Appendix F: Sleep hygiene protocol
(adapted from Sleep Disorders Australia handout)
Sleep hygiene is a term used to describe good sleep habits and things you can do to give yourself the best chance of a good refreshing sleep. Most of these suggestions are common sense but are often neglected. Here are some tips to help you get a good night sleep. If you are having trouble sleeping, paying attention to good sleep hygiene will usually help.
Do – Go to bed at the same time each day. The body has a natural clock which will make you sleepy when you are ready for bed. Try not to ignore this. Going to bed too early or too late may result in disturbed sleep.
Do – Get up from bed at the same time each day. Getting up at the same time helps to keep your body clock synchronised with what is going on outside. If you can stick to a fairly regular waking and sleeping time, your body will become accustomed to it. Avoid the temptation to try to make up for a poor night's sleep by sleeping in. The body doesn't understand catch-up sleep; this doesn't mean you need to be obsessive about it—an occasional night out or sleep in is not going to hurt.
Do – Try to spend some daytime outdoors or in natural light. Light is important for the body to produce melatonin which is a sleep promoting substance. Sunlight early in the day is especially useful in synchronising your body clock.
Do – Get regular exercise each day. There is good evidence that regular exercise improves restful sleep, but make sure it is not too close to bed time as this can stimulate your system
Do – Make your bedroom as restful as possible. This means keeping the temperature cool, keeping noises and outside light to a minimum, and leaving distracting things such as mobile phones, i-pads, computers, televisions, and other electronic devices outside.
Do – Use your bed only for sleep and sex. Some people use the bed and bedroom as a multifunction site. You need to avoid this and make sure that the bed and the bedroom are ONLY associated with drowsiness and sleep. The brain makes connections between places (the bedroom) and events (sleeping) and you need to reinforce these. Make sure the bed is for sleeping and that sleeping only happens in the bed.
Do – Take medications as directed. Prescription medications can make you alert or sleepy, and the instructions need to be followed, including not varying the time of day that you take the medication.
Do – Be comfortable and relaxed. If you are cold in bed, warm the room and warm the bed and your body. Warm hands and feet are particularly important. Make sure your bed, mattress, pillows, and bedding are all comfortable. A warm bath about a hour before bedtime causes the body's temperature to rise and then fall which may help sleep.
Do – Understand your sleep need. Most people need between 7-9 hours sleep each day but this includes naps and time spent dozing. Don't build up unreasonable expectations of your sleep needs.
Don’t – Exercise just before going to bed. Exercise immediately before bed stimulates the body and may make it difficult to fall asleep. Take your exercise earlier in the day, preferably before your evening meal.
Don’t – Engage in stimulating activity just before bed. Playing a competitive game, watching and exciting or scary program/movie, or having an important family discussion stimulates your mind and thoughts and will overflow to the bedroom. Worrying about or planning the next day's activity may be a natural thing to do, but try to avoid it. Relaxation strategies can be useful at this time.
Don’t – Drink anything containing caffeine in the evening. Coffee and tea (including green tea) are the obvious caffeine culprits, but colas and many other soft drinks also contain caffeine. Caffeine has a body life of up to 7 hours after ingestion. If frequent trips to the toilet are a problem try not to drink before bedtime and make sure you go to bed with an empty bladder.
Don’t – Go to bed too hungry or too full. If you are in the habit of taking a light supper, keep doing this, but don't eat too much.
Don’t – Nap in the evening before you go to bed. If you are in the habit of taking a daytime nap and it doesn't seem to affect your night sleep, you might at to keep doing this, but try not to sleep in the evening.
Don’t – Stay in bed if you are awake. This is the most important part of this protocol. You at fore yourself to sleep. If you do not fall asleep in a reasonable time, 20-30 minutes maximum, then get up and do something boring, but do this in another room (don't watch television or read). It is best to sit in a comfortable (and warm) armchair in a dim light until you feel drowsy and your limbs feel heavy. When you are tired, go back to bed. This helps your mind and your body to associate the bedroom with drowsiness and sleep.
Don’t – Share your bed with children and pets. Parents sleeping with young children sleep less and have more disturbed sleep.
Don’t – Look at the clock. Clocks with bright numbers are a distraction, and obsessing over time will just make it more difficult to sleep.
Don’t – Smoke. Nicotine is a stimulant and will work against good sleep.
Don’t – Use alcohol to help you sleep. Alcohol helps you fall asleep but it doesn't help you stay asleep. It causes more need to go to the toilet, you wake up earlier, it fragments sleep, and worsens snoring and sleep apnoea.
Don’t – Rely on sleeping tablets to help you sleep. Sleeping tablets have a role when there is some event or circumstances that may temporarily cause you to have difficulty sleeping, but they are a temporary fix.
Many sleeping problems are due to bad habits over a long time. You don't fix sleep problems i one night; persevere with good sleep habits and your sleep will improve. Different things may work for you, so find out what works and stick with it. Dot obsess about sleep problems—one poor night's sleep is not a problem. Just return to good sleep hygiene the next night. However, if despite good sleep habits you still have difficulty, see your doctor, as something else may be disturbing your sleep.
DISCLAIMER: INFORMATION PROVIDED IN THIS SHEET IS GENERAL IN CONTENT AND SHOULD NOT BE SEEN AS A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. CONCERNS OVERS SLEEP AND OTHER MEDICAL PROBLEMS SHOULD BE DISCUSSED WITH YOUR FAMILY DOCTOR.
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