Falling Asleep & Staying Asleep Handout

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1 Falling Asleep & Staying Asleep Handout This handout contains information that may help if you have difficulty falling asleep or staying asleep. In the pages that follow, you will learn about sleep disorders and the techniques that are used by insomniacs as part of a treatment plan, as well as by people who occasionally have trouble sleeping. Tips and strategies to help improve your sleep hygiene are as well included.

2 I. Introduction: What to do if you can t sleep Insomnia is the inability to sleep, the inability to stay asleep, or the inability to sleep well at night. Many different medical and mental problems can cause insomnia. It can be a symptom of a breathing problem, like sleep apnea, or it can be linked to heart failure, side effects from medications, anxiety, or depression. Insomnia may be situational, lasting a few days or weeks. It may also be chronic, lasting for more than one month. While short periods of insomnia may be treated with medication, chronic insomnia may not always be helped by sleeping pills. In severe cases, people experience fatigue, sleepiness, difficulty concentrating and difficulty thinking clearly. For some people with severe and chronic insomnia, an evaluation by a primary physician or a sleep specialist often helps get to the root of the problem. Seeing a doctor is important when insomnia is new or has worsened. Remember, in many cases insomnia is a symptom of an underlying disease. Insomnia is not a disease itself. Though it is best to see a physician for sleep disorders, here are a number of things you can do to improve your sleep. P a g e 1

3 Some Simple Things to Do When You Can t Sleep Take a warm bath Heat can relax your muscles, allowing you to fall asleep. Get a massage Another muscle relaxing techniques. However, be sure that the massage does not cause any pain. Listen to music Actually any soothing noise, played softly in the background may help you fall asleep by defocusing your mind. Drink warm milk Milk contains tryptophan, a natural sleep-inducer. Adding honey may also help. If you are lactose intolerant, skip this suggestion. Drink herbal tea Make sure the tea is decaffeinated. Some Simple Steps to Help You Get to Sleep Sleep on a firm mattress Sagging or poor quality mattresses can cause problems maintaining sleep. Sleep with your head facing north Some people believe that keeping your body inline with the earth s magnetic field helps. Count something Counting sheep can really help as long as the setting you picture in your mind is a peaceful, moving scene. Concentrating on a mental image can relax the body. Change the pillow Proper alignment of head, neck, and spine is important in reducing chronic sleep related problems. Practice relaxation techniques These can be very helpful in getting to sleep. Several of these techniques are described in the pages that follow. P a g e 2

4 II. Sleep Habits: Your Personal Habits Your daily routine can impact how well you sleep. Throughout the day, follow these guidelines. These may seem like common sense, but they are essential to good sleeping habits: Set a constant bedtime and wake-up time. Do not allow them to vary. The body gets used to falling asleep at certain times. No matter what your schedule, this is an essential component to good sleeping habits. Avoid napping during the day. If you must take an afternoon nap, limit it to minutes. Don t drink alcohol 4-6 hours before going to bed. Alcohol can have an immediate sleepinducing effect, but as the alcohol level in your body decreases there is a stimulant effect. Avoid caffeine, including coffee, tea and chocolate 4-6 hours before bedtime. Avoid spicy food 4-6 hours before going to sleep. Regular exercise, particularly in the afternoon, can help deepen sleep. However, it is not a good idea to exercise within 2 hours of going to bed. Your Sleeping Environment Uncomfortable bedding can prevent a good night s sleep. Evaluate if this is the source of your problem and make appropriate changes. Make sure your bedroom is not too hot or too cold. Find a comfortable setting and keep the bedroom well ventilated. A cool (not cold) room is often best for sleeping. Block out all distracting noises. Eliminate as much light as possible. The bed should be reserved for sleeping. Your body will then associate the bed with sleep. Don t use it as an office, workroom, or recreational room. P a g e 3

5 Getting Ready for Bed A light bedtime snack, especially warm milk and foods high in the amino acid tryptophan, like bananas, may help you fall asleep. Leave your worries from your job, school, and daily life behind. Don t use bedtime as a time to worry. You may want to take a warm bath or spend a couple of minutes reading in another room before going to bed. Relaxation techniques may help you relax and reduce muscle tension. Get into your favorite sleeping position. If you don t fall asleep within 30 minutes, get up, go into another room and do something else, like read, until you feel sleepy. If You Get Up in the Middle of the Night Most people wake up for a variety of reasons one or two times a night. If you wake up and you can t get back to sleep within minutes, do not remain in bed trying to fall back asleep. Get out of bed and leave the bedroom. Read, eat a light snack, take a bath, or engage in some quiet activity. Generally, you will be able to go back to sleep within 20 minutes of doing something else. Do not do office or homework and do not watch television. A Word about Television and Mobile Devices: The television should not be in the bedroom. If you like to watch TV before going to bed, watch it in another room. Mobile devices like smartphones, laptops, and tablets have similar stimulating effects and can make sleep difficulty, like the television. Some people like to listen to music while they are falling asleep. This is less engaging than television or mobile devices, so it can be a good idea for some people. P a g e 4

