Sleep Hygiene Tips: 6 Worksheets for a Healthy Night’s Rest

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Sleep Hygiene Tips: 6 Worksheets for a Healthy Night’s Rest
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A third of adults in developed countries fail to get seven to nine hours of sleep each night (Walker, 2018). Its effect is catastrophic. Not only does a lack of sleep affect mood and concentration in the short term, but it increases the risks of...

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Article Summary

A third of adults in developed countries fail to get seven to nine hours of sleep each night (Walker, 2018). Its effect is catastrophic. Not only does a lack of sleep affect mood and concentration in the short term, but it increases the risks of developing Alzheimer’s disease, diabetes, and certain cancers (Walker, 2018). Sleep may be vital to our well-being, but getting enough of...

Key Takeaways

  • This article explains What Is Sleep Hygiene in Psychology? 5 Scientific Facts in simple medical language.
  • This article explains How to Maintain Good Sleeping Habits: 10 Strategies in simple medical language.
  • This article explains 3 Helpful Handouts, Checklists, and Worksheets (PDFs) in simple medical language.
  • This article explains 8 Activities That Help Improve Sleep Hygiene in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
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Definition

A third of adults in developed countries fail to get seven to nine hours of sleep each night (Walker, 2018). Its effect is catastrophic.

Not only does a lack of sleep affect mood and concentration in the short term, but it increases the risks of developing Alzheimer’s disease, insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।" data-rx-term="diabetes" data-rx-definition="Diabetes is a condition where blood sugar stays too high because insulin is low or not working well. সহজ বাংলা: রক্তে চিনি বেশি থাকার রোগ।">diabetes, and certain cancers (Walker, 2018).

Sleep may be vital to our well-being, but getting enough of it is not always straightforward.

And this is where sleep hygiene comes in. This article looks at the habits involved in our bedtime rituals to help us get to sleep and have a restful night.

These science-based exercises will explore fundamental aspects of positive psychology, including strengths, values, and self-compassion, and give you the tools to enhance the well-being of your clients, students, or employees.

What Is Sleep Hygiene in Psychology? 5 Scientific Facts

In Why We Sleep, neuroscientist Matthew Walker (2018) suggests that if science announced a treatment that improved our memory, boosted our creativity, lowered food cravings, offered protection from cancer and dementia, and reduced the risk of heart disease, we would all be rushing to the doctor.

And yet, many of us are ignorant that good sleep offers us such benefits for free.

Indeed, “not only does sleep disruption play a role in the declining mental abilities that typify Alzheimer’s disease, but getting enough sleep is one of the most important factors determining whether you will develop the condition in the future” (Walker, 2017).

It is important to note that, as with other conditions, sleep disruption is only one of several risk factors involved in Alzheimer’s disease; however, prioritizing sleep is one way to lower your risk.

So, what is sleep hygiene?

Poor habits and unsuitable environments make it tough to fall asleep and stay asleep.

According to the UK’s Sleep Council (2020), “you have no control over what happens when you sleep, but you can control what you do throughout the day to prepare for a better night’s sleep.”

So, can we learn to sleep better? According to research, yes.

Charles Czeisler from the Division of Sleep Medicine at Harvard University says there are three points you need to consider: “how much you sleep, how well, and when,” impacted by the following factors (O’Callaghan, 2016):

  • Familiarity
    When we sleep in unfamiliar places, one hemisphere of our brain remains active. This night watch has developed to keep us safe in uncertain environments.
  • Noises
    Even if we sleep at home, noises can force us out of our deep sleep (a dog barking or a distant house alarm).
  • Temperature
    Our body temperature can significantly affect the quality and quantity of our sleep. Surprisingly, special sleep suits that slightly warm the skin (or taking a hot bath before bed) help the body release heat, reduce the number of nighttime awakenings, and increase restorative slow-wave sleep.
  • Timing
    Your circadian rhythm (tied to your mammalian biological clock) affects the amount of rapid eye movement (REM) sleep you get. Getting up too early means you miss out on later, longer REM sleep cycles.
  • Blue light
    When we use them late at night, the light emitted from our phones and tablets shifts our circadian rhythms. REM cycles start later, and we are less likely to reach extended REM sleep cycles.

