Brief Answer: Below simple steps will help. Detailed Answer: Hello, Thanks for your query. I appreciate your efforts for medical consultation in so much distress. Important aspects of your query are: • 30 year old female • Known case of (Medical history) depression, nail psoriasis, goiter, subacute thyroiditis, elevated creatinine, heart failure • Currently on: omega-3 softgels, vitamin d, multivitamin, probiotic capsules, potassium tablets • Complaints of: Poor sleep From the history causes of poor sleep in your case may be: -Poor sleep hygiene -Depression -Stress of multiple medical morbidity -Thyroid problem Following steps and principles of sleep hygiene will help you in sleep: • Monitor thyroid function by lab investigations like Serum T3/T4/TSH monitoring. You may need monitoring for medical problems and depression from your physician. • It is better to fix a bedtime and an awakening time. The body "gets used" to falling asleep at a certain time, but only if this is relatively fixed. • Block out all distracting noise, and eliminate as much light as possible. It is better to request your sister for not to vacuum in night. • Avoid napping during the day. • Avoid caffeine 4-6 hours before bedtime. This includes caffeinated beverages such as coffee, tea and many sodas, as well as chocolate, so be careful. Also restrict total caffeine intake in a day. • Avoid heavy, spicy, or sugary foods 4-6 hours before bedtime • Exercise regularly, but not right before bed. Regular exercise, particularly in the afternoon, can help deepen sleep. • Use comfortable bedding. • Find a comfortable temperature setting for sleeping and keep the room well ventilated. • Reserve the bed for sleep. Don't use the bed as an office, workroom or recreation room. Let your body "know" that the bed is associated with sleeping. • Practice relaxation techniques before bed. Relaxation techniques such as yoga, deep breathing and others may help relieve anxiety and reduce muscle tension. • Don't take your worries to bed. Leave your worries about job, school, daily life, etc., behind when you go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with these issues. • Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep. I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups. Wish you good health. Regards, http://bit.ly/Dr-Ashish-Mittal

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