Insomnia- Treatment, Medicine disorder is characterized by chronic dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep, frequent nighttime awakenings with difficulty returning to sleep, and/or awakening earlier in the morning than desired. Although progress has been made in our understanding of the nature, etiology, and pathophysiology of insomnia, there is still no universally accepted model. Greater understanding of the pathophysiology of insomnia may provide important information regarding how, and under what conditions, the disorder develops and is maintained as well as potential targets for prevention and treatment. most every night.
Insomnia is the most common sleep disorder affecting millions of people as either a primary or comorbid condition. Insomnia has been defined as both a symptom and a disorder, and this distinction may affect its conceptualization from both research and clinical perspectives. However, whether insomnia is viewed as a symptom or a disorder, it nevertheless has a profound effect on the individual and society. The burden of medical, psychiatric, interpersonal, and societal consequences that can be attributed to insomnia underscores the importance of understanding, diagnosing, and treating the disorder[Rx]
Treatment of Insomnia
Studies have suggested that electronic devices with self-luminous “backlit” displays can affect evening melatonin, which might result in delayed sleep.
Some types of insomnia resolve when the underlying cause is treated or wears off. In general, insomnia treatment focuses on determining the cause.
Once identified, this underlying cause can be properly treated or corrected. In addition to treating the underlying cause of insomnia, both medical and non-pharmacological (behavioral) treatments may be used as therapies.
Non-pharmacological approaches and home remedies for insomnia include:
- Improving “sleep hygiene” – not sleeping too much or too little, exercising daily, not forcing sleep, maintaining a regular sleep schedule, avoiding caffeine at night, avoiding smoking, avoiding going to bed hungry, and ensuring a comfortable sleeping environment
- Using relaxation techniques – such as meditation and muscle relaxation
- Cognitive therapy – one-on-one counseling or group therapy
- Stimulus control therapy – only go to bed when sleepy, avoid watching TV/ reading/ eating/ worrying in bed, set an alarm for the same time every morning (even weekends), avoid long daytime naps
- Sleep restriction – decrease the time spent in bed and partially deprive the body of sleep, this increases tiredness ready for the next night.
- Relaxation training – aims to reduce tension or minimise intrusive thoughts that may be interfering with sleep
- Paradoxical intention – you try to stay awake and avoid any intention of falling asleep; it’s used if you have trouble getting to sleep, but not maintaining sleep
- Biofeedback – sensors connected to a machine are placed on your body to measure your body’s functions, such as muscle tension and heart rate; the machine produces pictures or sounds to help you recognise when you’re not relaxed
Sleeping tablets (hypnotics) are medications that encourage sleep. In the past, they were frequently used to help with insomnia, but they’re used much less often nowadays.
They will generally only be considered:
- if your insomnia is severe
- as a temporary measure to help ease short-term insomnia
- if the good sleep habits and cognitive and behavioural treatments mentioned above don’t help
Doctors are usually reluctant to recommend sleeping tablets in the long-term because they just mask the symptoms without treating the underlying cause.They can also cause potentially dangerous side effects, such as drowsiness the following morning, and some people become dependent on them.
If they are recommended, you should have the smallest effective dose possible for the shortest time (usually no more than two to four weeks).
Over-the-counter sleeping pills
- A number of sleeping tablets are available to buy over the counter (OTC) from pharmacies. These are usually a type of antihistamine medicine that causes you to feel drowsy.
- Taking OTC sleeping tablets regularly isn’t usually recommended if you have insomnia, because it’s not clear how effective they are, they don’t tackle the underlying cause of your sleeping difficulties and they can cause side effects.
- In particular, they can cause you to feel drowsy the next morning, which can make activities such as driving and operating machinery dangerous.
- Speak to your GP for advice if you find yourself needing to take OTC sleeping tablets regularly.
- Benzodiazepines are prescription medicines that can reduce anxiety and promote calmness, relaxation and sleep. Your GP may prescribe them for a short time if you have severe insomnia or it’s causing extreme distress.
Examples of benzodiazepines include temazepam, loprazolam, lormetazepam, diazepam and nitrazepam.
Long-term treatment with benzodiazepines isn’t usually recommended because they can become less effective over time and some people become dependent upon them.
