trauma, and infection (TB and NCC). It is important to determine the cause to treat it with complete success.

How is epilepsy diagnosed?

The evaluation of patients with epilepsy is aimed at learning the type of seizures (epileptic or non-epileptic) and their cause, since various seizure types respond best to certain treatments. The diagnosis is based on:

1. The patient’s medical history, including any family history of seizures, associated medical conditions, and current medicines the patient is taking. Your doctor will ask you some important questions, including the following:
• At what age did the seizures begin?
• What circumstances surrounded your first seizure?
• What factors seem to bring on the seizures?
• What do you feel before, during, and after the seizures?
• How long do the seizures last?
• Have you been treated for epilepsy before?
• What medicines were prescribed and in what dosages?
• Was the treatment effective?

2. Others who have often seen you before, during, and after seizures, such as family and close friends, should be with you at the appointment to give details of your seizures if they involve loss of consciousness (if you passed out).

3. Additional testing often includes:
• An electroencephalogram (EEG), which measures electrical activity in the brain
• Imaging studies of the brain, such as magnetic resonance imaging (MRI)
• Blood tests to measure red and white blood cell counts, blood sugar, blood electrolyte levels, and to check how well your liver and kidney are functioning. Blood tests also help rule out other illnesses.
• Other tests are used as needed, including magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and single photon emission computed tomography (SPECT).

The most important part of the evaluation is the electroencephalogram (EEG) because it is the only test that directly detects electrical activity in the brain (seizures are defined by abnormal electrical activity in the brain). During an EEG, electrodes (small metal disks) are attached by glue to specific locations on your head. The electrodes are also attached to a monitor to record the brain’s electrical activity. The EEG is useful to confirm a diagnosis of epilepsy and to determine the type of epilepsy.
Prolonged EEG-video monitoring is an even better diagnostic method. During this type of monitoring, an EEG monitors (checks) the brain’s activity and cameras videotape body movements and behavior during a seizure. In order to perform prolonged monitoring, the patient may have to spend several days in a special hospital facility. Prolonged EEG-video monitoring is sometimes required to definitively diagnose epilepsy and to choose the best treatment option.

Who treats epilepsy?

A neurologist, a doctor who specializes in diseases of the brain and nervous system, best decides the diagnosis of epilepsy. He also finds out the cause of epilepsy and chooses best medication for individual patients out of more than 25 anti epileptic medications available.

How is epilepsy treated?

Most epileptic seizures are controlled with drug therapy, especially anticonvulsant drugs. The type of treatment will depend on several factors, including:
• The type of epilepsy (focal/partial or generalized)
• How often the patient has a seizure
• How severe the seizures are, and
• The person’s age, overall health, and medical history

The correct diagnosis of the type of epilepsy (not just the type of seizure, since most seizure types occur in different types of epilepsy) is very important to help choose the best treatment.
Although the types of epilepsy are widely different, in general, medicines can control seizures in about 70 percent of epilepsy patients.
It might take a few months before the best drug and dosage are determined for you.It is very important to follow-up with your doctor for monitoring of side effects and efficacy of drug.

What are the side effects of epilepsy medicine?

As is true of all drugs, epilepsy drugs may have side effects, which depend on the dose, type of medicine, and length of treatment. The side effects get worse with higher doses of medicine, but tend to be less severe over time as the body adjusts to the medicine. Anti-epileptic drugs are usually started at lower doses and increased gradually to make this adjustment easier.

Side effects of epilepsy drugs can include:
• Blurry or double vision
• Fatigue/sleepiness
• Unsteadiness
• Stomach upset
• Skin rashes
• Low blood cell counts
• Liver problems
• Swelling of the gums
• Hair loss
• Weight gain
• Tremor

When is surgery for epilepsy considered?

Generally, patients who have seizures that start in a focal area of the brain, and that have not been controlled with medicine, are considered for surgery.

What precautions should pregnant women who have epilepsy take?

Women who have seizures can have healthy children, as long as they receive good prenatal care. It is very important that women who have epilepsy discuss pregnancy with their doctors BEFORE getting pregnant. All women of child-bearing age who have epilepsy should take folic acid every day, because some epilepsy medicines drain the body of important vitamins.
If a woman becomes pregnant unexpectedly, she should NOT stop taking her seizure medicine without first talking to her doctor. Suddenly stopping seizure medicine commonly leads to more frequent seizures, which can also harm the baby.
Women who take seizure medicines can breast feed their infants. Some medicines can cause babies to become very sleepy and irritable after feedings. If these effects occur, stop breast feeding until you talk to your doctor.


