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Lifestyle and Behavioral Treatments for Sleep Disorders

Lifestyle and behavioral treatments for sleep disorders might include the following:

  • Stimulus control (SC)
  • Sleep restriction therapy (SRT)
  • Cognitive therapy
  • Relaxation training
  • Sleep hygiene

Typically these strategies are provided not individually but are each included as a part of a multi-component treatment called Cognitive-Behavioral Therapy for Insomnia.

Relaxation training

Relaxation training methods such as progressive muscle relaxation (PMR), deep breathing techniques, imagery, and self-hypnosis might help some people deal with sleep disorders. PMR involves helping the individual to sequentially tense and relax the body's major muscle groups while concentrating on and contrasting sensations of tension and relaxation. Daily practice of relaxation techniques between therapy sessions is essential and tends to enhance the effectiveness of the treatment.

Cognitive therapy

Cognitive therapy for insomnia includes interventions that are meant to help people identify and correct inappropriate thoughts and beliefs that might contribute to insomnia. Cognitive therapy can give people the proper information about sleep norms, age-related sleep changes, reasonable sleep goals, and the influence of naps and exercise.

Stimulus control (SC)

Stimulus control derives from the belief that insomnia might be related to the bedroom having become associated with other things (stressful situations, for example) besides sleep and sex.

Sleep restriction therapy (SRT)

Sleep restriction therapy is based on the belief that excess time in bed makes sleep problems worse. SRT consists of limiting a person's time in bed to only that time when he or she is sleeping.

Sleep hygiene

The concept of sleep hygiene refers to practices, habits, and environmental factors that are important for getting sound sleep. The four general areas important to sleep hygiene are the circadian rhythm (24-hour cycle); aging; psychological stressors that cause mini-awakenings (in which the brain wakes up for just a few seconds); and substances such as nicotine, caffeine, and alcohol.

Circadian rhythms influence when, how much, and how well people sleep. These rhythms might be altered by the timing of various factors, including naps, bedtime, exercise, and especially exposure to light.

Aging also plays a role in sleep and sleep hygiene. Sleep patterns change after people reach the age of 40. There are many more nocturnal awakenings as people age. The awakenings affect sleep quality and can interact with any other condition that might cause arousals or awakenings. The more awakenings people experience at night, the more likely they will awaken with a feeling of not being rested.

Psychological stressors such as exams, deadlines, or job problems might interfere with sleep. It is beneficial for people to develop some kind of pre-sleep ritual to break the connection between stress and bedtime. Some people find it helpful to make a list of all the stressors of the day, along with a plan to deal with them. In addition, periods of relaxation (meditating or taking a hot bath) can help a person relax and get to sleep.

Caffeine can stay in the body as long as 14 hours and can increase the number of times you awaken at night, decreasing your total amount of sleep time. The effects of nicotine, when consumed in high doses, are similar to those of caffeine. Alcohol might initially sedate you, making it easier to fall asleep. The downside to alcohol is that as it is metabolized and cleared from your system during sleep, it causes arousals that can last as long as two to three hours after it has been eliminated.

Environmental factors such as temperature and noise are important to good sleep. The sleeping environment should be relatively cool, dark, and silent. Patients may be encouraged to buy blackout curtains to eliminate extra light and wear ear plugs. A partner who disturbs the patient while sleeping or other factors (such as noise/light from TV, etc.) should be addressed.

References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.This document was last reviewed on: 7/20/2012...#12143