What can be done to improve my sleep hygiene?

Timing

• Go to bed at the same time each day.
  
• Set the alarm and get up at the same time everyday (regardless of how much you slept).
  
• Do not nap during the day. Eventually you will reestablish a sleep pattern.
  

Sleep Behavior

• Go to bed only when sleepy
  
• Use the bed only for sleep or sex (do not read, eat, watch TV in bed)
  
• If unable to sleep – get out of bed
  
• Don’t lie in bed for more than 15 minutes – get up, engage in quiet activity – return to bed when sleepy
  
• Repeat the above strategy for as many times as is necessary
  
• You must teach your body to associate the bed with sleep, not frustration.
  
• Restrict the amount of time you spend in bed to your usual amount of sleep (e.g. 7 hours) even if you did not get to sleep as well as you would have liked.
  

Thermal Tips

• You can raise body temperature by exercising 3 to 4 hours before bed.
  
• You can raise body temperature by taking a warm bath 20 minutes before bed.
  
• Sleeping is associated with a decline in core body temperature from a state of relative warmth.
  

Bedroom Environment Tips

• Maintain a steady temperature in the room throughout the night.
  
• Fluctuations in room temperature disrupt the Dream State.
  
• Illuminated wall clocks have been associated with awakening.
  
• Keep the room dark.
  

Ingestion

• Caffeine (a stimulant) should be discontinued 4 to 6 hours before bedtime.
  
• Nicotine (a stimulant) should be avoided near bedtime and upon night waking.
  
• Alcohol (a depressant) causes awakenings later in the night (though initially may promote falling asleep). Avoid the regular use of alcoholic drinks to help you sleep. It may seem like you are sleeping better (or falling asleep more easily), but alcohol can act as a stimulant – interrupting your sleep as your body metabolizes the sugars.
  
• A light snack may be sleep inducing; a heavy meal too close to bedtime is an interference.
  

Mental Control

• Making an "effort" to fall asleep will not produce sleep.
  
• Sleep should not be effortful.
  
• Avoid mentally stimulating activity just before bed (e.g. action movie, stimulating conversation).
  
• Mentally quiescent tasks such as listening to music, calming thoughts etc. can help.
  
• Relaxation techniques such as visual imagery and the tense-relax skill can help.
  
• Talk to other people. Many people think their symptoms of sleeplessness are unique to them. If you talk to others, you will find that many share your problems. Learning how others have coped can be helpful.
  
• Seek professional help. If you are unable to deal with the sleeplessness and it is becoming a problem for you, you might benefit from professional help. Your family doctor will know about medications that can help you fall asleep without a hangover the following day.
  

Remember – sleeplessness associated with an acute stressful situation usually improves on its own. Be patient.

Other items to consider:

• Nightmares can increase during periods of great stress for all people, though they occur most frequently in children age 3-6. Avoid eating or taking high-dose vitamins before bed, which can increase brain activity and the onset of nightmares. Also avoid alcohol, caffeine and other stimulants. Exercise and relaxation techniques may be helpful.
  
• Excessive Daytime Sleepiness (EDS) and Fatigue, with symptoms such as difficulty concentrating or dozing off while watching TV or reading, is best handled by stopping what you are doing and taking a nap, or retiring early and going to sleep. Be cautious about treating EDS with caffeine or over-the-counter stimulants as they temporarily mask sleep loss and can cause sleep disruption. If EDS persists for more than a few days, speak to a physician or other health care provider.
  
• Some people may find it helpful to designate a worry time. Worry time can be used for sorting out problems and coming up with possible solutions to those problems. Select about 30 minutes in the evening to sit alone undisturbed. On 3 X 5 cards write down each worry as it comes into your mind (one worry per card). These worries can range from having to call someone in the morning or remembering an anniversary to financial concerns or problems with a relationship. Once all the worries are written down, sort them into three to five piles according to the priority of the worry. Then look at each worry card and come up with a possible solution to that worry. While other worries will not have easy solutions, even making a dent in a worry will be progress. The next morning, review and begin to carry out your plans.
  

Other Resources:

For more information about sleep (including lists of accredited sleep centers), contact the:

National Sleep Foundation
1522 K St., NW, Suite 510
Washington, DC 20005
Or visit the NSF Web site at:
www.sleepfoundation.org

Breathing relaxation is a great relaxation skill that can help you achieve a relaxed state and fall asleep more easily. Don’t forget to continue to use deep breathing on its own or in combination with additional relaxation skills.

Now let’s focus on how to improve sleep with sleep hygiene ...

Improving Sleep Hygiene – Skills >