They can also cause a number of side effects, including:
- drowsiness and dizziness, which can persist into the next day
- finding it difficult to concentrate or make decisions
- feeling emotionally numb
You should avoid driving if you feel drowsy, dizzy, or unable to concentrate or make decisions, as you may not be able to do so safely.
Z–drugs are a newer type of medicine that work in a similar way to benzodiazepines and are similarly effective. They include zaleplon, zolpidem and zopiclone.
As with benzodiazepines, long-term treatment with Z–drugs isn’t normally recommended because they can become less effective over time and some people become dependent on them.
They’re usually only prescribed for a maximum of two to four weeks.
Side effects of Z-drugs can include:
- drowsiness and dizziness, which can persist into the next day
- feeling and being sick
- increased snoring and breathing problems during sleep
- dry mouth
Z–drugs can also sometimes cause psychiatric reactions, such as delusions, nightmares and hallucinations. Contact your GP if you experience any of these effects.
|Class/Drug||TMax (hours)||Elimination Half
|Triazolam||1 – 2||2 – 6||0.125 – 0.25||Yes||Early reports of adverse effects
were likely dose-related
|Temazepam||1 – 2||8 – 22||15 – 30||Yes||Metabolized mainly by
conjugation (no CYP-related
|Estazolam||1.5 – 2||10 – 24||1 – 2||Yes||Triazolo ring structure similar to
|Quazepam||2 – 3||48 – 120||7.5 – 15||Yes||Active metabolite (Ndesalkylflurazepam)
with repeated dosing
|Flurazepam||1.5 – 4.5||48 – 120||15 – 30||Yes||Active metabolite (Ndesalkylflurazepam)
with repeated dosing
|Alprazolam||0.6 – 1.4||6 – 20||No||Often noted for significant
|Lorazepam||0.7 – 1||10 – 20||1 – 4||No||Metabolized by conjugation (no
CYP-related drug interactions)
|Clonazepam||1 – 2.5||20 – 40||0.5 – 3||No||Often used for other sleep
disorders including RLS,
|Zaleplon||1 (0.5 – 2)||1 (0.8 – 1.3)||5 – 20||Yes||Shortest-acting BzRA|
|Eszopiclone||1.5 (0.5 – 2)||6 (5 – 8)||1 – 3||Yes||~30% may have unpleasant taste
|Zolpidem – Oral
|1.6 (0.5 – 1.5)||2.5 (1.4 – 4.5)||5 – 10||Yes||Most widely-prescribed hypnotic|
|1.5 (1.5 – 2.0)||2.8 (1.6 – 4.5)||6.25 – 12.5||Yes||Higher concentrations 3-8 hours
post dose than traditional
|0.6 (0.6 – 1.3)||2.5 (1.4 – 3.6)||1.75 – 3.5||Yes||Buffer permits increased buccal
absorption, lower dose
|1.4 (0.5 – 3.0)||2.7 ( 1.5 – 6.7)||10||Yes||Mainly absorbed via GI tract|
|Zolpidem: Oral Spray
|0.9||2.8 (1.7 – 8.4)||10||Yes||Bioequivalent to tablets in terms
of Cmax, Tmax, t1/2
- As an alternative to taking prescription drugs, some evidence shows that an average person seeking short-term help may find relief by taking over-the-counter antihistamines such as diphenhydramine or doxylamine.
- Diphenhydramine and doxylamine are widely used in nonprescription sleep aids. They are the most effective over-the-counter sedatives currently available, at least in much of Europe, Canada, Australia, and the United States, and are more sedating than some prescription hypnotics.
- Antihistamine effectiveness for sleep may decrease over time, and anticholinergic side-effects (such as dry mouth) may also be a drawback with these particular drugs. While addiction does not seem to be an issue with this class of drugs, they can induce dependence and rebound effects upon abrupt cessation of use. However, people whose insomnia is caused by restless legs syndrome may have worsened symptoms with antihistamines.
- The evidence for melatonin in treating insomnia is generally poor. There is low quality evidence that it may speed the onset of sleep by 6 minutes. Ramelteon, a melatonin receptor agonist, does not appear to speed the onset of sleep or the amount of sleep a person gets.
- Most melatonin drugs have not been tested for longitudinal side effects. Prolonged-release melatonin may improve quality of sleep in older people with minimal side effects.