Migraine is one of most common type of headache disorders, characterised by constant throbbing pain at the temples and forehead, one or both sides of the head. The pain is usually accompanied by a combination of nausea, vomiting, and sensitivity to light and noise. Some people (about 15% of migraine sufferers) experience an aura (visual disturbances) before an attack.

What is an aura?

About 15-20% of people with migraine get an “aura,” which is a manifestation of neurological symptoms that occurs before a migraine headache. Patient may see wavy or jagged lines, dots, or flashing lights; or you might experience tunnel vision or blind spots in one or both eyes. The aura can include visual or auditory hallucinations and disruptions in smell (such as strange odors), taste, or touch. Other symptoms include numbness, a “pins and needles” sensation, or difficulty in recalling or speaking the correct word. These neurological events may last as long as sixty minutes and will fade as the headache begins.

What is a trigger?

Certain physical or environmental factors, such as foods, hormonal changes, weather, sleep and stress, can lead to or “trigger” a migraine. However, it’s important to remember that triggers are different for everyone. That’s why, to help prevent migraine attacks, you need to figure out which triggers affect you and which ones don’t. Keeping a headache diary is an effective way to track triggers, and it will help you talk to your healthcare professional about your condition.

What are acute medications for migraine?

Acute medications – sometimes referred to as acute abortive medications – are used to treat the pain of the headache after it has started. Examples of acute abortive medications include over-the-counter medications, NSAIDs, ergots, and triptans.

What are preventive medications for migraine?

Preventive medications for migraine – sometimes referred to as “prophylactic” treatments – are used to reduce the frequency, severity, and length of migraine attacks. Examples of preventive medications include antiepileptic medications, antidepressants, beta-blockers, calcium channel blockers, and NSAIDs (nonsteroidal anti-inflammatory drugs).

What is a tension-type headache? What causes it, and how can I treat it?

Tension-type headaches occur randomly and are often the result of temporary stress, anxiety, fatigue, or anger. Symptoms include soreness in your temples, a tightening band-like sensation around your head (a “vice-like” ache), a pulling feeling, pressure sensations, and contracting head and neck muscles. The headache begins in your forehead, temples, or the back of your head and neck. Treatment for tension-type headache may include over-the-counter or prescription medications, as well as self-help techniques such as relaxation training and biofeedback.

What is a cluster headache? What causes it, and how can I treat it?

Cluster headache gets its name because the attacks come in groups. The pain arrives with little, if any, warning and is usually on one side of the head. A tearing or bloodshot eye and a runny nose on the side of the headache may also accompany the pain. Cluster headache, believed to be caused by chemical reactions in the brain, has been described as the most severe and intense of any headache type. Treatment for cluster headache includes prescription medication and oxygen.

What is a sinus headache? What causes it, and how can I treat it?

When a sinus becomes inflamed, usually as the result of an allergic reaction, a tumor, or an infection, the inflammation will cause a localized pain. If your headache is truly caused by a sinus blockage, such as an infection, you will probably have a fever. An x-ray will confirm a sinus blockage. Your physician’s treatment might include antibiotics for the infection, as well as antihistamines or decongestants.

Are headaches hereditary?

Not always.Despite the uncertainty, a child has a 50% chance of having migraine if one parent suffers and a 75% chance if both parents suffer.

What type of doctor should I see to diagnose and treat my headache?

A neurologist, a doctor who specializes in diseases of the brain and nervous system is the best person to diagnose and treat your headache.

The precise definition of vertigo is an illusion of motion. But it also refers not just to illusions of motions, but chronic or intermittent sensation of loss of balance.

What are common causes of vertigo?

There are a large number of causes of vertigo, but the three most common causes are:
• Cold viruses
• Head trauma
• Stroke
• Meniere’s disease

Those are the most common causes.

What do these conditions do to cause this problem?

These are all conditions that affect the inner ear, brain or their connection. The inner ear is responsible for our sense of balance and also our sense of position in space. When the inner ear dysfunctions, we lose our sense of balance and frequently suffer symptoms such as vertigo, nausea, vomiting, and loss of balance.

How can this be treated?

Most causes of vertigo are readily treatable with physical therapy, medication and time (many causes of vertigo resolve spontaneously).some patient might need surgery depending upon exact cause of their vertigo.

