Sleep disturbance or insomnia is not uncommon in women starting at midlife. While this may be due to a physical concern, usually it's not. Let's discuss some things you can do NOW to improve your sleep.

•Good sleep is a component of good health. Things that you do for good health are essential and will directly impact your quality of sleep. This means eating a healthy diet, regular exercise and good daily multivitamin/mineral supplements.

•A healthy diet that is high in phytoestrogens such as fruits and vegetables may help if the cause of your sleep disturbance happens to be related to being perimenopausal. Apples, carrots, cherries, green beans, oats, peas, potatoes, soybeans and sprouts - just to mention a few!

•Avoid stimulating agents such as nicotine and caffeine – that includes coffee, tea, soft drinks, and chocolate. Even one cup of coffee in the morning can affect sleep quality hours later. We, as women, tend to metabolize caffeine much slower than men. If you smoke or chew tobacco…quit. Short of that, avoid smoking/chewing within a few hours of going to bed.

•Sleep in a dark room. (How bright is your illuminated clock?)

•Develop a sleep routine: going to bed at the same time; rituals such as having a cup of relaxing tea and then washing up, and the like.

•Avoid taking naps.

•Is your sleeping space comfortable? Look at light, noise and temperature. How about your bed? Is it too firm or too soft?

•Avoid late night heavy meals. However, a light snack at bedtime may be helpful.

•Try relaxation – mediate, take a bath, listen to soft music, read a gentle book, get a massage.

•Avoid the news and other violent or emotional stimulation before bed! It's hardly relaxing!

•Avoid alcohol late in the day. It can cause waking in the night and impairs sleep quality.

•Limit your bed activities to sleep and sex.

•If you cannot sleep – get up and do something until you can sleep.

•If worries are keeping you awake, try journaling – it may provide a way for you to “release” the worry onto paper and thus relax and sleep.

There are natural supplements that can be tried. If you are a milk drinker, consider having a glass of warm milk. Milk when it is warm releases tryptophan, the same substance that was in that Thanksgiving turkey that had you napping. On the other hand, I recently read that warm milk also has substances that can keep you awake. Let your own body tell you what it likes about milk.

Other suggestions include valerian root, melatonin, passion flower and of course the chamomile, catnip, anise or fennel teas. Some companies package teas in their own formulations for sleep, such as "Sleepy Time". Your local herbalist or health food store may also be able to give you suggestions. As with anything else, the key to try different things and see what you respond to.

If none of these suggestions work, I would recommend the following. First of all, see your see your health care provider to ensure there is nothing physical that needs to be attended to. Keep a sleep diary for 3 months with the goal to see if there is some sort of pattern. Keep track of the time you go to bed, awaken, how often you are awake and/or up at night. Are you tired when you awaken in the morning? What time are you getting up? Is there something that is on your mind? Does any of this correlate with your cycles (if you still have them).

Use of sleeping medication is something that can sometimes be used to get your body back on track, but it's not for long term use, and should only be used when other remedies have been ineffective.