Sleep Hygiene (for the sleepless adult)

I went to a sleep hygienist several years ago and she gave me this hand out (sorry, I don't know where she got it, and yes, there is such thing as sleep hygienist:). This was written with adults in mind but much of the information can be applied to
babies and children. Plus, I'm pretty sure that many of us can use some helpful tips to sleep better ourselves. I know I can. I have added in a couple of my own comments in italics. I couldn't help myself.

If any of you have additional tips, let us in on your knowledge in the comment section.

  1. Sleep only as much as you need to feel refreshed the next day. Curtailing sleep solidifies sleep, excessive time in bed seems to fragment sleep. I have read that if you are very sleep deprived, you may actually feel worse when you start to get more sleep. This should go away shortly.
  2. Get up at the same time each morning, regardless of how poorly you slept the night before. Maintain the time of arising on weekends so as to not disturb your body's rhythms. A change in weekend hours can lead to "Monday blues" and sluggishness (as if kids would ever let you sleep in on the weekends).
  3. Going to bed early before a "big day" will probably only result in more tossing and turning.
  4. If you miss an entire night of sleep you will only need about 9.5-10 hours the following night to catch up.
  5. If you haven't fallen asleep after 20-30 minutes, get up. Do something else, perhaps something you dislike (i.e. endless housework), for a short time. Try to sleep again when you are tired. This helps you to not associate the bedroom with sleeplessness.
  6. Don't force yourself to sleep 8 hours. You may require less sleep (or more??). Each person's needs is different. The criterion is whether you feel alert and vigorous throughout the day. If you do, you are almost certainly getting the amount of sleep you need.

  1. The bedroom should be as quiet as possible. Occasional loud noises disturb even those who do not remember them the next morning.
  2. Find a comfortable room temperature. An ideal temperature for humans has not been determined, but too warm of a room can fragment sleep.
  3. Use the bedroom only for sleep and some pleasant activities. Do not make it a room where you eat or do all of your office or financial business or general social activities.
  4. A firm, not hard, mattress is suggested, but there is no right mattress for everyone.
  5. A well-made bed is more conducive to sleeping (or a well destroyed bed in the case of a toddler).
  6. Here's one of my own--keep the room nice and dark.

A Few Words About Stress (this section should be named after me!)
Stress is the number one enemy of sleep. As stress-related insomnia develops, so does a cycle. After a sleepless night a person may worry about the next night's sleep, becoming more anxious as night approaches and thus more awake, resulting in another sleepless night. This may result in what is called conditioned or psycholophysiological insomnia. A few suggestions:
  1. Go to bed only when sleepy.
  2. If unable to sleep, get up, go to another room, and return when sleepy. Repeat if needed.
  3. Arise at your normal time, regardless of how poor the night's sleep was, or you may be in for continued nights of the same problem.
  4. If you can't sleep because a project needs to be finished, get up and finish it.
  5. If your mind won't stop racing with worries, thoughts, ideas, get up and write them down. Having a paper pad and pencil at the bedside is useful (try this, it really does help). Writing down things can also you organize your day and make it less stressful which will help you sleep at night.
  6. Try some relaxation techniques, such as slow, deep breathing or tensing and relaxing each muscle group (starting at feet and moving towards head), or listen to a monotonous sound (soft radio static, waves, etc.). Be patient. It may take a month or more for you to see the results (I've even tried a bit of meditation).
  7. Above all - don't worry about the amount of sleep you need (no looking at the clock to see what time it is or how many hours you have left until you have to get up!). You can manage on surprisingly little. Insomnia will not kill you, but it can take over your life if you let it. Do not practice sleeping. Practice stress-control techniques and improving those parts of your life over which you have control.
  8. I also wanted to add that you should not feel guilty about getting your needed sleep. I bet there are many of you out there sitting in bed thinking about all the things you should be doing instead of sleeping (or trying to sleep). Sleep is important for your body, just like healthy exercise and food are important. You will be a better and more patient parent, spouse, friend etc if you get the sleep your body needs.

When To Consult A Physician
  1. If you don't sleep consistently for a long time (over 3 weeks).
  2. If you feel tired all day, despite following the above advice.
  3. If you awaken during the night gasping for air, sweating or with heart pounding.
  4. If you have a significant worsening of sleep so that you cannot relate to a specific event or problem or if you experience unexplained excessive daytime sleepiness.
  5. If your spouse or roommate reports snoring and periods of no breathing, or rhythmic, involuntary leg jerks, gagging, or coughing during sleep.

Habits And Rituals
  1. Try to establish a simple routine for going to bed. Habits help you sleep by helping your system psychologically unwind.
  2. On trips take along your own pillow if possible and arrange for a wake-up-call so that you don't worry about oversleeping (worry about "oversleeping"? Ha!).
  3. Do not nap during the day. (I have heard that a short nap can be very healthy but I'm not sure this is the case with insomniacs. Either way, if you nap, do not nap for more than an hour, and probably less)

Gentle exercise can help you relax and feel tired. Don't overdo, but do make it regular. Occasional exercise does not necessarily deepen sleep. Strenuous exercise prior to bedtime is not advised. Exercising in late afternoon or early evening is best for most people. I hear that a good rule of thumb is to not exercise closer than three hours before bed.

  1. Hunger makes for restless sleep. A snack (low protein, high carbohydrate) may help. Foods containing L-tryptophan, such as tuna, turkey, nuts, or warm milk, may help on occasional sleepless nights.
  2. High sugar foods are stimulants - avoid them at bedtime.
  3. Do not go to bed immediately following a heavy meal.
  4. Caffeine (colas, chocolate, coffee) disturbs sleep even in those who feel it does not. Older people metabolize caffeine more slowly and should stop it earlier in the day.
  5. Don't smoke. Nicotine is a stimulant and disrupts sleep.
  6. Alcohol may relax you and help you fall asleep, but the ensuing sleep is more fragmented, and total sleep time decreased.
  7. Any prescription or over-the-counter drug can disturb sleep-wake patterns, and regular, chronic use of any medication to help sleep is rarely indicated.
  8. An occasional sleeping pill may be of some benefit for short-term use, but chronic use is ineffective and eventually can contribute to poor sleep. It may also worsen underlying medical problems such as sleep apnea, especially when taken with alcohol.


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