Tuesday, 1 March 2011

Insomina and sleep training/hygiene

I find the term sleep hygiene odd.  Basically it refers to good sleeping habits (ie keeping the sleep timetable clean from distractions and corruptions) rather than sleeping after a shower and fresh undies.

A friend of mine is having difficulty sleeping, and it's something that I seem to see a lot of in hospital, patients saying they can't sleep unless they have their sleeping tablets etc.

So, before the start taking sleeping tablets (which are not a cure, and in the long term can be detrimental to sleep), here are some sleep tips.

(Interestingly, a lot of these translate to small children as well - I see the same tips for when trying to get good sleeping routines for babies and toddlers)

At night:
  • use the bed and bedroom for sleep and sex only
  • establish a regular bedtime routine and a regular sleep-wake cycle
  • create a sleep-promotig environment that is dark, cool and comfortable
  • avoid disturbing sounds - consider having a bedside fan or white noise machine to block out disturbing sounds
  • Do something relaxing in the 30 minutes before bedtime, like reading or meditation
  • Take a warm shower or bath 1.5-2 hours before bedtime, as taking a shower shortly before bed increases alertness.
During the day:
  • Avoid alcohol and caffeine especially late in the day.  Consider no caffeine.
  • Exercise but not within 3 hours of bedtime
  • Avoid later afternoon and evening naps
There are some Behavioural methods which can help train the mind to sleep better.  These include:
  • stimulus control
  • cognitive behavioural therapy
  • progressive muscle relaxation
  • paradoxical intervention
  • sleep restriction
  • imagery tasks
  • biofeedback

Stimulus control - the main goal is regain the idea that the bed is for sleeping. It involves the following:
  • go to bed only when ready to sleep
  • if unable to sleep within 15-20 mins get up and go into another room
  • maintain a regular wake up time no matter how few hours you actually sleep
  • avoid naps
Progressive muscle relaxation - takes about 10 minutes to perform
  • focus on one specific muscle group at a time.  Most people start with the foot.  Inhale and tense foot muscles for about 8 seconds.  Relax the foot and let it become loose and limp, stay relaxed for 15 seconds then repeat on other foot
  • move up to the next muscle group and repeat, doing one side of the body at a time.  Work from foot and leg up to abdomen and chest then hands and arms then to neck, shoulders and face.

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