- Studies have also shown that children who are on the Autism spectrum or have learning disabilities, Attention-Deficit Hyperactivity Disorder (ADHD) or related neurological diseases can benefit from the use of melatonin. This is because they often have trouble sleeping due to their disorders.
- For example, children with ADHD tend to have trouble falling asleep because of their hyperactivity and, as a result, tend to be tired during most of the day. Another cause of insomnia in children with ADHD is the use of stimulants used to treat their disorder.
- Children who have ADHD then, as well as the other disorders mentioned, may be given melatonin before bedtime in order to help them sleep.
- While insomnia – is a common symptom of depression, antidepressants are effective in treating sleep problems whether or not they are associated with depression. While all antidepressants help regulate sleep, some antidepressants such as amitriptyline, doxepin, mirtazapine, and trazodone can have an immediate sedative effect and are prescribed to treat insomnia.
- Amitriptyline – and doxepin both have anti histaminergic, anticholinergic, and antiadrenergic properties, which contribute to both their therapeutic effects and side effect profiles, while mirtazapine’s side effects are primarily anti histaminergic, and trazodone’s side-effects are primarily antiadrenergic.
- Mirtazapine – is known to decrease sleep latency (i.e., the time it takes to fall asleep), promoting sleep efficiency and increasing the total amount of sleeping time in people with both depression and insomnia.
|Intervention||General description||Specific techniques|
promoting behaviors that
help sleep, discouraging
behaviors that interfere with
|Stimulus control||Based on operant and
activities and the bedroom
environment can serve as
stimuli that interfere with
sleep. Treatment prescribes
behaviors that strengthen
associations between the
environment and sleep.
|Based on experimental
evidence that sleep is
regulated by circadian and
homeostatic sleep drive by
reducing time in bed, and
maintaining a consistent
wake time in the morning to
reinforce circadian rhythms.
|Relaxation training||Muscular tension and
cognitive arousal are
incompatible with sleep.
Relaxation decreases waking
arousal, and facilitates sleep
|Specific techniques may include:
|Cognitive therapy||Identify, challenge, and
replace dysfunctional beliefs
and attitudes regarding sleep
and sleep loss. These beliefs
increase arousal and tension,
which impede sleep and
further reinforce the
combining elements of above
|Core techniques from
Stimulus Control, Sleep
Good Sleep Habits for Beating Insomnia
Good sleep habits, also called sleep hygiene, can help you get a good night’s sleep and beat insomnia. Here are some tips:
- Try to go to sleep at the same time each night and get up at the same time each morning. Try not to take naps during the day, because naps may make you less sleepy at night.
- Avoid prolonged use of phones or reading devices (“e-books”) that give off light before bed. This can make it harder to fall asleep.
- Avoid caffeine, nicotine, and alcohol late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. Alcohol can cause waking in the night and interferes with sleep quality.
- Get regular exercise. Try not to exercise close to bedtime, because it may stimulate you and make it hard to fall asleep. Experts suggest not exercising for at least three to four hours before the time you go to sleep.
- Don’t eat a heavy meal late in the day. A light snack before bedtime, however, may help you sleep.
- Make your bedroom comfortable. Be sure that it is dark, quiet, and not too warm or too cold. If light is a problem, try a sleeping mask. If noise is a problem, try earplugs, a fan, or a “white noise” machine to cover up the sounds.
- Follow a routine to help you relax before sleep. Read a book, listen to music, or take a bath.
- Avoid using your bed for anything other than sleep or sex.
- If you can’t fall asleep and don’t feel drowsy, get up and read or do something that is not overly stimulating until you feel sleepy.
- If you find yourself lying awake worrying about things, try making a to-do list before you go to bed. This may help you to not focus on those worries overnight.
Home Remedies to overcome Insomnia
A glass of lukewarm milk before bedtime gives soporific effect on your body that helps you doze off easily. Additionally, it contains amino acid- tryptophan, which stimulates serotonin production that ultimately provides you with a better sleep.
- You can mix honey in the milk.
- Alternatively, along with honey, mix a dash of cinnamon powder in it.
- Massaging your toes with milk can induce sleep.
- Bottle gourd is one of the excellent remedies to induce sleep. Take out the bottle gourd juice and add sesame oil in same proportion. Massage with this on your scalp, before going to bed. Alternatively, include bottle gourd in your diet.
