It's midnight and you can't get to sleep. What do you do?

Perhaps, you take a sleeping pill; some 42 million prescriptions were filled last year by pharmacists in the United States, according to one study, a rise of nearly 60 percent in five years.

Roger Ekirch, a history professor at Virginia Tech, offers a preindustrial age alternative: Stay awake.

"Usually, people would retire between 9 and 10 o'clock only to stir past midnight to smoke a pipe, brew a tub of ale or even converse with a neighbor," Ekirch wrote in a New York Times opinion piece on Sunday. "Others remained in bed to pray or make love."

Ekirch, the author of "At Day's Close: Night in Times Past," compared people's quality of sleep in the modern age to that of our ancestors, who had two waves of sleep with an hour or two of wakefulness.

"There were far more prevalent threats to sound slumber two or three hundred years ago than currently is the case," Ekirch said in a telephone interview this week.

Having to use an outhouse, for instance, hindered sound sleep, Ekirch said.

On Monday, Ekirch received an e-mail from a fellow in Ohio who read his opinion piece and felt reassured about his midnight routine of waking up.

He wrote, "It's nice to feel normal again."

"The pattern of sleep [he is] experiencing may in fact be an echo of this segmented pattern that has been with us for so long," Ekirch said. "I have gotten several responses from people saying, 'Yes, that this is how I sleep.' "

-- Evelio Contreras

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