When you turn your clock back an hour at bedtime on October 31, you have the prospect of an hour’s extra shuteye without sleeping any later.

However, if you’re a troubled sleeper, additional, restful sleep will remain as elusive and costly as ever. You are among the 40 million who struggle nightly with falling and staying asleep.

The consequence for this exhausting state of affairs?

Loss of productivity and a whopping $16 billion in medical costs every year, according to the National Institutes of Health (NIH).

Lifestyle, work demands, family responsibilities and medical conditions keep millions awake long after they’ve turned in. The ramifications go way beyond feeling tired the next day. According to the National Sleep Foundation (NSF), people who don’t get enough sleep are at more risk of motor vehicle accidents, endure increased risk of obesity, diabetes, heart problems, depression and substance abuse and have greater problems with attention, reaction and learning.

How much sleep you need depends on your age. According to the NSF, adults should sleep seven to nine hours each day or night. Children require varying amounts (see the graph from the NSF.)

Yet, two out of ten adults sleep less than six hours a night, the NSF says. The foundation goes on to say if you spend a good bit of time tossing and turning over pocketbook issues, you’ve got lots of company; nearly one-third of those reporting sleep problems said financial worries keep them up or wake them up. Shift work, travel, school rigors and chronic pain also contribute to less than restful slumber.

The NSF offers tips that may resolve bedtime blues. They include:

A standard relaxing bedtime routine in a dark, cool and quiet place
Regular exercise, but stopping at least three hours before bedtime
No caffeine for at least eight hours prior to bedtime
Use of your bedroom for sleep and sex only (move the television out!)
If all else fails, a number of natural, over-the-counter and prescription medications are available that may help you sleep. Talk to your health care provider before trying any of them.

[Janet Lubman Rathner]