INSOMNIA: SLEEPING TIPS FROM A TO ZZZZ

We all have occasional bouts of mild insomnia. It may be due to an excessively stimulating day, a particularly disturbing event, or perhaps an especially difficult work assignment due the next day.

Usually these periods are brief and we are able to resume our normal sleep pattern. There are times, though, when stress may be prolonged for several weeks, altering our sleep pattern so that getting a good night's rest is quite hard. We may toss and turn, ruminate over too many things, or wake up frequently during the night. It seems the harder we try to sleep, the more difficult it is to fall asleep. We unwittingly condition ourselves to experience nighttime wakefulness. We even take daytime naps to "catch up" which makes sleep at night more difficult.

Rest assured. Sleep research shows that even chronic insomniacs get sleep. They may report getting no sleep, but laboratory results indicate that sleep. does occur, albeit uneven. What is sought is the return of the subjective feeling that one has rested well.

If you suffer from poor sleep, be sure to consult your physician to see if there are any physiological reasons for your situation. Certain disorders may have serious implications. You may be asked about any personal problems or stresses you have been under lately, since these psychological factors can interfere with restful sleep. Talking with a clinical or counseling psychologist may also help identify psychological complications to sleep

Once you have ruled out any physical or serious psychological reasons for poor sleep, consider the following suggestions for better sleep habits (it would be wise to review these with your physician).

RESTFUL TIPS

1. Maintain a regular wake-tip times. This will help synchronize your circadian rhythms (your biological sleep-wake clock). If you work a swing or night shift, stay with your regular sleep-wake schedule as closely as possible even on your day off. Changing your pattern may result in "jet lag" symptoms.

2. Create a sleep environment. Muffle loud noises, screen light from entering your room, use a good bed, maintain a room temperature between 64 F and 66 F, and turn your clock 't see it in the middle of the night (seeing the time tick by creates more pressure to sleep, making it ).

3. Develop bedtime rituals. These will serve as reminders that it is time for sleep. You may start with locking your doors and closing your windows. Then, take a warm bath or shower, brush your teeth, change into your sleepwear (if you use it), turn down your bed, set your alarm clock, recite your prayer or meditate, turn off the lights, and use any other behavior that can be ritualized in the preparation for sleep.

4. Condition yourself to sleep. Learn to associate lying in bed with sleep. If you go to bed and end up worrying about things, get out of bed. It is better to go to sleep when you're drowsy. Avoid sleeping in other places around your house or apartment. Your bed, too, is not for studying or doing work. Use your desk and save your bed mainly for sleep.

5. Omit daytime naps. They will throw off your sleep-wake cycle.

6. Learn to relax. If you are tense, deep-muscle relaxation will help. Clench your fists, feel the tension for a few short seconds, then quickly relax your hand and allow the tension to escape. Do the same for your arms, then your neck, your abdominal area, and finally your legs. Take d-e-e-p, slow, rhythmic breaths to help you relax.

7. Engage in daily exercise. This tends to deepen sleep. Try aerobics, jogging, calisthenics, swimming, walking, and the like. Refrain from workouts a few hours before sleep since exercise is stimulating.

8. Avoid caffeine, cigarettes. and alcohol before going to bed. Caffeinated coffee, tea, cola, and chocolate increase arousal, so eliminate them after midday. Decaffeinated beverages are usually fine. Since cigarettes can increase stimulation, butt them out. Alcohol, while facilitating some relaxation, typically leads to fragmented and poor sleep.

9. Over-the-counter sleep aids typically contain antihistamines. While they induce drowsiness in many, some may become overstimulated. Use caution: sleep aids are for occasional use only. Regular use may lead to over-reliance.

10. Don't label yourself an "insomniac." Should you have a difficult night, the experience will only reinforce the label and create a fear of insomnia which could become a self-fulfilling prophecy. Everyone has a difficult night now and then. Remind yourself that you will probably get some sleep even though it feels like you've had none. Concentrate on the idea that "rest will come.

11. Reduce fluids after dinner time. This will lessen the likelihood of having to use the toilet in the middle of the night and thereby permit uninterrupted sleep.

12. If you must drink a beverage at night, try a glass of milk. Milk is a natural source of tryptophan, an amino acid that is helpful in inducing sleep

13. If you stayed up all night (or a good portion of it) to celebrate or otherwise have a good time, remember it will take a few days to readjust your sleep-wake cycle.

14. If worrying keeps you awake, set up a 30 minute "worry" period to occur at the same time and in the same place every day. Be certain to confine all worrying to just the one time slot and to think intensely about your concerns. As you toss and turn in bed or wake up trying to solve your problems in the middle of the night, remind yourself that you'll have time during the worry period that next day. Remember, too, that you're not really alert enough to resolve problems when you're half asleep.

If you still are not sleeping well after trying the above tips, contact your physician again or consult a clinical or counseling psychologist. For a referral, you may contact the local office of your state's psychological association, or the department of psychology or psychological services center of a nearby college or university.

This handout was prepared by Kent T. Yamauchi, Ph.D. Reproduced from: Innovations in Clinical Practice: A Source Book (Vol.7 ) pp. 497-498, by L. VandeCreek and T.L.Jackson (Eds.), Sarasota, FL: Professional Resource Press. Copyright © 1999 by the Professional Resource Exchange, Inc., P.O. Box 15560, Sarasota, FL 34277-1560.