I have had insomnia all my life, but my stroke brought this problem to a new level. I had a stroke in the brainstem which puts us to sleep and wakes us up. Since my stroke I have repeatedly had nights where I get only two hours of sleep per night. When I did not sleep and did not feel sleepy for two days I FREAKED OUT so I got aggressive about addressing this problem.
Daytime routine. I avoid caffeine after lunch time. This meant changing to decaffinated iced tea for dinner and drinking water when I eat out at night.
Bedroom environment. I sleep in a dark bedroom with no TV. The alarm clock is placed where I cannot see it. Sometimes I wake up and find I am sweating. So I lowered the room temperature because a lower body temperature tells the brain to sleep.
Preparing for bed. If I am sleepy at 9 p.m. I go to bed. If I wake up in the middle of the night at least I have slept for 4 or 5 hours because I went to bed early. If I am still wide awake at 10 p.m.
I go to war. I turn off the TV, wash my face and brush my teeth, and come back to the living room to listen to a calming CD. If my body aches I take Tylenol. The constant burning in my hemiplegic foot keeps me awake so I provide a competing sensation by taking a warm gel pack to bed.
Back up plans. (1) If I lay in bed and cannot fall asleep, I get up and eat a tiny bowl of cereal with milk. (2) If I wake up at 3 a.m. to go to the bathroom and cannot fall asleep, I get up and turn on a calming CD or a fan at a low volume for background noise. These strategies work only IF I realize I have been lying awake for an hour or more.