SleepWell® Program
Week 1
Complete the following.
* Why I am concerned about my sleep?
* What I think is the biggest challenge with my sleep: (e.g. not being able to fall asleep or stay asleep, waking up often, not feeling refreshed when I wake up)?
* Could any medical issues or medications be causing my sleep problems? (If you answered yes to this question, talk with your doctor about your sleep issues.)
© American Institute for Preventive Medicine
SleepWell® Program
Week 2
Driving while sleepy can severely impair your driving and cause an accident. Studies have linked sleepiness and fatigue to decreases in reaction time, decision making, and mind and body coordination. All of these factors are very important for safe driving.
According to estimates from the American Automobile Association (AAA), one out of every five deadly traffic accidents is due to drowsy driving. More than one-quarter of drivers admitted to driving in the past month while having trouble keeping their eyes open. (Source: AAA, 2014.)
Drive when you feel alert. On long drives, plan 15 minute breaks to get out and stretch your legs every two hours.
Closing your eyes for even a second (called microsleep) can be enough to travel blindly far down the road (or off the road). If you drive while you are fatigued, you and anyone around you is at serious risk.
Signs of fatigue:
* You can’t stop yawning
* You have trouble keeping your head up
* Your eyes close for a moment or go out of focus
* You have wandering, disconnected thoughts
* You have no memory of driving the last few miles
* You miss seeing a sign or your exit
* You slow down when you don’t mean to or break suddenly or too late
* You drift across the road or veer off onto rumble strips
What to do:
* Pull to the side of the road or go to a rest stop
* Take a 15-20 minute nap. If you can, have 250-300 mg caffeine (amount in 2 cups of coffee) before the nap.
* Get a non-drowsy person to drive or find some way of getting home without driving yourself
* Drive to a motel or place where you can sleep
© American Institute for Preventive Medicine
SleepWell® Program
Week 2
Caffeine
Caffeine is a stimulant drug. It increases alertness. Caffeine can interfere with sleep in these ways:
* It makes it take longer for you to fall asleep.
* It makes you wake up more often when you are sleeping.
* It lowers the amount of deep sleep you get.
Limit caffeine to 300 mg a day.
More than 500 to 600 mg a day may cause you to feel anxious and nervous and make it harder to sleep well.
Early is better.
Drink caffeinated beverages early in your day. It can take eight to 14 hours to clear caffeine from the body. Avoid caffeine at least six hours before bedtime.
Cut down gradually.
Daily usage of caffeine can result in physical dependence. If caffeine is stopped abruptly, withdrawal symptoms can occur. These include headache, feeling down, having a hard time concentrating, and fatigue.
Avoid All Nicotine
Nicotine is a stimulant. Nicotine raises blood pressure, increases heart rate, and makes you feel more alert. Health problems from smoking, chewing, or vaping may make sleep more difficult.
QUITsmoking, chewing, or vaping. Nicotine withdrawal can cause you to wake up during the night, but this will go away. It is worth it to quit.
Alcohol
Alcohol may help you to fall asleep, but it will interfere with quality sleep. Alcohol can lead to lighter sleep and waking up often. All stages of sleep are affected, but deep sleep and REM sleep are most affected. You may not reach the sleep stages needed to feel restored and refreshed upon waking.
After drinking alcohol you may experience:
* More dreaming
* More nightmares
* Faster heart rate
* Sweating
* Need to use the bathroom
Limit Alcohol
Don’t have more than one alcoholic drink with or after dinner. If you take sleep medicines or other medicines, ask your health care provider if you can have any alcohol. If you are taking sleep medicine, it can be extremely dangerous to drink alcohol.
© American Institute for Preventive Medicine
SleepWell® Program
Week 3
Wait, I thought I am trying to sleep more? Yes-and this is going to help you. Sleep restriction means that you limit your time in bed only to when you are sleeping. This strategy can increase sleep drive (pressure to sleep) by creating a temporary state of sleep deprivation. You may feel extra sleepy the first few days. If you feel very sleepy, avoid driving or activities that require you to be alert.
Keep using your SleepWell® Tracker. You will not always need to restrict your time in bed or track your sleep. Remember, you are re-setting your body’s natural sleep drive. Your body can manage sleep when natural processes work properly.
Set Regular Sleep and Wake Times
Going to sleep and waking up at different times each day creates an artificial “jet lag” feeling in your body. A regular wake time helps the body maintain a regular circadian rhythm and strengthens sleep drive. Remember, both of these forces help you sleep well.
1. Choose a Time to Wake Up Every Day. Pick a time that you can maintain for all seven days of the week. It needs to be a realistic time for your work and personal life. Wake up at the same time even on days off and weekends. Wake up at the same time even if you did not sleep well or went to bed late.
2. Calculate Your Total Sleep Time. Average sleep per night subtract the average amount of time you woke up and got out of bed during the night. This will equal your total sleep time. * If your total sleep time is less than 5 hours, use 5 hours (do not go below this number).
3. Set Your Bedtime. Subtract your total sleep time from your wake time (go backwards from wake time). Add 30 minutes to this time. This allows for a normal time to fall asleep and brief awakenings. Calculate the bedtime you will follow for the next week. Your goal is to limit your time in bed to actual sleep time.
