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  • Plan Your Sleep Environment

    SleepWell® Program

    Week 2

    Image of bedroom.

    Start by creating a comfortable place for sleep. Plan a physical space that is calming and designed to promote healthy sleep. This section also discusses how lifestyle habits affect sleep. These include exercise, diet, and the use of stimulants (e.g. caffeine, nicotine) and depressants (e.g. alcohol).

    Together, your lifestyle habits and sleeping environment are known as “sleep hygiene.” You may have heard of these sleep hygiene tips before. You may already be using some, but if you are struggling with sleep, now is the time to make changes. Use this section to discover the factors that have the biggest impact on your sleep and wake-time energy.

    © American Institute for Preventive Medicine

  • Plan Problem Solving

    SleepWell® Program

    Week 4

    Image of hand holding a missing piece in a square puzzle.

    Your worries and concerns take up time in your day. Many issues cannot simply be ignored or brushed aside. To avoid carrying these thoughts with you to bed, address them earlier in the day.

    Steps to Address Your Worries

    1.  At least two hours before bedtime, write a worry at the top of a piece of paper.

    2.  Divide the paper into three columns:

    a. What I can’t do. Recognize what is out of your control.

    b. What I can do. List possible actions that are within your control. Write things you know how to do and that are realistic actions for you to take.

    c. What I will do. Decide which action you are ready to take first. This action may not solve every part of the problem, but is a small step you plan to take. Write when you will do this.

    Mind Dump

    Use a small notebook or index cards to “mind dump” thoughts that come to mind before bed or during sleep. Write down concerns, ideas, or things you need to remember the next day. If you wake up during the night with concerns, write these down, too. Put the notebook out of sight and go back to sleep. Avoid dwelling on these issues while you are in bed.

    © American Institute for Preventive Medicine

  • Mindfulness 3

    SleepWell® Program

    Week 4

    Image of women sitting out in nature.

    Mindfulness means you are fully aware of all aspects of what you are sensing in the present moment.

    *  You focus on current thoughts without judging them.

    *  You put past thoughts and what the future has in store out of your mind.

    Mindfulness Exercise

    *  Set aside five (or more) minutes. Find a place with no distractions. Get comfortable.

    *  Focus on your breathing or anything in the present, such as the sounds you hear or an object in your sight.

    *  As thoughts pop up in your mind, let them go without judging them. Return your focus to what you see, hear, feel, or are doing in the moment.

    You can also practice mindfulness while you listen to music, walk, run, garden, or with any activity.

    Take a Rest from Your Emotions

    Detach yourself from your thoughts and emotions. Imagine sitting on a hill and viewing your thoughts and feelings at the bottom of the hill. Observe your thoughts as they pass by. Or, you can stop and think about them. Tell yourself: “I have control over when and how I think about a situation.”

    Allow your emotional reactions to a situation or issue take a rest for a bit. This helps your mind use logical thinking.

    © American Institute for Preventive Medicine

  • Medication & Sleep Aids

    SleepWell® Program

    Week 2

    Image of a package of pills.

    Over-the-Counter Products

    It is best to check with your doctor before you take over-the-counter (OTC) medicines or supplements that promote sleep. Why?

    *  Some products could cause harmful interactions with medications you take and with alcohol.

    *  You may need to find out the right dose for you to take.

    *  You could have side effects, such as daytime sleepiness.

    *  Some products may worsen health problems you have.

    *  You could have a medical problem that needs proper diagnosis and treatment.

    In general, do not take OTC sleep medications for more than two weeks without your doctor’s advice.

    Use Caution with Prescribed Sleeping Pills

    Prescribed sleeping pills can cause daytime drowsiness and other side effects. Do not drive or do other activities that require you to be alert.

    *  Follow your doctor’s advice for taking prescribed sleeping pills. Do not increase the dosage without your doctor’s okay.

    *  Let him or her know about side effects that bother you.

    *  Discuss how long to take sleeping pills to avoid getting addicted to them.

    *  Do not stop taking them abruptly. Doing this could cause withdrawal symptoms. Discuss this with your doctor.

    *  Ask your doctor how to reduce your intake gradually and ways to promote sleep that work best for you without taking sleeping pills.

    Signs to seek help for a problem with sleeping pills

    *  Taking sleeping pills every night for more than two weeks

    *  Taking a higher dose than you did before to fall asleep

    © American Institute for Preventive Medicine

  • Manage Risks Of Shift Work

    SleepWell® Program

    Week 3

    Image of 2 co-workers talking.