Who should I see for vertigo treatment?

Neurologists or Otolaryngologists.

Can stress cause vertigo?

Mental stress can make many forms of vertigo worse, but will not, by itself, produce vertigo.

What is positional vertigo?

Positional vertigo refers to a variety of conditions where a change in the position of your head produces a sense of vertigo. The most common form is a condition called benign paroxysmal positional vertigo or BPPV for short. In BPPV when one lies down with the affected ear toward the floor, one gets a brief but very intense feeling of the world spinning around.

Is ataxia/unsteadiness related to vertigo?

Ataxia refers to clumsiness. Disease of the inner ear does not produce ataxia per se but can be confused with ataxia. Ataxia is produced by disease of the cerebellum, a part of the brain that works with the inner ears to help maintain balance and also fine motor control.

Can the symptoms of vertigo be confused with the symptoms of other diseases or conditions?

Yes, this is a common occurrence. Usually they are mistaken because of use of the word dizziness. Dizziness can refer to light headedness, which is not vertigo and is commonly produced by vascular problems. Dizziness also can mean vertigo, and there are very few causes of vertigo that do not come from the inner ear. Occasionally, rare types of strokes can cause vertigo, but these are usually associated with other neurological symptoms as well.

Does physical therapy help vertigo?

Yes. The reason physical therapy is helpful is that it helps train the brain to compensate for the loss of function in the ear. Just as you can make a muscle stronger by exercising it, you can make the balance system in the brain work better by exercising it.

What kind of physical therapy works to reduce vertigo?

It’s called vestibular rehabilitation, and it is a relatively new form of physical therapy. Not all physical therapists are trained in the practice. Typically the exercises consist of movements that initially make the vertigo worse and balance tasks that are quite difficult. By doing these repetitively, the balance system in the brain learns to function better. Common exercises include moving the eyes from side to side, rotating the head from side to side, rotating the head from side to side while walking down a corridor, and things like this.

Is anxiety associated with vertigo?

Yes, vertigo causes extreme anxiety in most people. Anxiety, by itself, does not produce vertigo. However, in association with conditions that do produce vertigo, anxiety can make the vertigo much worse. People with certain anxiety disorders such as panic attacks can sometimes also experience vertigo.

What is particle repositioning maneuver?

Particle positioning maneuvers are a treatment for BPPV, which we defined earlier in this chat. BPPV is caused by loose otoconia within the inner ear. Otoconia are small calcium carbonate crystals that are part of the balance mechanism. In BPPV, these crystals break loose from their normal attachments and are free to tumble around the inner ear. When the involved ear is suddenly put in a downward position, the otoconia stimulate part of the inner ear abnormally. This results in a brief but intense whirling vertigo. Particle position maneuvers are a series of body turns that maneuver the otoconia into a different part of the inner ear where they will not cause symptoms. It is a very effective maneuver that takes just a few minutes to perform.


STROKE is sudden vascular damage to brain either due to blockage of a blood supply of brain (ischemic), or leakage of blood in brain(hemorrhagic). In an ischemic stroke, a blood clot blocks or plugs a blood vessel or artery in the brain. About 80 percent of all strokes are ischemic. In a hemorrhagic stroke, a blood vessel in the brain breaks and bleeds into the brain. About 20 percent of strokes are hemorrhagic.

What happens when you have a stroke?

When a stroke occurs, the blood supply to part of the brain is suddenly interrupted. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.

What are the symptoms of stroke?

Symptoms include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.

An easy was to remember the symptoms is F.A.S.T
• Facial Droop
• Arm Weakness
• Speech
• Time

Why can’t some victims identify their stroke symptoms?

Because stroke injures the brain, one is not able to perceive one’s own problems correctly. To a bystander, the stroke patient may seem unaware or confused. A stroke victim’s best chance is if someone around her recognizes the stroke and acts quickly.

What should I do if I think someone is having a stroke?

During a stroke, bystanders should know the signs and act in time. If you believe someone is having a stroke — if the person loses the ability to speak, to move an arm or leg on one side, or experiences facial paralysis on one side — call ambulance. Stroke is a medical emergency. Immediate stroke treatment may save someone’s life and enhance his or her chances for successful rehabilitation and recovery.

Why is it important to get to the hospital as quickly as possible?