According to Walker (2018), almost 10 million Americans daily take something to help them sleep. And yet, sleeping pills do not provide natural sleep, and they “can damage health, and increase the risk of life-threatening diseases” (Walker, 2018).

Sleeping pills work by knocking out higher regions of the brain’s cortex, resulting in a lack of the largest and deepest brainwaves. The result is a catalog of possible side effects during the day, including forgetfulness, daytime grogginess, and slowed reactions.

Where possible, therapists and mental health practitioners should promote good practices that result in a more natural night’s sleep (Walker, 2018).

How to Maintain Good Sleeping Habits: 10 Strategies

There are several relatively straightforward habits and techniques, known as sleep hygiene practices, that promote a better night’s sleep (Walker, 2018; National Institute on Aging, 2020):

  • Maintain a regular sleep schedule.
    Aim for consistency when you go to bed and get up, even during the weekend.
  • Avoid napping in the late afternoon.
    While it may be necessary for those with prolonged sleep deficits, it can disrupt sleep for others.
  • Create a bedtime routine.
    A soak in the bath, relaxing music, or a book before bedtime can set the scene for sleep.
  • Avoid phones, tablets, and TV immediately before bed.
    The light from digital sources can damage your sleep and overstimulate your brain.
  • Find the right temperature.
    Your bedroom should be neither too hot nor too cold, and where possible, quiet.
  • Lower the light.
    Reduce the lighting as you prepare for bed.
  • Avoid late-night exercise.
    Do not exercise in the three hours before going to sleep.
  • Avoid big meals late in the evening.
    Eat earlier in the evening.
  • Time your caffeine.
    Caffeine (found in coffee, tea, chocolate, and soda) can make it more challenging to get to sleep and stay asleep.
  • Reduce alcohol consumption.
    Contrary to what many think, alcohol negatively affects our sleep quality.

According to Walker (2018), if you only adopt one of the above good habits, make it “going to bed and waking up at the same time of day” no matter what.

3 Helpful Handouts, Checklists, and Worksheets (PDFs)

The following handouts help you to look at the environment, habits, and practices surrounding your sleep routine.

Sleep Hygiene Checklist and Actions

Use the Sleep Hygiene Checklist and Actions worksheet to assess your bedroom environment and identify what can be improved to encourage a good night’s sleep.

Consider your bedroom and what it needs to be more sleep-friendly. Accept that you must care for yourself. Self-care is not selfish.

Two-Week Sleep Diary

Keeping track of sleeping habits can be a helpful way to identify factors that may interfere with your sleep.

Complete the Two-Week Sleep Diary over the next 14 days. Look for patterns based on sleep, when you go to bed, alcohol and caffeine intake, etc.

Try to identify what may interrupt your sleep. Make one positive change at a time, continue for a week, and observe the results.

Bed Checklist

With up to a third of our lives spent in bed, it should be as comfortable as possible.

Sleeping on a supportive, good-quality bed can be the difference between a refreshing night’s sleep and waking up tired and aching.

Ask yourself the questions in the Bed Checklist to identify if your bed contributes to your poor night’s sleep and may need replacing.

8 Activities That Help Improve Sleep Hygiene

There are several activities throughout the day that can positively impact your sleep:

Mental tricks

Some people find that playing mental tricks can make them sleepy.

Try gently counting back from 100.

Or, if you prefer, reflect on the following three points based on the day’s events:

  • Three things you enjoyed the most
  • Three actions you performed well
  • Three things you learned in the last 24 hours

This reflection activity will remind you that the day was valuable and contained positive events and memories.

Adequate sunlight exposure

Many of us work indoors in artificial light (especially in the winter) with limited sunlight exposure. And yet, “daylight is key to regulating daily sleep patterns” (Walker, 2018).

