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