Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression

Building, Maintaining and Benefiting from Sleep

When someone in pain cannot sleep, they often complicate their attempts to fall asleep by practicing what is called _poor sleep hygiene._ This does not refer to cleanliness; it refers to behaviors that are known to interfere with effective sleep onset falling asleep) or sleep maintenance (staying asleep).

Here are the rules:

-protect the need and right to sleep

-Ensure adequate time in bed, free from interruptions and demands.

-Keep regular sleep habits!

-Avoid going to bed after midnight

-Go to bed prepared to sleep

Àô Avoid vigorous exercise shortly before retiring.

Àô At the same time, exercise at least several hours before retiring has been shown to be helpful.

Àô Avoid late afternoon/evening naps

Àô Do not allow doze off while reading or watching television prior to bedtime. Even brief episodes of sleep may interfere with subsequent sleep.

Àô Do not lie in bed worrying about problems or challenges of the upcoming day. If necessary, set aside a ‘worry time’ some hours before bedtime; any difficulties cannot be resolved during that allotted time can be put on until the next day.

Àô the bed should be used for sleep –and not for reading of interesting materials, watching television, working on a laptop, or other activities that may keep one awake.

Àô Learn to associate bed with relaxation and not with activities that will be likely to keep one alert for prolonged periods.

Àô Avoid large meals and excessive fluid intake that may provoke poor sleep, indigestion, heartburn or frequent awakenings to urinate.

Àô Any bedtime snacks should be small and consist of non-spicy foods with sedating potential. Examples include peanut butter and dairy products (both are high in tryptophan, an amino acid or “building block of proteins” that tends to increase sleepiness).

Àô Some patients also report that apples taken before bedtime increase their sleepiness and ability to doze off promptly.

Àô Caffeine and smoking prior to retiring are additional factors that can worsen one’s ability to fall asleep and stay asleep.

Àô Warm baths (not showers) prior to bedtime truly can prove helpful–as can engaging in relaxing, calming and soothing activities.

Àô Tranquil music composed for sleep induction, waterfalls and light/sound/aromatherapy units often are used effectively to facilitate dozing off into natural sleep.

– Make sure that the bedroom is conducive to good sleep

o Ensure a dark environment, unless a night light is needed in the room.

o Ensure a quiet environment_or a soft, low-level noise such as a fan

o Use measures to block out outside sounds, or utilize either white noise generators or earplugs that are ‘waxy” and capable of being molded to fit the ear canal.

o Ensure a reasonably cool environment. Overly warm bedrooms are not conducive to quality sleep.

o Ensure a comfortable environment. Be sure that the mattress is adequately firm and comfortable.

o Take steps to create a relatively allergen-free bedroom

-Avoid oversleeping and lying in the bed for prolonged periods after sleep is completed 7-9 hours).

-Cannot get to sleep or return to sleep?

o Realize that frustration and ‘trying harder’ to fall asleep can be enough to keep anyone awake. Not caring whether sleep will occur can facilitate its onset.

o At such times, don’t engage in activities that will render sleep unlikely or impossible. Don’t go shopping, do laundry, clean house, read an interesting book or play computer games. Focus upon things inherently boring

o Snacks at that time should be light and contains foods that will promote sleep without causing unwanted weight gain.

-Avoid medications if at all possible that can interfere with either sleep or alertness. This precaution includes many over the counter remedies and ‘natural’ (ex: herbal) products. The number of different medications and health foods that can influence one’s ability to sleep and one’s alertness levels is staggering. Such applies to many classes of drugs that would not be suspected by most people. For example, over the counter nasal sprays are a notorious cause of insomnia.

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