Homeostatic Drive for Sleep
- Avoid naps, except for a brief 10- to 15-min nap 8 h after arising; but check with your physician first, because in some sleep disorders naps can be beneficial.
- Restrict the sleep period to the average number of hours you have actually slept per night in the preceding week. Quality of sleep is important. Too much time in bed can decrease quality on the subsequent night.
- Get regular exercise each day preferably 40 min each day, of an activity that causes sweating. It is best to finish exercise at least 6 h before bedtime.
- Take a hot bath to raise your temperature 2° C for 30 min within 2 h before bedtime. A hot drink may help you relax as well as warm you.
- Keep a regular time out of bed 7 days a week.
- Do not expose yourself to bright light if you have to get up at night.
- Get at least one half-hour of sunlight within 30 min of your out-of-bed time. If early-morning awakenings and sleepiness in the evening are problems, then exposure to bright light should be used in the evening and avoided before mid morning.
- Do not smoke to get yourself back to sleep.
- Do not smoke after 7 PM, or give up smoking entirely.
- Avoid caffeine entirely for a 4-week trial period; limit caffeine use to no more than three cups no later than 10 AM.
- Practice light to moderate use of alcoholic beverages. Alcohol can fragment sleep over the second half of the sleep period.
Arousal in Sleep Setting
- Keep the clock face turned away, and do not seek out what time it is when you wake up at night.
- Avoid strenuous exercise after 6 PM.
- Do not eat or drink heavily for 3 h before bedtime. A light bedtime snack may help.
- If you have trouble with regurgitation, be especially careful to avoid heavy meals and spices in the evening. Do not retire too hungry or too full. The head of the bed may need to be raised.
- Keep your room dark, quiet well ventilated, and at a comfortable temperature throughout the night. Earplugs and eye shades are OK.
- Practice a bedtime ritual. Reading before lights-out may be helpful if it is not occupationally related.
- List problems and one-sentence next steps for the following day Set aside a worry time. Forgive yourself and others.
- Learn simple self-hypnosis to use if you wake up at night. Do not try too hard to sleep; instead, concentrate on the pleasant feeling of relaxation.
- Use stress management in the daytime.
- Avoid unfamiliar sleep environments.
- Be sure that the mattress is not too soft or too firm, and that the pillow is of the right height and firmness.
- An occasional sleeping pill is probably all right.
- Use the bedroom only for sleep; do not work or do other activities that lead to prolonged arousal.
- If possible, make arrangements for care giving activities (children, others, pets) to be assumed by others.