    You have special sleep challenges if you work long hours, rotating shifts, permanent night shifts, or multiple jobs. School and/or family responsibilities on top of shift work may also interfere with sleep time. Night-time shift work involves working against your body’s natural rhythm. Remember, your body clock is “set” by exposure to sunlight. Shift work presents challenges:

    *  You need to sleep at times that your body is not naturally inclined to sleep.

    *  You need to be alert during times your body expects to be sleeping.

    *  Going to and from work may involve driving during times your body wants to be sleeping. Shift workers are six times more likely to be in a fatigue-related road accident than other workers.

    *  You may struggle to feel connected to family and friends. You may feel unable to do activities or attend events that are important to you.

    *  You may be more sleep deprived, have a harder time falling asleep, sleep lighter, and feel less rested upon waking.

    Control Risk Factors for Work-Place Fatigue

    *  Work in well-lit, safe areas.

    *  Work in well-ventilated areas and reduce exposure to industrial chemicals and toxins. Follow your workplace’s Material Safety Data Sheets (MSDSs).

    *  If possible, avoid working overtime during times that would interfere with your scheduled sleep time.

    *  Avoid shift-swapping and changing schedules more than necessary.

    *  Use breaks, meal times, and rest periods at work. Don’t work through your breaks.

    *  Use equipment provided (machinery, lifting equipment, comfortable chairs, anti-fatigue matting, etc.) to reduce the physical demands of a job.

    *  If working in warmer temperatures, take more breaks and seek shelter often. Drink plenty of water to stay hydrated.

    Plan Transportation

    Take public transportation, a taxi, or share rides after a long or overtime shift. Plan a car pool and have an alert person drive. Or, arrange for someone to pick you up. Avoid driving alone after a long shift. Do not drive if you are too drowsy.

    Exercise briefly before you drive home. Jump in place or walk briskly around the parking lot. Drive carefully and defensively.

    Time Your Fuel

    Eat three regular meals spaced evenly during the day. Eating helps cue your body’s clock.

    *  Make your first two meals larger and avoid having your largest meal before bedtime.

    *  Avoid drinking any alcohol within three hours of bedtime.

    *  Avoid eating a lot of snacks and fast food.

    *  Drink a caffeinated beverage early in your shift, if you need it. Avoid caffeine six hours before bedtime.

    Light Exposure

    *  If you are coming off a night shift, limit exposure to early-morning daylight on the way home. Wear sunglasses to reduce the light level. Your body will be more ready for sleep when you get home.

    *  If you sleep during daylight hours, use window coverings that darken your bedroom. Use curtains with black-out backing or cover the windows with black plastic garbage bags. Use a sleep mask to further limit light exposure to your eyes.

    *  Draw the blinds and pull shades down before you leave the house to go to work. When you arrive home, the darker room will help cue your body to sleep. If you wake up after you fall asleep, the dark room will help you fall back asleep.

    Scheduling Shift Work

    Talk to your supervisor or manager about the right kind of schedule for you and your team. The risk for accidents and on-the-job errors decreases when employees are alert and well-rested. A schedule allowing everyone enough time to sleep and recover from shift changes is in the group’s best interest.

    Forward rotating schedules make it easier for your body to adjust to changes. This type of schedule follows a clockwise pattern. For example:

    Day shift > Evening shift > Night shift > Morning shift > Day shift

    Reverse rotating schedules make it more difficult for your body to adjust to changes. This type of schedule follows a counter-clockwise pattern. For example:

    Day shift > Morning shift > Night shift > Evening shift > Day shift

    Randomly rotating shifts are very hard on your body. Try to stay on the same schedule-this helps align your body clock with your sleep and wake patterns.

    Planning Sleep with a Rotating Schedule

    Begin to adjust sleep before your shift changes. Gradually move your sleep and wake times to prepare for the new schedule.

    Example: Rotating from evening shift to night shift

    Delay the times you go to bed and wake up by one to two hours on the last few days of your evening shift. When you begin the night shift, your body will already be getting ready for the new schedule. Give your body time to adjust. By making changes gradually, you can avoid the harsh disruption of a sudden schedule change. This will help you to sleep better through the change in your work schedule.

    Plan Your Sleep Transition: Start with the time you normally sleep for your current shift. A few days before your shift changes, start to move your sleep time towards the time you will be sleeping for your next shift.

    Extra Tips for Changing Shifts

    *  After your last night shift, try to adjust your body clock to be awake in daytime. Sleep only two to three hours on the first morning after a night shift and then get a good sleep that night and on the following nights.

    *  Avoid abruptly going back to a daytime schedule during a day or night off. This change makes the circadian rhythm unstable and can make it more difficult to sleep when you want to.