Ischemic strokes, the most common strokes, can be treated with a drug called tPA, which dissolves artery-obstructing clots. The window of opportunity to use tPA to treat stroke patients is small, so the sooner stroke patients can get to the hospital to be evaluated and receive treatment, the better their outcome. Stroke patients who receive tPA for their stroke symptoms are at least 30 percent more likely to recover from their stroke with less disability after three months than those who present to the hospital after three hours and are thus unable to receive tPA.

What are risk factors for stroke?

There are things you can do to lower your risk of stroke. High blood pressure increases your risk of stroke four to six times. Heart disease, especially a condition known as atrial fibrillation, can double your risk of stroke. Your risk also increases if you smoke, have diabetes, sickle cell disease, high cholesterol, or a family history of stroke.

What is the treatment for stroke?

Generally, there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual’s underlying risk factors for stroke such as high blood pressure, atrial fibrillation, and diabetes. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet drugs and anticoagulants or “blood thinners”) and thrombolytics.

What is the prognosis for stroke?

Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech. A stroke can lead to emotional problems; patients may have difficulty controlling their emotions or may express inappropriate emotions, and many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations, including pain which is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.
Recurrent stroke is frequent; about 25% of people who recover from their first stroke will have another stroke within five years.

What can be done to reduce the risk of stroke?

To reduce your risk of stroke, monitor your blood pressure, track your blood sugar and cholesterol level, stop smoking, exercise regularly, and find out if you should be taking a drug to reduce blood clotting.


Parkinson’s disease is a progressive degenerative disorder of brain due to loss of dopamine-producing cells in basal ganglion region of brain. The four primary symptoms of Parkinson’s are tremor or trembling in hands, arms, legs, jaw, and face; rigidity or stiffness of the limbs and trunk; bradykinesia, or slowness of movement; and postural instability or impaired balance and coordination. Patients may also have difficulty walking, talking, or completing other simple tasks. The disease is both chronic and progressive.

How Parkinson is’s diagnosed?

There is no standard test to conclusively show if a person has Parkinson’s disease. The disease should be diagnosed by a neurologist with clinical features and examination.

Is there any treatment?

A variety of medications provide dramatic relief from the symptoms, but no drug can stop the progression of the disease. In some cases, surgery (Deep brain stimulation) is an appropriate treatment. Physical therapy, healthy life style or exercises might help. Surgical options, such as deep brain stimulation, may help alleviate a person’s Parkinson’s symptoms if and when they stop responding favorably to medication. However, surgery is only effective for a small group of people with Parkinson’s and is only recommended if an individual meets specific criteria.

What is the prognosis?

Its a progressive disorder, most patients are disabled by 10 years of disease onset. At present, there is no way to predict or prevent Parkinson’s disease.

Can people die from Parkinson’s?

Parkinson’s disease is a progressive disorder, and although it is not considered to be a fatal, disease, symptoms do worsen over time and make life difficult. People with Parkinson’s experience a significantly decreased quality of life and are often unable to perform daily movement functions, such as getting out of bed unaided and driving. In some cases, people have died from Parkinson’s-related complications, such as pneumonia.


Multiple sclerosis (MS) is a central nervous system disorder that affects the brain ,optic nerve and spinal cord. MS is an inflammatory demyelinating disorder because the myelin sheath that protects nerves is stripped off during inflammation. When this happens, the nerves cannot conduct electricity as well as they should, causing various symptoms. Symptoms may be the type that come and go over time (relapsing-remitting MS) or progress over time (progressive MS). MS can happen to just about anyone and is long-term.

How is MS diagnosed?

Multiple sclerosis is often difficult to diagnose because there is no single test or finding on an exam that makes the diagnosis and because the disorder varies from person to person. In most cases, there is a history of neurological symptoms that come and go over years. Clinical course and specific changes in magnetic resonance imaging (MRI) suggest the diagnosis of MS. Spinal fluid testing may show that the immune system is active in and around the brain and spinal cord, supporting the diagnosis. Evoked potentials may assist in diagnosis. All of these need to be put together by the physician to determine if MS is the actual diagnosis.

What are some early symptoms of MS?

MS varies from person to person so there is no ‘standard’ set of symptoms for MS. However, we know that common symptoms of MS include:
• Numbness or tingling in various parts of the body
• Walking difficulties
• Weakness of one or more body part
• Fatigue
• Visual blurring, and occasionally, double vision
• Dizziness
• Lhermitte’s phenomenon, a symptom in which people feel electrical tingling or shocks down their back, arms, or legs when they bend their neck forwards
• Urinary symptoms, such as hesitancy when trying to urinate, or a feeling of urgency (when you have to go, you have to go)

There is no way to predict which symptoms one person might develop.