Get outside for at least 30 minutes daily to increase your time in natural light.

Smells and sounds

Try calming sounds and smells to see if they help you sleep and leave you feeling more rested in the morning.

When researchers played natural sounds such as a waterfall or gentle waves (known as pink noise) to sleeping participants, their sleep quality and learning improved (Ngo, Martinetz, Born, & Mölle, 2013).

Smells can also stimulate the brain overnight. Participants exposed to lavender while they slept experienced increased slow-wave sleep and reported feeling more invigorated on waking (Goel, Kim, & Lao, 2005).

Treating sleep apnea

Sleep apnea occurs when people have momentary pauses in their breathing during sleep. This can happen throughout the night and, if left untreated, can be linked to high blood pressure, memory loss, and even strokes (National Institute on Aging, 2020).

If you are experiencing tiredness during the day and snoring loudly at night, it is worth seeking help from a specialist.

Seeking help for sleep disorders.

It’s helpful to be aware of some more unusual behaviors humans exhibit during sleep, as they can affect sleep quality.

If you are experiencing any of the following (or other phenomena not mentioned) and it is damaging your sleep, it may be helpful to seek expert advice (Lange, 2016):

  • Sleep paralysis
    During REM sleep, our body becomes temporarily paralyzed to avoid excessive movement.

However, some individuals find that this paralysis can, terrifyingly, continue for a few moments when they wake, sometimes accompanied by pressure on the chest.

  • Hypnagogic jerks
    While not fully understood by science, it is not uncommon to twitch or experience a sense of falling as you drift into sleep. This often results in a sudden awakening. If it is only occasional, this is unlikely to need further attention.
  • REM sleep disorder
    Talking, shouting, or even hitting your partner during sleep can be upsetting and potentially harmful for you both. It can happen during bad dreams when the body is not fully paralyzed.
  • Exploding head syndrome (not as bad as it sounds)
    This affects 1 in 10 of us from the age of 50. As we drop off, we hear a loud bang (like a gunshot) waking us up. It may be because of aging-related physical changes to the middle ear.

Handling nightmares

Recurring nightmares or bad dreams can be very upsetting and are not uncommon. Indeed, 6% of adults describe having monthly nightmares (Centre for Clinical Interventions, 2020).

When woken by a disturbing dream, returning to sleep is difficult. If happening over a prolonged period, it can harm your rest.

Pushing away the images is natural but unhelpful.

Imagery rescripting – closing our eyes and working through the images and narrative in our minds – can help us regain a sense of control by rewriting what happens. It could be (possibly with the help of a sleep therapist) that you rescript the end of a car chase into something less spectacular or with a different ending.

Overcoming insomnia

Insomnia is the medical term for persistent problems with sleep that can last for more than a month involving one or more of the following (Centre for Clinical Interventions, 2020):

  • Difficulty getting asleep (onset insomnia)
  • Waking during the night (middle insomnia)
  • Poor sleep quality

While insomnia may begin in response to stress, pain, or other factors, negative thoughts about sleep can perpetuate the problem.

  • Assuming the worst
    Losing confidence in the ability to sleep
  • Blaming everything on sleep
    Blaming everything that goes wrong during the day on a lack of sleep
  • Unrealistic expectations
    Believing everyone has the same sleep pattern
  • Unhelpful thinking styles
    Catastrophizing, overgeneralizing, and black-and-white thinking suggest sleep is always either ‘great’ or ‘awful.’

A Thought Diary can be valuable for challenging negative thinking and inaccurate beliefs.

Sleep restriction

Cognitive-behavioral therapy for insomnia was developed to provide patients with a “bespoke set of techniques intended to break bad sleep habits and address anxieties” (Walker, 2018).

One of the surprisingly successful techniques for improving sleep quality is restricting time spent in bed. Doing so encourages the patient to form a stronger connection between their time in it and sleep.

The aim is to limit the hours spent in bed to the typical number of hours asleep, known as the sleep window.

