(MONEY Magazine) – Your alarm jolts you into consciousness every weekday morning; you need a cup or two of joe just to get out the door--and two or three more to make it through the day. You rub your eyes to stay awake through boring afternoon meetings and during the ride home. If this sounds like you, would you say you're: a) a typical American wage slave, or b) dangerously sleep deprived?

The correct answer, alas, is both. "Most people function optimally with about eight hours of sleep, yet the average adult in our society is getting six, seven hours if they're lucky, and many people routinely get by on five hours or less," notes David Neubauer, associate director of the Johns Hopkins Sleep Disorders Center. "They may not even remember what it's like to feel fully refreshed and awake."

It's not just your quality of life that suffers when you don't get enough z's. Poor sleep strains the body, exacerbating a host of serious and costly medical problems such as diabetes, heart disease and obesity. In fact, insomniacs visit their doctors twice as often--and are hospitalized twice as often--as those who sleep well.

Lack of sleep also makes it damn near impossible to live up to the demands of a high-powered, high-stress job. Without proper sleep, you're little more than an automaton at work, says Rosalind Cartwight, a pioneering sleep researcher at Rush University's Sleep Disorders Center in Chicago. "You can do routine things, things that are well practiced. But you can't respond well to new challenges."

A variety of studies show that the sleep deprived work more slowly and less creatively, make more mistakes and suffer more accidents than the well rested. They're more likely to come to work grouchy and to be less satisfied with their job. A National Sleep Foundation poll found that those with sleep disturbances are three times more likely to miss work than those who get a good night's rest. Not surprisingly, one study by the U.S. Navy found that insomniacs were promoted less often than those who slept better, and were far more likely to drop out of the service.

Sleep debt, in other words, can whack your finances as hard as any other kind of debt--running up your medical bills and running down your health, potentially costing you a promotion and maybe even your job. If you're among the 47 million Americans who are sleep deprived, these steps can help you pay down your sleep debt and take control of your life.

Kick the Caffeine Habit

The main reason most of us get less sleep than we need: We give ourselves too little time to sleep right, then compound the problem by swilling coffee, cola and the occasional Red Bull to keep going. In small doses, caffeine can be helpful, especially for getting you through the circadian lull that hits most of us in the mid-afternoon hours. But it's no substitute for adequate sleep, and the more you use, especially late in the day, the harder it is to get to sleep at night.

Sleep specialists are also wary of using the prescription medicine modafinil as a means to stay focused and energized when you haven't gotten enough rest. Sold under the brand name Provigil, the drug seems to deliver all the alertness of caffeine without any of the jitteriness. But while it can work miracles for people who suffer from narcolepsy and help shift-workers stay awake on the job, it's no solution for chronic sleep deprivation. "Our bodies need sleep," Neubauer says. "There's no medication that can replace that."

Establish a Bedtime Routine

Even if you hit the sack at a reasonable hour every night, you may find yourself tossing and turning until four in the morning. You're not alone: Roughly a third of American adults suffer from chronic or occasional insomnia.

The best remedy is to follow good sleep hygiene: Go to bed at the same time every night (your body is programmed to operate best on a regular schedule), avoid caffeine and alcohol before bedtime (and ideally after 6 p.m.) and exercise regularly (but not before bedtime). Try turning your bedroom into a sleep sanctuary: Use the bedroom only for sleeping and sex (just not at the same time). Keep it dark and cool, with no TVs or PCs to distract you. And turn your clock around so you can't see the time; watching the clock just makes it harder to get to sleep. If necessary, use soothing white noise to drown out car alarms and yowling dogs. But there's no need to spend $200 on a white-noise machine; fans and air conditioners work fine for this purpose.

If your bed is comfortable, don't rush out to buy one of those pricey mattresses that late-night TV ads promise will make you sleep like a baby. But if an uncomfortable or worn-out mattress is part of the problem--life expectancy for a good mattress is about nine to 10 years--grit your teeth and spend what you need to get a quality mattress with the right back support and low motion transfer (so your spouse's tossing and turning won't keep you awake). "With mattresses you get what you pay for," says James Maas, a psychology professor at Cornell University and author of Power Sleep. "You'll likely have to spend around $1,200 for a queen-size mattress with individually pocketed coils. But if it solves your sleep problems, it's worth it."

Don't Rely on Pills

If better bedtime habits and a new mattress don't help, you may be tempted to pick up an over-the-counter sleep aid or pester your doctor for a prescription sleeping pill like Ambien. You wouldn't be the first: Doctors wrote more than 40 million sleeping-pill prescriptions last year, a seemingly cheap fix since the costs are usually covered by insurance.

