Sleep Hygiene

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Sleep Hygiene

• Phyllis M.Connolly, PhD, RN, CS

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Sleep Disorders Facts

• Mood disorders often have sleep disruption as
  chief complaint
• Major depression characterized by either insomnia
  or hypersomnia
• Anxiety disorders often coexist
• Worry and nervousness lead to sleep disruption
• Primary insomnia occurs in generalized anxiety,
  panic disorder posttraumatic stress disorder
• 50 of elders experience poor sleep
• 94 of institutionalized prescribed
  sedative-hypnotics
• Males 8 times risk for obstructive sleep apnea

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Characteristics Primary Sleep Disorders
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Sleep-Wake Pattern Circadian Cycle
Glod, 1998

• Sleep cyclical 90 minute cycle
• repeats 4 - 5 times during the night
• Stages (EEG pattern)
• Stage 1--drowsiness and slowing of eye muscle
  movements, lasts only few minutes
• Stage 2-- light sleep, 10-25 minutes, muscles
  further relax (sleep spindles emerge)
• Stage 3--deep sleep, few min. to 30 - 40 mins. VS
  physical activity ? REM 5 -30 mins.
• Stage 4--final stage of NREM, Slow wave EEG, 20
  -40 mins.

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Medical Conditions Sleep Disruption

• Arthritis
• Chronic fatigue syndrome
• Hyperthyroidism
• Menopause
• Allergies
• AIDS
• Pain secondary to a medical condition

• Fibromyalgia
• Cystic fibrosis
• Head injury
• Migraine headaches
• Huntingtons chorea
• Tourettes syndrome
• Alzheimers disease
• Cancer

Glod, 1998
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Substance-Induced Sleep Disorder

• Antidepressants
• Antihypertensives
• Antihistamines
• Corticosteroids
• Stimulatants
• Sedative-hypnotics

• Cholinergic agents
• Cold preparations
• Alcohol
• Caffeine
• Opiods
• Amphtemines

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Methods of Evaluating Sleep Disorders

• Sleep Diaries
• History, Physical Exam, Detailed Sleep Disorders
  Assessment
• Polysomnography (PSG)
• Multiple sleep Latency Test (MSLT)
• Actigraphy

Glod, 1998
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Sleep Hygiene Environment

• Avoid working in bed set reasonable limit for
  finishing work prior to bedtime
• Avoid serious discussions or arguments prior to
  bedtime
• Avoid working on potentially upsetting things

• Adequate comfortable temperature
• Ensure absence of light
• Reduce eliminate noise
• Remove TV avoid listening to radio in bed
• Avoid other activities
• Do not look at the clock when you wake up at night

Glod, 1998
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Sleep Hygiene Environment Cont.

• Protect bedtime and sleep from disruptions
• Minimize effects from bed partner (snoring,
  different bedtime, movement
• Take hot bath within 2 hrs
• Drink small amt. Of warm drink (noncaffeinated)

• Do not make late night phone calls
• Exercise in morning or several hrs. before bed
• Obtain 1/2 hr. sunlight shortly after arising
• Make bed and bedroom as comfortable as possible
• Do not turn lights on when getting up during the
  night

Glod, 1998
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Sleep Hygiene Cont.

• Set regular bedtime and rise times, even weekends
• Determine your individual amt. of sleep duration
  (6-10 hrs.)
• Dont sacrifice sleep
• If insomnia, daytime sleepiness consult clinician

• Avoid alcohol
• Avoid caffeine
• Avoid OTC medications that cause sleep problems
• Establish regular pattern prior to bed (brush
  teeth, change clothes)
• Avoid naps

Glod, 1998