When we sleep poorly, we often spend too much time in bed, despite not being asleep. Restricting time can resynchronize natural sleep cycles.

Use the Sleep Restriction worksheet to calculate the sleep time needed.

Under increasing sleep pressure, the patient will, over time, gain more psychological confidence in “being able to self-generate and sustain healthy, rapid, and sound sleep, night after night” (Walker, 2018).

As that confidence increases, it will be possible to increase time in bed gradually.

Assessing Sleep Patterns: 2 Quizzes & Questionnaires

The following two quizzes can help you identify if you are taking your lack of sleep seriously and to what degree you are sleep deprived.

Sleep Quiz

Understanding if you are giving sleep the priority it deserves is practical.

Take the following Sleep Quiz.

If you are answering Yes to multiple questions, you are possibly not putting your sleep first.

Consider what actions you need to take to ensure sufficient, good-quality sleep receives appropriate focus daily.

Are You Sleep Deprived?

Use the Are You Sleep Deprived? Quiz to identify if you have a sleep problem.

If you have answered correctly several times, review the handouts and activities to see how you can improve your sleep hygiene.

5 Techniques for Sleep Therapy & Education

There are several excellent sleep resources available online for free. They describe our current understanding of sleep, disorders, and techniques that can help.

For prolonged sleeping disorders, it may be advisable to seek expert help. Lack of sleep has health risks and affects judgment and skills in driving and operating machinery, etc.

Top 3 Apps to Sleep Better at Night

Many apps can help you reach a calm state and encourage a good night’s sleep.

Three of our favorites include the following:

Calm

A hugely popular app for reducing stress and anxiety and improving sleep quality.

Sleep Sounds – Sleep melodies & Calming sounds

An excellent app that can help you relax and fall asleep to sounds from nature and other meditation sounds.

Endel

Creates personalized soundscapes to help you relax, focus, or sleep. Purports to align with your circadian rhythms based on health data available on your phone.

3 Best Books on the Topic

The following books are three of our favorites on the subject of sleep.

1. Why We Sleep: Unlocking the Power of Sleep and Dreams – Matthew Walker, PhD

This insightful and engaging book by neuroscientist Matthew Walker (2018) uncovers why we sleep and dream and what happens when things go wrong.

Besides incorporating decades of learning, it brings the reader up to date with the latest research on this fascinating subject.

Find the book on Amazon.

2. The Sleep Solution: Why Your Sleep is Broken and How to Fix It – W. Chris Winter, MD

Use the latest sleep science lessons and more traditional techniques to achieve a healthy night’s sleep with no medication.

Neurologist W. Chris Winter (2018) encourages the reader to develop a personalized approach to sleep that fits their lifestyle.

Find the book on Amazon.

3. Say Good Night to Insomnia: The Six-Week Drug-Free Program Developed by Harvard Medical School – Gregg D. Jacobs and Herbert Benson

The author’s program, developed at Harvard Medical School and based on CBT, promises to improve sleep in 80% of patients.

Try out some of the science-backed techniques to overcome insomnia without the use of sleeping pills.

Find the book on Amazon.

A Take-Home Message

A regular good night’s sleep will not only make you feel and perform better, but it could also help you live longer. Science is clear. Low-quality long-term sleep hugely damages our mental and physical well-being (Walker, 2018).

We do not need to accept a poor night’s sleep. We can take practical steps to put in place appropriate sleep hygiene – habits that ready our mind and body for falling asleep.

We can begin by looking at our environment. How does our bedroom look, sound, feel, and smell? And what are our worries? If sleep is causing concern, we can manage it by only getting in bed when the weight of tiredness means staying awake is no longer an option.

Gaining confidence in our ability to drift off and our capacity to stay asleep can remove some blocks to getting a good night’s rest.

Try out our handouts, including the checklists. Gain a better understanding of what may be getting in the way of your sleep and try out the techniques to restore regular, practical sleep hygiene.

REFERENCES
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Orthopedic doctor, rheumatologist, or physiotherapist depending on cause.

