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Instructions to help improve your sleep

Sleep difficulty often begins in response to a problem or stressful event in your life. In response to the stress (which you may not even remember), you start sleeping poorly. In time, the stressful event may go away but you continue to sleep poorly.

As we struggle with sleep difficulty, we may do things to help ourselves that seem logical such as going to bed earlier, sleeping later in the morning, taking naps. As our sleep difficulty continues, we may develop poor sleep habits like spending too much time in bed awake, reading and watching TV in bed, lying awake in bed tossing, turning, worrying, and feeling frustrated about not sleeping.

Poor sleep habits are much like other poor habits, they can be changed. Here are some suggestions to begin to change your poor sleep habits.

1. Go to bed only when you are sleepy.

If you are not sleepy, you will get frustrated. This leads to associating the bed and bedroom with frustration and wakefulness. You want your mind and body to learn to associate the bed and bedroom with sleepiness and sleep.

You need to stay up until you are sleepy and then go to bed. Staying up until you are truly sleepy will increase your sleep drive.

2. Do not use your bed or bedroom for any activity other than sleep.

You should not read, watch television, eat, or worry in bed. Sexual activity is the only exception to this instruction. On such occasions, the instructions are to be followed afterward when you intend to go to sleep.

Being awake in bed reinforces the idea that things other than sleep happen in the bed and bedroom. Your mind and body learn that the bed and bedroom is a place for wakefulness. You want to teach the mind and body to associate the bed and bedroom with a feeling of sleepiness and sleep.

3. Get out of bed when you can't fall asleep or stay asleep.

If you cannot fall asleep or fall back to sleep within about 15 to 20 minutes, get up and go into another room. Although we do not want you to be a clock watcher, we want you to get out of bed if you do not fall asleep fairly soon. Remember, your goal is to start to associate your bed with falling asleep quickly not with frustration!

When you get out of bed, do a quiet activity that will help to make you sleepy. Keep the lights dim, use a reading light, and be aware of signs of sleepiness so you can return to bed before you fall asleep. Do not lay down on the sofa or the recliner. You might fall asleep there. You want to sleep only in your bed. Return to the bedroom when you start to feel sleepy.

If you can't fall asleep, get up. Get up so your mind and body learn to associate the bed and bedroom with sleepiness not wakefulness.

The new sleep habits will come only with repeated practice. It is common to have to get up several times each night when you first start this.

4. Set your alarm and get up at the same time every morning regardless of how many times you were up during the night.

This will help your body to have a balanced sleep-wake rhythm. Remember from the basic information about sleep that a regular wake-up time is a powerful signal we can use to help set our body's sleep-wake clock.

You may feel sleepy during the day so be careful with your activities. In the basic information about sleep, we talked about the role of your sleep drive in balancing wake and sleep. The sleepiness that you build up during the day will help you to fall asleep and back to sleep more easily the next night. You will start to strengthen the bed and bedroom as signals for sleepiness instead of wakefulness. That's your goal!

5. Avoid napping.

If you must nap, take a nap for no longer than 15 to 30 minutes. Nap only in your bed. Remember, you want to associate the bed with sleepiness not the sofa! If you cannot fall asleep within about 15 minutes, get out of bed. Nap only once each day. The best time to nap is 7 to 9 hours after your morning wake up time to coincide with natural shifts in your internal clock and sleep drive.

Based on guidelines developed by Richard R. Bootzin, Ph.D., University of Arizona and used with permission.