-Legs feel restless, "antsy"; can't hold them still (Restless Legs Syndrome or RLS: can "run" in families or result from drugs, medical problems, certain drugs, etc.)

--Avoid caffeine, completely.
--Check with your doctor to see if a cause is present (ex.-low iron levels, medications that aggravate it, etc.)

-Other physical symptoms (such as shortness of breath/ pain/ possible medication side effects)

--See your doctor to try to diagnose/treat their cause.

-No physical symptoms or cause (just remain wide awake, unable to "turn thoughts off" and sleep)

--Follow all sleep hygiene measures listed above.
--Relaxation training to help you learn simple tricks to "bore yourself into sleep". Call your doctor for a referral if needed.

-Feeling down, depressed, unhappy, discouraged with life, no interest in activities, change in appetite.

--Consider counseling or treatment for depression--a common cause of early awakenings.

-No symptoms of depression at all.

--Sleep monitoring may be necessary&emdash;ask bed partner about any abnormal-behaviors, snoring, breathing abnormalities, body jerks, etc. observed while you sleep.
--Write down any symptoms you can recall at those times you awaken (snores, choking, breathlessness, nasal congestion, headaches, pain, dry mouth, dream recall, etc.) and inform the physician.

If problems falling within any of these types of insomnia have persisted despite good sleep hygiene, sleep evaluation may be necessary to define what sleep-related events might be interfering with your ability to enter and stay in good, sound sleep. Anything that awakens you will have occurred while you're asleep: so you probably won't know exactly what it was! There are many medical possible causes--such as breathing problems, snores, leg jerks, and seizures-- that can be treated to correct the insomnia complaint. Please write down any specific symptoms and your bed partner's observations (if any are available) to discuss with the physician.