    “Catching Up” on Sleep

    Avoid over-sleeping, even when you have missed sleep in the previous days. If you sleep too much, your sleep drive will decrease. With decreased pressure to sleep, your sleep may be lighter and you are more likely to wake up. When you keep regular sleep and wake times, it will be easier for you to fall asleep and stay asleep.

    © American Institute for Preventive Medicine

  • Manage Conflicts

    SleepWell® Program

    Week 5

    Image of couple smiling over breakfast.

    Even with your best efforts to discuss what you are doing and why, conflicts may arise. You will need to manage conflicts to keep your sleep plan on track.

    Saboteurs. Do not expect everyone to be happy that you are following a different schedule and making changes to your sleep environment. What you are doing may seem confusing to someone else. Use assertive communication to address issues.

    © American Institute for Preventive Medicine

  • Lights Out

    Sleep Well

    Window light hitting the bed.

    Light exposure has a critical effect on sleep. At night, dim the lights and shut off electroncis, such as TVs, tablets, and smartphones that emit blue light, 30 minutes before bedtime. Aim for complete darkness when sleeping. Waking to natural light can also help you sleep better at night, by helping your brain regulate its hormones and help your body develop healthier sleep rhythms.

    Be More Earth-Friendly

    Using primarily natural light at home and work can save a significant amount in energy used in buildings, while increasing health and comfort for occupants.

    © American Institute for Preventive Medicine

  • Learn To Relax

    SleepWell® Program

    Week 4

    Image of relax sign decorated with various flowers and candle.

    Improving sleep will help you manage stress. Managing stress will help you improve your sleep.

    Relaxation Techniques

    *  Help the body to relax when under stress. This minimizes the physical wear and tear from stress.

    *  Help the mind relax. Where the mind goes, the body follows.

    *  Help you to recognize body tension and work to reduce it. The more these techniques are practiced, the easier they are to do.

    *  Help you resist stress. The more you practice, the more relaxed your natural state will become.

    Plan Relaxing Activities

    Do leisure activities during your week. Plan a variety of activities. Include both short and long ones. Try to make at least one activity something you plan to do regularly.

    Here are a few ideas of activities you can try. For activities that are not part of your routine, write if and when you would like to try them.

    Leisure & Recreation Activities

    *  Take a warm bath

    *  Read a book

    *  Look through photo albums

    *  Listen to music

    *  Write in your journal or a notebook

    *  Get a massage

    *  Swim or play in a pool or lake

    *  Knit, sew, or do another hobby

    *  Watch a movie, especially a comedy

    *  Do yoga

    *  Meditate

    *  Take a few deep breaths

    *  Get a manicure or pedicure

    *  Ride a bike

    *  Go for a walk

    *  Play with your pet

    *  Play with animals at a pet store or pet shelter

    *  Go to a park

    *  Sit near water

    *  Sketch what you see

    *  Volunteer at a soup kitchen, shelter, or other place in the community

    *  Write a letter or a card

    © American Institute for Preventive Medicine

  • Keep A Sleep Journal

    SleepWell® Program

    Week 1

    Image of the SleepWell Tracker.

    Use the SleepWell® Tracker (click above image to download a copy) to help you monitor and better understand your own sleep habits. With this information, you can make changes to improve the quality of your sleep.

    Start now! The sooner you can understand your own sleep patterns, the sooner you can start to make changes to enhance your sleep and improve daytime energy.

    Use your SleepWell® Tracker throughout the program. If you do not have a separate SleepWell® Tracker booklet, make copies of the SleepWell® Tracker and “Sleep Trends”.

    How to Use the SleepWell® Tracker

    *  Recording each day’s sleep and activities on the SleepWell®Tracker takes only a few moments of your day. Complete the top half of each day in the morning. Complete the bottom half of each day before you go to bed.

    *  This tracker has places to record eight weeks of your sleep habits. If you would like to do this beyond eight weeks make additional copies.

    *  Review your completed SleepWell®Tracker to notice any trends or patterns in your sleep or daily practices. At the end of each week, there is a “Sleep Trends” to record your common habits related to sleep. Use these to identify factors that help, as well as hinder your sleep.

    *  Compare your habits with those described in the SleepWell®guide. Use the “Sleep Trends” to define measurable goals for the upcoming week. Make gradual changes to your habits as you work towards healthier sleep.

    © American Institute for Preventive Medicine

  • Insomnia 4

    Sleep Well

    Image of woman in bed awake at 2:40am.

    Do You Have Insomnia?

    Answer these questions:

    1. Do you have trouble falling asleep?

    2. Do you have problems staying asleep?

    3. Do you wake up too early and can’t get back to sleep?

    4. