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Wake at the same time every day (within 30 minutes), even weekends Get bright light exposure within 30 minutes of waking (10 to 15 minutes outdoors or near a window) Avoid naps longer than 20 minutes Go to bed only when sleepy, not by the clock Step 3: Meal timing and composition (week 1) Finish dinner at least 3 hours before bed Make dinner the smallest meal of the day (GLP-1 medications make this easier) Avoid high-fat meals after 4 PM (fat delays gastric emptying further, worsening reflux risk) If hungry before bed, choose protein (Greek yogurt, cottage cheese) over carbs or fat Step 4: Sleep hygiene fundamentals (week 2) Bedroom temperature 65 to 68°F Complete darkness (blackout curtains or eye mask) No screens 60 minutes before bed (blue light suppresses melatonin) No caffeine after 2 PM No alcohol within 3 hours of bed (alcohol fragments sleep architecture) White noise or earplugs if noise is an issue Step 5: Consider melatonin supplementation (week 3) If steps 1 to 4 don't restore sleep after 2 weeks, add melatonin 0.5 to 3 mg taken 60 to 90 minutes before target sleep time

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It’s nothing short of a scandal how so many patients with severe B12 deficiency are being refused repeat prescriptions for B12 shots