Practicing Good Sleep Hygiene

Sleep disruption is common, especially during times when you may feel emotionally overwhelmed. Anxiety, relentless replaying of the day's events, and heightened emotions may significantly interfere with your sleep. Lack of sleep robs you of needed rest, making management of your illness more difficult. For some, the horrific events of September 11, 2001, which saw the destruction of the World Trade Centers and partial destruction of the Pentagon, has wrought fear and sleep problems.

Bringing sleep patterns under control and working at a consistent, stable pattern is very important to illness management. Remember, you need your rest to remain healthy.

The most common cause of insomnia is a change in your daily routine. For example traveling, change in work hours, disruption of other behaviors (eating, exercise, leisure, etc.), relationship conflicts may cause sleep problems.

Paying attention to good sleep hygiene is the most important thing you can do to maintain good sleep.

Do:

• Go to bed at the same time each day.

• Get up from bed at the same time each day.

• Get regular exercise each day, preferably in the morning. There is good evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise.

• Get regular exposure to outdoor or bright lights, especially in the late afternoon.

• Keep the temperature in your bedroom comfortable.

• Keep the bedroom quiet when sleeping.

• Keep the bedroom dark enough to facilitate sleep.

• Use your bed only for sleep and sex.

• Take medications as directed. It's often helpful to take prescribed sleeping pills about one hour before you plan to go to bed. This allows them to begin causing drowsiness when you lie down.

• Use a relaxation exercise just before going to sleep.

• Muscle relaxation, imagery, massage, warm bath, etc.

• Keep your feet and hands warm. Wear warm socks and/or mittens or gloves to bed.

Don't:

• Exercise just before going to bed.

• Engage in stimulating activity just before bed, such as playing a competitive game, watching an exciting program on television or movie, or having an important discussion with a loved one.

• Have caffeine in the evening (coffee, many teas, chocolate, sodas, etc.)

• Read or watch television in bed.

• Use alcohol to help you sleep.

• Go to bed too hungry or too full.

• Take another person's sleeping pills.

• Take over-the-counter sleeping pills, without your doctor's knowledge. Tolerance can develop rapidly with these medications. Diphenhydramine (an ingredient commonly found in over-the-counter sleep medications) can have serious side effects for elderly patients.

• Take daytime naps.

• Command yourself to go to sleep. This only makes your mind and body more alert.

If you lie in bed awake for more than 20 to 30 minutes, get up, go to a different room (or different part of the bedroom), participate in a quiet activity (e.g. non-excitable reading or television), then return to bed when you feel sleepy. Do this as many times during the night as needed.