SECTION ONE

Workshop 5 - Developing Better Sleep Habits

A. Stress can cause sleep problems. Developing better sleep habits can eliminate some of the unwanted stress.

The need for sleep is not the same for everyone. Some need more sleep than others and there are times we can go without much sleep. Because we can function without sleep, we often forget there are consequences of doing so. Some of the consequences seem minor like drowsiness, irritability or a lack of focus; although in a combat zone, they are not minor. The long-lasting consequence of not enough sleep may affect your physical, emotional and social health.

The short survey below may help you evaluate the quality of your sleep.

Sleep Diary for the Last Week

• How many nights did you have trouble falling asleep?
  
• On these nights, how long did it take you to fall back asleep?
  
• How many nights did you awaken and have difficulty falling back asleep?
  
• How often do you typically wake up?
  
• How long were you typically awake?
  
  • Was part of waking up due to nightmares?
    
  • Was part of waking up due to bad dreams?
    
  • Was part of waking up due to flashbacks?
    
• On average how many hours did you sleep a night?
  
• I often feel sleepy during the day
  True
  False
• Given the opportunity (a meeting, a bus ride, a class) I can quickly fall asleep most days
  True
  False
• What was your average sleep quality on a scale of 1 (poor) to 10 (excellent)?
  12345678910

C. Difficulty falling or staying asleep are obvious indicator that you may need to improve the quality of your sleep. One of the best indicators of quality sleep is feeling rested and fresh throughout your day. Fortunately, many people can improve the quality of their sleep by following simple techniques. Use the list below to assess your behaviors that will lead to more healthy sleep.

D. Sleep Hygiene

• Do you refrain from caffeine after noon?
  
  • If not, how many caffeine drinks have you had since noon?
    
  • Do you know whether what you drink has caffeine?
    
• Do you avoid exercise within 4 hours of bedtime?
  
• Do you avoid nicotine within 2 hours of bedtime?
  
  • If not, how many cigarettes or other forms of nicotine have you had since dinner?
    
• Do you avoid alcohol or other drugs within 2 hours of bedtime?
  
  • If not, how many drinks or other drugs have you had since dinner?
    
• Do you avoid heavy meals within 2 hours of bedtime?
  
• • Some people may still have problems sleeping when following the techniques above. Sometimes, just being in our bedroom stimulates our body to be awake. To break this awake/bedroom connection, these behaviors should be followed as strictly as possible for up to two weeks in a row.

E. Suggestions for Better Sleep

• Go to bed only when sleepy.
• The bed should only be used for sleep and sex.
• Television and/or radios should not be turned on in bed.
• When you do go to bed, try to fall asleep for no more than 20 minutes. If you are unsuccessful, leave room until you feel sleepy. If you do not fall asleep quickly upon returning to bed, repeat as many times as necessary.
• When out of the room waiting for sleepiness, do something boring (chores, less stimulating reading). Do not watch TV, use the internet, or engage in stressful activities.
• Use your alarm to wake you up at the same time every morning regardless of the amount of sleep obtained.
• Avoid watching the clock when you are in bed. Instead turn the clock face so you do not see it.
• Avoid taking naps during the day, especially on a chair or couch.
• Something to remember that many forget-- A day (or a few days) without sleep is not “the end of the world.” You can function this way for short periods of time quite easily.
• Relaxation exercises often are very effective in helping you to go to sleep.
• Finally, if you have a lot of worries and racing thoughts at night, consider the following,
  • Set a 15 to 30 minute time slot that is the same for everyday and call it the “Worry Time.”
  • Have a pen and pad of paper by your bed.
  • Whenever you have a worry or racing thought, write it on the pad of paper and tell yourself, “I cannot worry about this now; I have to wait and worry about this during my “Worry Time.”
  • During Worry Time, do not do any other activity except worry about the things bothering you. Do it for the full time.
  • When you have no worries left, you can stop having that time slot specifically for worrying.
  • However, if new worries appear, you should reinstitute Worry Time.

Practice these suggestions and sleep hygiene for 2 weeks.

• What sleep hygiene guidelines have you found the easiest?
  
• What sleep hygiene guidelines have you found the hardest?
  
• What sleep suggestions have you found the easiest?
  
• What sleep suggestions have you found the hardest?
  

E. A. Sleep Diary for the Week Following Your Completion of the Sleep Program

• How many nights did you have trouble falling asleep?
  
• On these nights, how long did it take you to fall back asleep?
  
• How many nights did you awaken and have difficulty falling back asleep?
  
• How often do you typically wake up?
  
• How long were you typically awake?
  
  • Was part of waking up due to nightmares?
    
  • Was part of waking up due to bad dreams?
    
  • Was part of waking up due to flashbacks?
    
• On average how many hours did you sleep a night?
  
• I often feel sleepy during the day
  True
  False
• Given the opportunity (a meeting, a bus ride, a class) I can quickly fall asleep most days
  True
  False
• What was your average sleep quality on a scale of 1 (poor) to 10 (excellent)?
  12345678910
• What difference, if any, did you find?
  
• What areas do you need to continue to work on?
  
• Remember, quality sleep may take time, effort and trial-and-error. If these methods do not work for you after much effort, you may want to consult a professional who has expertise with improving sleep habits.