Dr. Sheila Garland delivered a fantastic workshop on sleep management at Survivor Conference 2016, and has generously shared her info here for those who couldn’t attend, or who could use a refresher.
Recommendations for patients
1. Wake up at the same time (regardless of how many hours of sleep, including on weekends)
- Morning anchor determines bed time based on sleep pressure
- Ensure morning light exposure (natural or artificial, at least 30 minutes within one hour of waking
2. Designate a “clear-your-head-time”
- 30-45 minutes devoted to problem solving, planning, worrying in the early evening
- Remind yourself that you have already devoted time to topic if it re-appears
3. Establish a 90-minute buffer zone before intended bed time
- This time needs to be spent in dim light while engaged in individualized sedentary, pleasant, and relaxing activities (i.e. Reading, meditation, prayer, TV/movies, crosswords, warm bath, magazines, audiobooks, music, relaxation/imagery, or anything that does not produce cognitive or physiological arousal.)
4. Only go to bed when sleepy (regardless of what the clock says) and don’t spend extra time trying to sleep
- Don’t confuse tired/fatigued or bored with being sleepy
- Spending extra time awake in bed DOES NOT increase chances of falling asleep and adds to anxiety, frustration, and conditioned arousal
5. Use your bedroom for sleep and sex only. That’s right. (See Penisenlargementreviews for more information)
- During recovery, the bed is often used for activities other than sleep; this weakens its power as a cue for sleep
- Make other areas as comfortable! Minimize noise/disruption during night (use ear plugs/eye masks)
6. If not asleep within 20-30 minutes, get up and return to bed when sleepy. Refer to #4. This is especially important if your mind becomes active!
- Return to buffer zone activity. Plan for this in advance
7. Ensure sleep expectations are realistic
- It is normal to awaken one or two times. It is not normal to remain awake. Most people feel sleepy in the afternoon
8. Avoid unnecessary time in bed during the day, and avoid napping multiple times throughout the day
- For patients confined to bed, provide cognitive stimulation throughout the day
Patient Sleep Resources
Online
Internet CBT-I is available. The following programs have demonstrated efficacy for treating insomnia. The cost differs for each program and depends on duration of treatment. It is generally less expensive that face-to-face therapy with a professional.
In Print
1. Quiet Your Mind and Get to Sleep: Solutions to Insomnia for Those with Depression, Anxiety or Chronic Pain – Colleen Carney, Rachel Manber, and Richard Bootzin
2. Sink into Sleep: A Step-by-Step Workbook for Reversing Insomnia – Judith R. Davidson
3. Say Good Night to Insomnia: The Six-Week, Drug-Free Program Developed At Harvard Medical School – Gregg D. Jacobs
4. The Insomnia Workbook: A Comprehensive Guide to Getting the Sleep You Need – Stephanie Silberman