Whoa! I can’t stay up that late!
Your planned bedtime may seem very late to you. Remember, sleep restriction strengthens your natural sleep drive. Follow this bedtime for at least a week. Your ability to fall asleep at that time and to stay asleep should improve.
Increasing the time you are awake during the day will also increase your natural sleep drive. As your sleep improves, your bedtime will shift. You will eventually be in bed longer and sleep more restfully.
© American Institute for Preventive Medicine
SleepWell® Program
Week 1
Starting today, complete the SleepWell® Tracker for seven full days. Answer the questions and fill in the charts.
SleepWell® Program
QUICK LINKS: WEEK 1
Keep a Sleep Journal
Why Sleep Enhancement is Important
When You Don’t Get Enough Sleep
A Dangerous “Solution” to Busy Lives
Basics of Sleep
Insomnia
Circadian Rhythm, Sleep Drive & Shift Work
Approaching a Lifestyle Change
Review and Prepare
© American Institute for Preventive Medicine
SleepWell® Program
Week 6
If you have a few poor nights of sleep, shift back to a more restrictive sleep window to increase your sleep drive.
Recall what helped you to improve your sleep. Focus on these strategies to help re-set your healthy sleep.
Example:
* Stay up late to increase sleep drive.
* Get out of bed when you can’t sleep.
* Clear your head by writing down your thoughts and worries.
* Track your sleep.
You will never be back at “square one” because you have learned so many things about healthy sleep. If what you tried before does not work, go back through this guide and try new tools. You may need to use different skills to address the new challenge to your sleep.
See Slip-Ups in a Positive Light
No one is perfect. If you slip back into old habits, like watching TV late in bed, you may feel guilt or conflict. Also, you may view the slip-up as being due to a lack of willpower or strength. You may feel a sense of being helpless or hopeless. These feelings are not productive or motivating.
It is important to understand the feelings that relate to a slip-up. You have not failed. You now have a new challenge to address. Define a new goal. Apply what you already know. Seek out new skills, tools, or support that you need for success.
© American Institute for Preventive Medicine
SleepWell® Program
Week 2
There is no “one size fits all” sleep guideline. The National Sleep Foundation (NSF) has defined ranges that are adequate for most people (see chart below). However, the best indicator of how much sleep you need is your daytime energy and alertness. If you are meeting the NSF guideline, but you need caffeine to get through your day and are falling asleep at the wheel, you may need more quality sleep.
For most adults, seven to nine hours is a good amount of sleep. Older adults may not need as much and children need much more.
Sleep Length Guidelines
© American Institute for Preventive Medicine
SleepWell® Program
Week 4
Downtime is idle time between activities. Examples are the moments you have waiting at a red light, the time spent riding in an elevator, and the extra time during a lunch break.
Idle time allows your brain to rest and process and store information (how you learn and form memories). If you’ve ever had a great idea come to you in the shower, you know how creative your mind is during this time.
Often, multi-tasking steals this time away. The resulting “addiction to activity” does not let your mind rest during the day. The result can be a feeling of being busy all the time. You may feel like you need “time to think.” If you go all day without downtime, it can be harder to quiet your mind at night and go to sleep.
Practice letting your mind rest every day. If you are used to filling your time with multiple tasks at once, the following exercise may be eye-opening!
Try this: Sit in a room for 15 minutes and do nothing. Don’t look at your phone or seek any other distractions. Let thoughts enter your mind.
Reflect:
How did you feel at the end of 15 minutes?
Natural Ways to Include Downtime Daily
* Turn off notifications on your phone. Set aside time for social media during the day-and avoid it at other times.
* Listen to music instead of the news or talk radio while driving. Or, sit in silence and let your mind wander.
* Set an alarm on your phone to remind you to take five minutes of “blank space” time in your day.
© American Institute for Preventive Medicine
SleepWell® Program
Week 2
Answer the following.
* How did your sleep this week compare to the first week?
* What changes did you made to my sleep environment?
* What changes did you make to your eating habits?
* What Changes did you make to your exercise habits?
* What changes will you continue?
* What is one S.M.A.R.T. goal you have for next week?
© American Institute for Preventive Medicine
SleepWell® Program
Week 1
You move through several stages during sleep. Each stage has an important role. The first REM sleep cycle is reached about 90 minutes after falling asleep.
Stage 1
Your muscle activity decreases and your eyes move slowly. It is easy to wake someone in this stage.
Stage 2
Your body temperature and heart rate decrease as your body prepares for deep sleep. Your brain waves slow.
Stage 3
Deep sleep with slow brain waves occurs. Your body repairs damaged cells.
Stage 4
Deep sleep with very slow brain waves takes place. You have no muscle activity. It is difficult to wake someone in this stage.
REM Sleep
Your breathing rate increases, brain waves speed up, and your eyes move rapidly. Your heart rate, blood pressure, and body temperature rise. Dreams occur in this stage. REM sleep helps you to feel refreshed and energetic upon waking.
© American Institute for Preventive Medicine