Lifestyle and Behavioral Treatments for Sleep Disorders
Lifestyle and behavioral treatments for sleep disorders might include the following:
- Relaxation training
- Cognitive therapy
- Stimulus control (SC)
- Sleep restriction therapy (SRT)
- 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.