- Poppy seeds are a good source of minerals, calcium, carbohydrates and B-complex vitamins. Taking 1 teaspoon of poppy seed/oil before going to bed can actually solve the problem of insomnia.
- Alternatively, get 1 teaspoon each of white poppy seeds and coconut powder and adds a small amount of water, in order to make a thick paste. Now, take a frying pan and melt some clarified butter in it. Then, add a pinch of cumin and turmeric and remove immediately from heat. After a minute, mix that paste in it and add salt to taste. Chomp this mixture one hour before you sack out.
- Or else, consume 30 grams of poppy seeds’ milk flavored with a little sugar.
- Nutmeg effectually heals insomnia. It is loaded with myristicin which works as a tranquilizer and helps you get natural sleep. You can mix a pinch of nutmeg powder with one teaspoon of fresh Indian gooseberry juice. Consume it 3 times a day. Apart from insomnia, it also resolves the problem of indigestion and depression.
- Alternatively, blend ½ teaspoon of powdered nutmeg with a pinch of cinnamon powder, 1 teaspoon each of raw honey and water to form a paste. Now, boil a cup of milk and pour all the mixture in it. Stir well and sip it before you hit the hay.
- Take a one-eighth teaspoon of nutmeg powder and mix it with one cup of lukewarm milk.
- Take a quarter teaspoon of nutmeg powder. Add it in a cup of warm water or any of your favorite juice.
- Don’t consume it more than a pinch, at one time.
- Over doses of nutmeg may cause hallucination and some other psychiatric turmoil.
- Green tea is full of theanine and amino acid that helps combat anxiety and de-stress a person. Drink a cup of green tea 1-2 hours before bedtime.
- Banana contains melatonin, tryptophan, magnesium and serotonin, which work as body relaxants. The high amount of carbohydrate in bananas will make you sleepy. Simply eat a banana before going to bed.
- A blend of mashed banana and roasted cumin seeds can be consumed after dinner.
- Alternatively, you can also have a banana smoothie one hour before your bedtime.
- You can also try banana with some toast and peanut butter.
- Take one teaspoon of aniseeds and add it to 375ml of boiling water. Simmer this concoction for 15 minutes. Filter this solution and add honey and milk to it. Sip this tea every day before bedtime.
- Oats are rich in melatonin which makes it a sleep inducing meal. Simply eat oatmeal regularly to get rid of this problem. You can also sprinkle two tablespoons of flaxseeds in your oatmeal. Chomp it at night.
- Curd enables the body to absorb essential minerals and nutrients and improves the digestive system as well. A person suffering from insomnia should consume 3 cups of curd daily, in order to get a sound sleep. Besides eating curd, its massage on head is also beneficial.
- Heat 1 teaspoon of cumin seeds for about 5 seconds. Then, add 1 cup of water in it and simmer it to the boiling point. Remove it from heat and cover it with a lid. Strain the solution after 5 minutes. Drink this tea before you hit the sack.
- Saffron contains mild sedative properties that help treat the problem of insomnia. Take 3-4 strands of saffron and soak them in a cup of warm milk. Sip this warm drink every day before you sack out.
Apple Cider Vinegar and Honey
- Apple cider vinegar is loaded with amino acids that relieve body from fatigue, thereby help you get natural sleep. On the other side, honey raises the insulin levels that release serotonin, thus, promotes sleep. Take a glass of warm water and mix two tsp each of honey and organic apple cider vinegar to it. Drink it before you hit the hay.
- Otherwise, blend 2 tsp of apple cider vinegar in a cup of honey. Take one tbsp of this mixture with or without water.
- Have a hot shower about two hours before going to sleep. It will soothe the nerves and relax your body. You can also add a few drops of essential oils like chamomile, lemon balm, lavender or rosemary to the bathwater, as it soothes your body in an effective way.
- Acupuncture is somewhat similar to acupressure. It heals the problem by putting a thin needle in your skin, at some specific points. It works wonders for insomnia.
Note- Get this therapy done from an experienced practitioner.
- Almonds relax your muscles, as it contains magnesium as well as tryptophan. Simply eat a handful of almonds throughout the day, in order to treat the problem of insomnia.
- Honey works tremendously great for treating insomnia. Due to its hypnotic and sedative effects, it induces sound sleep. It also promotes relaxation. Simply mix 2 tbsp of honey in a cup of water. Stir well and drink it before you sack out.
