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.