What to tell the doctor

  • Write which joints hurt, swelling, morning stiffness duration, fever, injury, and walking difficulty.
  • Bring X-ray, uric acid, ESR/CRP, rheumatoid factor, or previous reports if available.

Questions to ask

  • Is this injury, osteoarthritis, rheumatoid arthritis, gout, infection, or another cause?
  • Which exercises, supports, or lifestyle changes are safe?
  • Do I need blood tests or X-ray?

Tests to discuss

  • Joint examination and range of motion
  • X-ray when chronic arthritis or injury is suspected
  • ESR/CRP, uric acid, rheumatoid tests when inflammatory arthritis is suspected

Avoid these mistakes

  • Do not ignore hot swollen joint with fever.
  • Avoid repeated steroid injections/tablets without a clear diagnosis and follow-up.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Drink safe fluids and monitor temperature.
  • In dengue-prone areas, discuss CBC and platelet count when fever persists or warning signs appear.
  • Use tepid sponging for high fever discomfort; avoid ice-cold bathing.

OTC medicine safety

  • For fever, common fever medicine may be discussed with a clinician or pharmacist.
  • Avoid aspirin/ibuprofen-like medicines in suspected dengue unless a doctor says it is safe.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Fever with breathing difficulty, confusion, repeated vomiting, bleeding, severe weakness, stiff neck, or dehydration needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Sleep Hygiene Tips: 6 Worksheets for a Healthy Night’s Rest