- Alternatively, intake a spoon full of honey before you hit the hay. This is one of the best remedies, for children suffering from insomnia.
- Sesame seeds are affluent in polyunsaturated fat that helps relieve the nervous and muscular tension and gives sound sleep. Regular consumption of sesame oil improves blood circulation, prevents digestive disorders and reduces anxiety. Massage your feet with this oil daily before you hit the sack.
- Celery is rich in phthalides that decreases the secretion of stress-inducing hormones and, ultimately, relax the muscular and nervous systems. This feature of celery makes it an excellent home cure for insomnia. Crush celery leaves along with their stalk, in order to extract their juice. Mix a tablespoon of honey with it. One should consume it at night before catching some zzz’s.
Note- Honey and celery should be taken in equal proportion.
Herbal Remedies to Cure Insomnia
- Indian Sorrel – Juice of Indian sorrel leaves is very useful in healing insomnia. Extract some juice of these leaves and mix it with castor oil, in equal amount. Now, boil down the water content. Store it in a bottle when it cools down. Massage the scalp with this oil before bedtime. It gives cool sensation near the eyes which induces sound sleep.
- Lavender Oil – This oil works as a tranquilizer and helps you get a good sleep. Take a few drops of this herbal oil and apply it on the forehead and temple. The fragrance of this oil induces sleep. So, use it before catching some zzz’s.
- Jasmine Essential Oil – Take a few drops of this oil and apply it on your wrist. Perform this before you hit the sack and you will certainly have a better sleep.
- Rauwolfia – Rauwolfia is loaded with sedative properties, which cures insomnia. Take around 0.25 to 0.5 grams of its root powder and mix it with cardamom. A patient of chronic insomnia can take it two times a day- in the morning and at night.
- Basil – A person suffering from sleep disorder should be given a leaf of basil for chomping. Alternatively, spread some basil leaves beneath the patient’s pillow and around the corners of the bed throw. The aroma of the leaves will strike the person’s nostril which will make him/her feel sleepy.
- Fenugreek Juice – Fenugreek juice acts as a tranquilizer that induces sleep and effectively prevents insomnia. Extract 2 tsp of fresh fenugreek juice from its leaves. Add one tsp of honey to it. Take it on a daily basis before catching some zzz’s.
- Valerian – Valerian is a very popular herb that is commonly used to treat sleep disorders. It gives sedative effect and relaxes body muscles. Combine ½ teaspoon of grated valerian root and nutmeg. Add this mixture in 2 cups of hot water. After 15 minutes, strain the solution and drink it.
- Alternatively, boil a cup of water and remove it from heat. Add one tsp of valerian herb to it. Stir well. After a few minutes, strain this decoction and then, drink.
- Or else, use valerian tincture. Dilute half tsp of its tincture in a glass of water. Drink it two times a day.
Note- This herb should not be consumed by children and pregnant or breastfeeding women.
- Chamomile Tea – Chamomile tea is a good herbal remedy to get a sound sleep. It contains apigenin that gives sedative effect to the body. Brew 1 tsp of chamomile herb in one cup of water for a few minutes. Stir well and filter this solution. You can add a dash of cinnamon and a little bit of honey to it.
- Lemon Balm – Mix 2-3 teaspoons of lemon balm to a cup of boiling water. Steep it for a few minutes. For effective results, drink this herbal tea before bedtime.
- Lettuce – Lettuce contains a sleep stimulating substance called lectucarium, which has tranquilizing properties and give effects similar to the opium poppy. Take 2 lettuce leaves and boil them in two cups of water for 5 minutes. Add either honey or sugar to the solution. Wait until it cools down. Then, strain it. Drink a cup of lettuce tea at least half an hour before you sack out. It will definitely give you a sound sleep.
- Alternatively, lettuce juice can also be consumed.
- Moreover, take one tsp of lettuce seeds and boil them in half liter water until it reduces to 1/3. Strain this infusion and drink it throughout the day.
- Acidum phos.(tds) – Sleeplessness after depressing events, sorrow or loss and death of a friend or a relative.
- Ambra grisea (tds) – Sleeplessness due to worries or business troubles.