What is demyelination?

In MS, patients develop various areas in the brain and spinal cord where the myelin is stripped off of the nerves. These areas are called plaques or sometimes lesions. When the myelin is off, the electrical conduction of these nerves is altered. It is like getting a fuzzy signal on a television set. This event may affect any aspect of central nervous system functioning, causing symptoms. The symptoms may vary over time depending on how extensive the demyelination is and on factors such as fatigue and heat.

Are there different types of MS?

MS varies from patient to patient so that each individual has their own set of symptoms, problems, and their own course. There are people who have MS so mildly that they never even know that they have it. Of course, there are also others that have it severely. It is really a spectrum that ranges from mild to severe. An international panel of experts developed a classification of MS in 1999 that most neurologists use today:
• Relapsing-remitting: Patients have attacks of symptoms/signs, with or without recovery, but between attacks have no interval worsening.
• Secondary progressive: This is often after a few years of relapsing-remitting MS. The pattern changes from a relapsing pattern to progressive in between attacks, usually with fewer attacks.
• Primary progressive: This involves a gradual onset from the beginning and no attacks.
• Progressive relapsing: This is a rare form, and begins with a progressive course, while later developing attacks.
• Fulminant: This is a rare form, and is very severe, rapidly progressive MS.

What is an attack?

An MS attack is also known as a ‘relapse’, an ‘exacerbation,’ or a ’bout’ of MS. All of these terms mean the same thing–usually a worsening of MS symptoms or new MS symptoms lasting more than 48 hours and not due to infection or fever. An attack may be mild or severe; it may or may not correlate with MRI changes, though neurologists do not usually perform MRI imaging as part of an attack evaluation. Many patients have a daily variation of their symptoms; this is not an attack. Similarly, some patients may develop transient symptoms lasting only seconds such as twitching in an arm or a leg. This is also not an attack. Attacks are one marker of disease activity.

Is MS contagious or inherited?

No. MS is not contagious or directly inherited. Studies do indicate that genetic factors and certain environmental factors may make certain individuals more susceptible to the disease.

Can MS be cured?

Not yet. There are now FDA-approved medications that have been shown to “modify” the course of MS by reducing the number of relapses and delaying progression of disability to some degree. In addition, many therapeutic and technological advances are helping people manage symptoms. Advances in treating and understanding MS are made every year, and progress in research to find a cure is very encouraging.

Sciatica is a term used to describe a group of symptoms that can result from compression of the sciatic nerve. The largest and longest nerve in the body, the sciatic nerve, spans from the base of the spine through both legs to the feet. Sciatic nerve compression can lead to pain that originates in the lower back and radiates through the buttocks, legs and feet. It can also cause other symptoms, such as tingling, numbness and muscle weakness. Generally, sciatica manifests on only one side of the body, but it can sometimes affect both sides.

What causes sciatica?

Most often, sciatica results from a degenerative spine condition, such as a herniated disc or bone spur. When damaged disc material or excess bony growth is positioned in such a way that it exerts pressure on the sciatic nerve, painful symptoms can arise. Similarly, sciatica can be caused by a traumatic injury, such as a pelvic fracture, or by spasms of the piriformis muscle in the pelvic region.
Sciatica symptoms can also occur along with diseases like diabetes, which can cause neural damage, or by the formation of tumors that press on the sciatic nerve. This is why it is so important to get a proper diagnosis if you are experiencing symptoms.

What are the symptoms of sciatic nerve compression?

The hallmark of sciatica is radiating pain — tingling, numbness and burning sensations that originate in the lower spine and travel down through the buttocks, the backs of the legs and sometimes into the soles of the feet. Sciatica can also cause weakness in the legs, knees and feet and, in severe cases, a loss of mobility.

What are the treatment options?

Treatment usually begins conservatively with options like rest, pain relievers, hot and cold compression and physical therapy. Your doctor may also recommend making lifestyle changes to potentially improve the health of your spine. This can include weight management, ceasing tobacco use and improving posture. The goal of any plan should be to relieve symptoms, improve mobility and decrease the pressure being placed on the spine and the sciatic nerve.

Insomnia is usually a symptom, typically secondary to something else. It is best characterized as the inability to fall asleep, stay asleep, or waking too early in the morning. These types of sleep disruptions are often indicators of other medical or psychological problems, such as sleep disorders or depression and anxiety.

