We all have occasional nights of it. You toss and turn and just can't get comfortable sleeping. As long as it happens just here and there, you can live with it. But it's when it goes on for nights in a row and you are up every two hours looking at your clock that you know something needs to change.

Insomnia is a serious sleep disorder, and can involve all types of sleeplessness. Sometimes you have difficulty falling asleep; other times it may be that you have difficulty staying asleep; and other times, you wake too early in the morning and are unable to return to sleep.

Whatever the case, 30-40 percent of people in the United States are affected by insomnia. The United States leads the way with the most people with insomnia followed by Germany and then the United Kingdom. Women tend to be more affected than men, but often men have more severe cases that are reported.

Insomnia can be temporary or chronic in nature, and can be brought on by physical, environmental or psychological issues. Medical conditions, hormonal issues, changes in work time frames, or changed in your diet and exercise are examples of physical issues. Environmental issues could be excessive travel, different time zones, seasons or cultural challenges. Stress, depression and anxiety are other reasons that sleep often evades us, and this can happen in the midst of physical and environmental changes. Often what we are eating and drinking also affects the natural sleep patterns, along with medications that we might be taking.

So why do we need so much sleep, anyway? Well, the body has a natural cycle called the Circadian rhythm. This cycle regulates our system and its daily functions. The body likes consistency and regular patterns, and it is when we throw these patterns off this cycle that sleep deprivation most likely will happen. Fatigue, irritability, frustration, loss of clear thinking, and poor healing of the body's injuries are some of the most common symptoms that happen when we are not sleeping well.

In physical therapy, we ask all our patients this important question, "How long do you sleep at night, and how many times do you wake up with pain or discomfort that interrupts your sleep?" The answer to this question helps us know how well our patient will do in therapy. You see, a patient who is not sleeping through the night, whether due to pain or the inability to get comfortable, will have difficulty in rehabilitation after a total mastectomy, total hip replacement, back surgery or shoulder tendonitis, just to name a few. Healing happens well with good sleep cycles, and if you don't seem to have any, then our progress in rehab is limited. Those patients who are tossing and turning all night will not heal as well as those who are getting eight hours of sleep a night.

So, how much sleep should we really get every night to get and stay healthy? The National Institute of Health suggests that school-age children need at least 10 hours a night, teenagers need 9-10 hours a night, and adults need 7-8 hours of sleep a night. Unfortunately, that does not appear to be happening. According to the Institute's study, 30 percent of adults reported an average of only six hours per night, and only 31 percent of all the high school students interviewed reported eight hours a night.

So what can help you get a better night's sleep? Here are some tips for sleep hygiene:

* Have a before-bedtime ritual: a warm bath, a cup of hot tea, 10 minutes of reading, relaxation activities, a good laugh, etc.

* Avoid computer, smart phone and TV use in bed. The light of these gadgets causes the brain to think it is still time to be active. (It has been reported that you should stop doing these activities two hours before bed).

* Have a sleep schedule. Go to bed at the same time every evening during the week and wake at the same time, so your body has more of a natural rhythm.

* Avoid excessive stimulants before bed, caffeine especially.

* Avoid taking naps during the day.

* Have a comfortable, dark, and quiet area to sleep in. Many times, you are doing too many other activities in your bedroom; it should be a soothing place only.

* Take up the art of deep breathing. It is one of the best ways to facilitate deep relaxation before bedtime. Breathe in to a four-count and out to a four-count. When you are laying flat on your back, your belly will rise to the ceiling on the in count and fall to the floor on the breathing out.

Remember, sleeping is the best thing you can do for your health, and it is the best way for your body to have what it needs to heal properly.

Happy sleeping!

Sheree DiBiase, PT, is the owner of Lake City Physical Therapy. She and her staff can be reached in Coeur d'Alene at (208) 667-1988 and Spokane Valley at (509) 891-2623.