I've struggled with sleep issues since I was a small child; even after doing all the reasonable exercise/caffeine/no-bright-lights things people recommended, my brain sometimes just wouldn't shut down. After some introspection, I came to realize that my body seemed be on a 25 hour day, and it just wanted to stay awake an hour later each time.
Then I read gwern's article on melatonin[1], and it changed everything. I don't get the shorter sleep he describes, but I take it once or twice a week to give me what feels like complete control over my sleep cycle. In addition the alertness/grumpiness benefits, it is truly great just being able to go to sleep and wake up at the same time as my wife (who seems to be on a 23-hour day).
I haven't read gwern's article, but I did discover that when my sleep cycle gets weird, a few nights with a melatonin supplement seems to reset things.
I discovered it by accident. Years ago I was having terrible patterns, so out of desperation I tried melatonin. I'm a little paranoid of taking anything to the point of dependency so I would only do a couple of nights in a row, then not use it until I needed it.
It works quite well for me this way, but I must say that occasionally I'll have dreams that are vivid and intense (meaning it get's my adrenaline going). Not nightmares, more anxiety-like.
I haven't asked a doctor for it, and I don't know what their reaction would be.
When I've struggled with insomnia I've been given advice about sleep hygiene; then had someone give me help with sleep hygiene; then got a prescription for zopiclone.
That was great for me, at that time. (I really needed sleep!!) but unfortunately the care got handed back to my GP and he was careless about the repeat prescriptions. SO, I ended up being able to get it for about a year. Luckily I didn't suffer too much from it, but some people find zopiclone addictive and there are other risks from it.
What I'd really want, before getting to zopiclone (and probably before melatonin) would be access to a cognitive behaviour therapy course for insomnia.
Have you heard of sleep.io (online automated CBT course for insomnia)? No connection, just sounded like something that might be helpful and cheaper/easier than getting actual CBT.
I've had a lot of success combining melatonin, low light before bedtime, drinking a moderate amount of water before bed, and f.lux (software). I use a heavier dose Friday+Saturday night to help me stay with a normal sleep schedule.
I'm frustrated at how frequently gwern is assumed to be male. If you aren't sure of someone's gender, please use gender-neutral pronouns. So many of her articles have been posted to HN lately, yet I've only seen masculine pronouns used to refer to her.
Then I read gwern's article on melatonin[1], and it changed everything. I don't get the shorter sleep he describes, but I take it once or twice a week to give me what feels like complete control over my sleep cycle. In addition the alertness/grumpiness benefits, it is truly great just being able to go to sleep and wake up at the same time as my wife (who seems to be on a 23-hour day).
[1] http://gwern.net/Melatonin