What causes insomnia and what symptoms should I look for?

Insomnia is thought to be symptomatic of other things. For instance, many psychiatrists have long noted a strong connection between depression sufferers and insomnia symptoms to the point that they believe insomnia is a symptom of depression and anxiety. But insomnia can also be caused by poor sleep hygiene or lifestyle habits and practices surrounding bedtime—you might not have a set bedtime, or keep the TV on while you’re trying to sleep. You may drink a cup of coffee or a diet caffeinated soda too close to bedtime, or you might just be going through a spell of work-related stress that ‘s keeping you awake. Symptoms to be on the look-out for include: fatigue during awake hours, problems concentrating, irritability, lack of concentration, mood swings, and possible lack of good coordination.

How long does insomnia last?

Insomnia can be short-term, even one night—called transient insomnia, or it could be long-term or chronic. Some people live with insomnia for years, passing it off as their “normal” sleep pattern. Most adults require between 7 and 9 hours of sleep per night. This can drop slightly as you age, but 3 hours of sleep is abnormal.

Is insomnia treatable?

Insomnia treatments are available. Problem is that since insomnia is a big sign of some other problem your physician’s overall goal is to diagnose the primary cause for your insomnia before he or she can provide treatment for the insomnia or secondary sleep disturbance. However, treatments can include: prescription sleep aids, non-prescription or over-the-counter sleep aids, sleep hygiene, alternative therapies, or cognitive behavioral therapy (CBT).

Do I have to see a doctor for this?

Brief bouts of insomnia happen to most adults for one reason or another—relationship problems, pulling an all-nighter, PMS can cause a monthly bout, stress at work, — all of which usually resolve themselves. Long-term insomnia that affects your daily life should be brought to the attention of your doctor. Remember, insomnia is a secondary symptom of something else going on physically or mentally. Here is a self assessment quiz to help you to evaluate your situation.

What is sleep hygiene?

1. Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.

2. Practice a relaxing bedtime ritual. A relaxing, routine activity right before bedtime conducted away from bright lights helps separate your sleep time from activities that can cause excitement, stress or anxiety which can make it more difficult to fall asleep, get sound and deep sleep or remain asleep.

3. If you have trouble sleeping, avoid naps, especially in the afternoon. Power napping may help you get through the day, but if you find that you can’t fall asleep at bedtime, eliminating even short catnaps may help.

4. Exercise daily. Vigorous exercise is best, but even light exercise is better than no activity. Exercise at any time of day, but not at the expense of your sleep.

5. Evaluate your room. Design your sleep environment to establish the conditions you need for sleep. Your bedroom should be cool – between 60 and 67 degrees. Your bedroom should also be free from any noise that can disturb your sleep. Finally, your bedroom should be free from any light. Check your room for noises or other distractions. This includes a bed partner’s sleep disruptions such as snoring. Consider using blackout curtains, eye shades, ear plugs, “white noise” machines, humidifiers, fans and other devices.

6. Sleep on a comfortable mattress and pillows. Make sure your mattress is comfortable and supportive. The one you have been using for years may have exceeded its life expectancy – about 9 or 10 years for most good quality mattresses. Have comfortable pillows and make the room attractive and inviting for sleep but also free of allergens that might affect you and objects that might cause you to slip or fall if you have to get up

7. Use bright light to help manage your circadian rhythms. Avoid bright light in the evening and expose yourself to sunlight in the morning. This will keep your circadian rhythms in check.

8. Avoid alcohol, cigarettes, and heavy meals in the evening. Alcohol, cigarettes and caffeine can disrupt sleep. Eating big or spicy meals can cause discomfort from indigestion that can make it hard to sleep. If you can, avoid eating large meals for two to three hours before bedtime. Try a light snack 45 minutes before bed if you’re still hungry.

9. Wind down. Your body needs time to shift into sleep mode, so spend the last hour before bed doing a calming activity such as reading. For some people, using an electronic device such as a laptop can make it hard to fall asleep, because the particular type of light emanating from the screens of these devices is activating to the brain. If you have trouble sleeping, avoid electronics before bed or in the middle of the night.

10. If you’re still having trouble sleeping, don’t hesitate to speak with your doctor or to find a sleep professional. You may also benefit from recording your sleep in a Sleep Diary to help you better evaluate common patterns or issues you may see with your sleep or sleeping habits.