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

What Is Sleep Hygiene in Psychology? 5 Scientific Facts In Why We Sleep, neuroscientist Matthew Walker (2018) suggests that if science announced a treatment that improved our memory, boosted our creativity, lowered food cravings, offered protection from cancer and dementia, and reduced the risk of heart disease, we would all be rushing to the doctor. And yet, many of us are ignorant that good sleep offers us such benefits for free. Indeed, “not only does sleep disruption play a role in the declining mental abilities that typify Alzheimer’s disease, but getting enough sleep is one of the most important factors determining whether you will develop the condition in the future” (Walker, 2017). It is important to note that, as with other conditions, sleep disruption is only one of several risk factors involved in Alzheimer’s disease; however, prioritizing sleep is one way to lower your risk. So, what is sleep hygiene? Poor habits and unsuitable environments make it tough to fall asleep and stay asleep. According to the UK’s Sleep Council (2020), “you have no control over what happens when you sleep, but you can control what you do throughout the day to prepare for a better night’s sleep.” So, can we learn to sleep better? According to research, yes. Charles Czeisler from the Division of Sleep Medicine at Harvard University says there are three points you need to consider: “how much you sleep, how well, and when,” impacted by the following factors (O’Callaghan, 2016): Familiarity When we sleep in unfamiliar places, one hemisphere of our brain remains active. This night watch has developed to keep us safe in uncertain environments. Noises Even if we sleep at home, noises can force us out of our deep sleep (a dog barking or a distant house alarm). Temperature Our body temperature can significantly affect the quality and quantity of our sleep. Surprisingly, special sleep suits that slightly warm the skin (or taking a hot bath before bed) help the body release heat, reduce the number of nighttime awakenings, and increase restorative slow-wave sleep. Timing Your circadian rhythm (tied to your mammalian biological clock) affects the amount of rapid eye movement (REM) sleep you get. Getting up too early means you miss out on later, longer REM sleep cycles. Blue light When we use them late at night, the light emitted from our phones and tablets shifts our circadian rhythms. REM cycles start later, and we are less likely to reach extended REM sleep cycles. According to Walker (2018), almost 10 million Americans daily take something to help them sleep. And yet, sleeping pills do not provide natural sleep, and they “can damage health, and increase the risk of life-threatening diseases” (Walker, 2018). Sleeping pills work by knocking out higher regions of the brain’s cortex, resulting in a lack of the largest and deepest brainwaves. The result is a catalog of possible side effects during the day, including forgetfulness, daytime grogginess, and slowed reactions. Where possible, therapists and mental health practitioners should promote good practices that result in a more natural night’s sleep (Walker, 2018). How to Maintain Good Sleeping Habits: 10 Strategies There are several relatively straightforward habits and techniques, known as sleep hygiene practices, that promote a better night’s sleep (Walker, 2018; National Institute on Aging, 2020): Maintain a regular sleep schedule. Aim for consistency when you go to bed and get up, even during the weekend. Avoid napping in the late afternoon. While it may be necessary for those with prolonged sleep deficits, it can disrupt sleep for others. Create a bedtime routine. A soak in the bath, relaxing music, or a book before bedtime can set the scene for sleep. Avoid phones, tablets, and TV immediately before bed. The light from digital sources can damage your sleep and overstimulate your brain. Find the right temperature. Your bedroom should be neither too hot nor too cold, and where possible, quiet. Lower the light. Reduce the lighting as you prepare for bed. Avoid late-night exercise. Do not exercise in the three hours before going to sleep. Avoid big meals late in the evening. Eat earlier in the evening. Time your caffeine. Caffeine (found in coffee, tea, chocolate, and soda) can make it more challenging to get to sleep and stay asleep. Reduce alcohol consumption. Contrary to what many think, alcohol negatively affects our sleep quality. According to Walker (2018), if you only adopt one of the above good habits, make it “going to bed and waking up at the same time of day” no matter what. 3 Helpful Handouts, Checklists, and Worksheets (PDFs) The following handouts help you to look at the environment, habits, and practices surrounding your sleep routine. Sleep Hygiene Checklist and Actions Use the Sleep Hygiene Checklist and Actions worksheet to assess your bedroom environment and identify what can be improved to encourage a good night’s sleep. Consider your bedroom and what it needs to be more sleep-friendly. Accept that you must care for yourself. Self-care is not selfish. Two-Week Sleep Diary Keeping track of sleeping habits can be a helpful way to identify factors that may interfere with your sleep. Complete the Two-Week Sleep Diary over the next 14 days. Look for patterns based on sleep, when you go to bed, alcohol and caffeine intake, etc. Try to identify what may interrupt your sleep. Make one positive change at a time, continue for a week, and observe the results. Bed Checklist With up to a third of our lives spent in bed, it should be as comfortable as possible. Sleeping on a supportive, good-quality bed can be the difference between a refreshing night’s sleep and waking up tired and aching. Ask yourself the questions in the Bed Checklist to identify if your bed contributes to your poor night’s sleep and may need replacing. 