- Ammonium val.3x(tds) – Insomnia especially during pregnancy and menopause, with a neuralgic headache.
- Arnica mont.(tds) – Sleeplessness caused by over-exertion. Mental or physical. Bed appears too hard. Tosses about to find a soft portion of the bed.
- Avena saliva Q 10 (bd) – 10 drops in !A cup of water: Sleeplessness in alcoholics and those with morphine habits.
- Cataria nep Q (od) – 5 drops in ‘A cup of water. It relieves sleeplessness Of children who cannot sleep due to colic. It cures colic and produces sleep.
- Chloralum 200 (od) – It is a powerful sleep producing remedy in patients with mental diseases, with asthma, hallucinations and night terrors. Insomnia from over-fatigue.
- Cimicifuga (tds) – Sleeplessness in children during the period of dentition.
- Conium mac (tds) – Sleeplessness due to neuralgic pains.
- Helonias – Sleeplessness on account of tiring hard labor with aching of muscles.
- Kalium phos – A great remedy for. sleeplessness. The patient is weak and nervous. Sleeplessness due to business worries and due to mental disturbances.
- Magnesium phos (tds) – Sleeplessness on account of indigestion.
- Nux vomica (tds) – Sleeplessness is due to over-excitement exhaustion and stress.
- Pulsatilla nig.(tds) – falls asleep but cannot sleep. Bed feels hot. Moves about in vain in bed to find a cool spot. Even the ticking of a clock disturbs.
- Antinionium crud.(Ids) – Continuous drowsiness in old people.
- Baptisia.(Ids) – Falls asleep while being spoken to.
- Causticum.(bd) – Very drowsy. Can hardly keep awake. Suited to old people.
- Chloralosum.(tds) – A useful remedy for prolonged drowsiness, which may continue for number of days. It is also useful for drowsiness and sleep of drunkards, whose faculties are only partially depressed.
- Cimex lect.(tds) – Irresistible sleepiness.
- Gelsemium (tds) – Patient is sluggish and always feels sleepy. He does not like to discuss matters but likes to be alone and undisturbed.
- Hydrocyanicum acidum (tds) – Irresistible drowsiness.
- Hypericum 3x (tds) – The patient constantly feels drowsy.
- Indolum (tds) – Wants to sleep all time. Aversion to work .
- Lupulus (tds) – Drowsy during the day.
- Lycopodium (tds) – Feels sleepy soon after taking dinner.
- Natrium sulp.(tds) – Sleepy while reading.
- Nux mosch (tds) – Great drowsiness.
- Opium (tds) – Great drowsiness. Falls asleep at work.
- Paullinia sorb (tds) – Feels sleepy after eating. Patient cannot control sleep. Head becomes heavy if he does not sleep.
- Staphysagria (tds) – Feels sleepy after eating.
Simple Tips (Home Remedies) to cure Insomnia
- Maintaining regular sleep schedule and getting up the same time everyday morning. This helps synchronize the body’s biological clock
- Do not mix activities like watching TV or mobile chatting from the Bed. Keep it reserved for sleeping activity only
- If you do not fall asleep within 20 minutes of getting into bed, try and use a body massager, listen to slow music or try a warm oil head massage
- Limit daytime sleep (cat naps)
- Having a hot bath or a glass of warm milk before bed abets sleep better
- Don’t drink caffeinated beverages & chocolate in the evening
- Keeping hands & feet warm in a cold bedroom induces sleep quickly ( as per researchers at the Psychiatric university, clinic of chronobiology & sleep Laboratory, Switzerland)
- Perform deep breathing exercises, meditation, and yoga.
- Sleep in a peaceful, dark, comfortable room.
- Have dinner at least 2-3 hours before bedtime.
- If you need to stay up late at night, then snack only on those stuffs that are low in protein and high in carbohydrates.
- Listen to soft music around 45 minutes before catching some zzz’s.
- Consume raw onion salad.
- Take ample calcium, potassium and iron to cope up with sleep disorders.
- Blue wavelengths of your phones reduce the secretion of melatonin which, in turn, affects your sleep. So, stay away from laptop, iPod, and smart phones at night.
- Avoid watching TV before bedtime.
- Reduce the consumption of alcohol and caffeine.
- Avoid naps during the day time.
- Don’t take excessive liquids half an hour before you hit the sack, in order to avoid urination.
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