Consumers may be more inclined to ask for prescription sleep aids these days because of relentless advertising by pharmaceutical companies. After all, who doesn't recognize the softly glowing Lunesta moth? But doctors also may be more apt to prescribe them because the newest generation of sleeping pills are more effective and have far fewer side effects than the scary sleep meds of old. They also work better than over-the-counter drugs. But most doctors prescribe sleeping pills only for short-term use since the long-term effects are unknown. Many physicians are wary of herbal sleep aids like valerian root or melatonin as well ($10 or less for 100 pills). Both seem to work, but the verdict is still out on the long-term consequences of taking them.

A no-cost, safer alternative: Soak in a hot bath for 20 minutes about two hours before bed, suggests Cartwright of Rush University Hospital. In addition to its relaxing effects, a hot bath will raise your body temperature. Your body sees a falling temperature as a signal to go to sleep, Cartwright says, so you'll start to feel sleepy as soon as you begin to cool off from your bath--and sleep longer and more deeply than if you'd simply popped an Ambien.

Try Snorkeling if Needed

Far more serious than occasional insomnia is sleep apnea, a pernicious disorder that causes a sleeper's air passages to close up, momentarily stopping breathing maybe dozens or even hundreds of times an hour. If that sounds scary and dangerous, it is: Untreated, apnea doubles the risk of stroke and leaves many sufferers struggling through their waking hours in a somnambulant daze. The National Institutes of Health reports that more than 12 million Americans have sleep apnea, and up to 90% of those cases remain undiagnosed.

If you routinely feel tired even after a full night of sleep or you're a loud snorer, talk to your doctor about scheduling an overnight study at a sleep clinic to determine whether you're suffering from apnea or another sleep disorder. The tab is steep--$1,500 or so--but is usually covered by insurance. Only a doctor can tell you for sure whether your fatigue is the result of poor sleep habits, apnea or another medical problem like depression.

If you're diagnosed with apnea, the doctor will probably prescribe continuous positive airway pressure (CPAP) therapy, which involves sleeping with a snorkel-like mask that's hooked up to a machine that blows air up your nose to keep the passages open. As undignified as this sounds, CPAP is the most effective cure for apnea. The price, including various diagnostic tests, can easily add up to $10,000, but insurance typically covers it.

For some people, the effect of CPAP is miraculous, enabling them to awaken feeling truly refreshed for the first time in years. But it isn't a magic bullet for everyone. The mask is so uncomfortable (and insomnia-inducing) that many people find it nearly impossible to wear it all night, every night. Others simply can't tolerate it at all and may turn to dental appliances or surgery to keep the throat open and prevent blockages.

Grab a Catnap

If you still can't get a decent night's sleep, try sleeping during the day. Short naps can be an effective way to boost your alertness, researchers say. "Even a 15-minute nap is enough to make you feel and perform better over the next couple of hours," says Harvard psychiatrist Robert Stickgold. Keep the naps short, though: Snoozing for longer than half an hour can leave you feeling groggy, a phenomenon called sleep inertia.

Open Your Eyes

If you feel that you're just too busy with work and life to grab the rest you need, give some hard thought to the real costs of running a sleep deficit: the career opportunities missed, the dollars lost, the health risks you run. Sleep (or rather, the lack of it) is a serious and expensive business. "If you start treating sleep as a necessity, not a luxury," says Maas, "your whole life will change."

Are You Getting Enough Shut-Eye?

The answer is no if at least two of these statements describe you

1. I need an hour or more to fall asleep.

2. I nod off at inopportune moments (at meetings, at movies, while taking magazine quizzes).

3. I'm useless if I don't drink a few cups of coffee during the day.

4. I sleep longer on weekends than during the week.

5. I regularly feel sleepy even after eight to 10 hours of sleep.

6. I'm a new parent.

7. I often have dreams in which I am Paris Hilton (and I'm not).[1]

[1] We're not quite sure what this means, but frankly, it doesn't sound good.

The High Cost of Sleep Debt

Think you're doing just fine on less than eight hours a night? Consider the price you may be paying.

$4,220 The additional medical costs that bad sleepers pay compared with good sleepers

43% of people with sleep problems say they're confused in their thinking.

.10 Going 24 hours without sleep has the same effect on drivers as a blood-alcohol level of .10, illegal in many states.

SOURCES: Meir Kryger, Journal of Clinical Sleep Medicine, 2005; Industrial Health, 2005; University of Chicago; National Sleep Foundation.