8 Activities That Help Improve Sleep Hygiene There are several activities throughout the day that can positively impact your sleep: Mental tricks Some people find that playing mental tricks can make them sleepy. Try gently counting back from 100. Or, if you prefer, reflect on the following three points based on the day’s events: Three things you enjoyed the most Three actions you performed well Three things you learned in the last 24 hours This reflection activity will remind you that the day was valuable and contained positive events and memories. Adequate sunlight exposure Many of us work indoors in artificial light (especially in the winter) with limited sunlight exposure. And yet, “daylight is key to regulating daily sleep patterns” (Walker, 2018). Get outside for at least 30 minutes daily to increase your time in natural light. Smells and sounds Try calming sounds and smells to see if they help you sleep and leave you feeling more rested in the morning. When researchers played natural sounds such as a waterfall or gentle waves (known as pink noise) to sleeping participants, their sleep quality and learning improved (Ngo, Martinetz, Born, & Mölle, 2013). Smells can also stimulate the brain overnight. Participants exposed to lavender while they slept experienced increased slow-wave sleep and reported feeling more invigorated on waking (Goel, Kim, & Lao, 2005). Treating sleep apnea Sleep apnea occurs when people have momentary pauses in their breathing during sleep. This can happen throughout the night and, if left untreated, can be linked to high blood pressure, memory loss, and even strokes (National Institute on Aging, 2020). If you are experiencing tiredness during the day and snoring loudly at night, it is worth seeking help from a specialist. Seeking help for sleep disorders. It’s helpful to be aware of some more unusual behaviors humans exhibit during sleep, as they can affect sleep quality. If you are experiencing any of the following (or other phenomena not mentioned) and it is damaging your sleep, it may be helpful to seek expert advice (Lange, 2016): Sleep paralysis During REM sleep, our body becomes temporarily paralyzed to avoid excessive movement. However, some individuals find that this paralysis can, terrifyingly, continue for a few moments when they wake, sometimes accompanied by pressure on the chest. Hypnagogic jerks While not fully understood by science, it is not uncommon to twitch or experience a sense of falling as you drift into sleep. This often results in a sudden awakening. If it is only occasional, this is unlikely to need further attention. REM sleep disorder Talking, shouting, or even hitting your partner during sleep can be upsetting and potentially harmful for you both. It can happen during bad dreams when the body is not fully paralyzed. Exploding head syndrome (not as bad as it sounds) This affects 1 in 10 of us from the age of 50. As we drop off, we hear a loud bang (like a gunshot) waking us up. It may be because of aging-related physical changes to the middle ear. Handling nightmares Recurring nightmares or bad dreams can be very upsetting and are not uncommon. Indeed, 6% of adults describe having monthly nightmares (Centre for Clinical Interventions, 2020). When woken by a disturbing dream, returning to sleep is difficult. If happening over a prolonged period, it can harm your rest. Pushing away the images is natural but unhelpful. Imagery rescripting – closing our eyes and working through the images and narrative in our minds – can help us regain a sense of control by rewriting what happens. It could be (possibly with the help of a sleep therapist) that you rescript the end of a car chase into something less spectacular or with a different ending. Overcoming insomnia Insomnia is the medical term for persistent problems with sleep that can last for more than a month involving one or more of the following (Centre for Clinical Interventions, 2020): Difficulty getting asleep (onset insomnia) Waking during the night (middle insomnia) Poor sleep quality While insomnia may begin in response to stress, pain, or other factors, negative thoughts about sleep can perpetuate the problem. Assuming the worst Losing confidence in the ability to sleep Blaming everything on sleep Blaming everything that goes wrong during the day on a lack of sleep Unrealistic expectations Believing everyone has the same sleep pattern Unhelpful thinking styles Catastrophizing, overgeneralizing, and black-and-white thinking suggest sleep is always either ‘great’ or ‘awful.’ A Thought Diary can be valuable for challenging negative thinking and inaccurate beliefs. Sleep restriction Cognitive-behavioral therapy for insomnia was developed to provide patients with a “bespoke set of techniques intended to break bad sleep habits and address anxieties” (Walker, 2018). One of the surprisingly successful techniques for improving sleep quality is restricting time spent in bed. Doing so encourages the patient to form a stronger connection between their time in it and sleep. The aim is to limit the hours spent in bed to the typical number of hours asleep, known as the sleep window. When we sleep poorly, we often spend too much time in bed, despite not being asleep. Restricting time can resynchronize natural sleep cycles. Use the Sleep Restriction worksheet to calculate the sleep time needed. Under increasing sleep pressure, the patient will, over time, gain more psychological confidence in “being able to self-generate and sustain healthy, rapid, and sound sleep, night after night” (Walker, 2018). As that confidence increases, it will be possible to increase time in bed gradually. Assessing Sleep Patterns: 2 Quizzes & Questionnaires The following two quizzes can help you identify if you are taking your lack of sleep seriously and to what degree you are sleep deprived. Sleep Quiz Understanding if you are giving sleep the priority it deserves is practical. Take the following Sleep Quiz. If you are answering Yes to multiple questions, you are possibly not putting your sleep first. Consider what actions you need to take to ensure sufficient, good-quality sleep receives appropriate focus daily. Are You Sleep Deprived?

Use the Are You Sleep Deprived? Quiz to identify if you have a sleep problem. If you have answered correctly several times, review the handouts and activities to see how you can improve your sleep hygiene.

References

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