6 Other Factors Several physical factors are known to upset sleep. These include arthritis, acid reflux with heartburn, menstruation, headache, and hot flashes. Psychological and mental health problems like depression, anxiety and stress are often associated with sleeping difficulty. In many cases difficulty staying asleep may be the only presenting sign of depression. A physician should be consulted about these issues to help determine the problem and the best treatment. Many medications can cause sleeplessness as a side effect. Ask your doctor or pharmacist if the medications you are taking can lead to sleeplessness. To help overall improvement in sleep patterns, your doctor may prescribe sleep medications for short-term relief of a sleep problem. The decision to take sleeping aids is a medical decision to be made in the context of your overall health picture. You should always follow the advice of your physician and other healthcare professions. The goal is to rediscover how to sleep naturally. P a g e 5

7 III. Relaxing Techniques Progressive Relaxation This technique is most effective if you are able to record yourself saying the instructions aloud. Read the instructions slowly and take a short pause after each one. Then listen to the recording when needed. 1. Lie on your back, close your eyes. 2. Feel your feet. Sense their weight. Consciously relax them and sink into the bed. Start with your toes and progress to your ankles. 3. Feel your knees. Sense their weight. Consciously relax them and feel them sink into the bed. 4. Feel your upper legs and thighs. Feel their weight. Consciously relax them and feel them sink into the bed. 5. Feel your abdomen and chest. Sense your breathing. Consciously will them to relax. Deepen your breathing slightly and feel your abdomen and chest sink into the bed. 6. Feel your buttocks. Sense its weight. Consciously relax it and feel it sink into the bed. 7. Feel your hands. Sense their weight. Consciously relax them and feel them sink into the bed. 8. Feel your upper arms. Sense their weight. Consciously relax them and feel them sink into the bed. 9. Feel your shoulders. Sense their weight. Consciously relax them and feel them sink into the bed. 10. Feel your neck. Sense its weight. Consciously relax it and feel it sink into the bed. 11. Feel your head and skull. Sense its weight. Consciously relax it and feel it sink into the bed. 12. Feel your mouth and jaw. Consciously relax them. Pay particular attention to your jaw muscles and unclench them. Pay particular attention to your jaw muscles and unclench them if you need to. Feel your mouth and jaw relax. And sink into the bed. 13. Feel your eyes. Sense if there is tension in your eyes. Sense if you are forcibly closing your eyelids. Consciously relax your eyelids and feel the tension slide off the eyes. 14. Feel your face and cheeks. Consciously relax them and feel the tension slide off into the bed. 15. Mentally scan your body. If you find any place that is still tense, then consciously relax that place and let it sink into the bed. P a g e 6

8 Toe Tensing By alternately tensing and relaxing your toes, you actually draw tension from the rest of the body. Try it! 1. Lie on your back, close your eyes. 2. Sense your toes. 3. Now pull all ten toes back toward your face. Count to 10 slowly. 4. Now relax your toes. 5. Count to ten slowly. 6. Now repeat the above cycle 10 times. Deep Breathing Deep breathing allows your body to relax and is a great way to help you get to sleep. 1. Lie on your back. 2. Slowly relax your body. You can use the progressive relaxation technique described already. 3. Begin to inhale slowly through your nose if possible. Fill the lower part of your chest first, then the middle and top part of your chest and lungs. Be sure to do this slowly, over 8-10 seconds. 4. Hold your breath for a second or two. 5. Then quietly and easily relax and let the air out. 6. Wait a few seconds and repeat this cycle. 7. If you find yourself getting dizzy, then you are overdoing it. Slow down. 8. You can also imagine yourself in a peaceful situation such as on a warm, gentle ocean. Imagine that you rise on the gentle swells of the water as you inhale and sink down into the waves as you exhale. 9. You can continue this breathing technique for as long as you like until you fall asleep. P a g e 7

9 Guided Imagery (Visualize Something Peaceful) 1. Lie on your back with your eyes closed. 2. Imagine yourself in a favorite, peaceful place. The place may be on a sunny beach with the ocean breezes caressing you, swinging in a hammock in the mountains or in your own back yard. Any place that you find peaceful and relaxing is ok. 3. Imagine you are there. See and feel your surroundings, hear the peaceful sounds, smell the flowers or the barbecue feel the warmth of the sun and any other sensations that you can imagine. Relax and enjoy it. 4. You can return to this place any night you need to. As you use this place more and more you will find it easier to fall asleep as this imagery becomes a sleep conditioner. 5. Some patients find it useful to visualize something boring. This may be a particularly boring teacher or lecturer, co-worker or friend. Quiet Ears 1. Lie on your back with your eyes closed. 2. Place your hands behind your head. Make sure they are relaxed. 3. Place your thumbs in your ears so that you close the ear canal. 4. You will hear a high-pitched rushing sound. This is normal. 5. Listen to this sound for minutes. 6. Then put your arms at your sides, actively relax them and go to sleep. P a g e 8

10 Conclusion Insomnia is a persistent disorder that can make it hard to fall asleep, hard to stay asleep or both, despite the opportunity for adequate sleep. This brochure provided some tips and strategies that could be helpful for some patients to assist in falling asleep and staying asleep. Further strategies would be discussed and provided by the sleep physician during your evaluation. We wish you a good night sleep. Please do not hesitate to contact us if you have further questions Arlington Road T-100 Bethesda, MD (301) P a g e 9

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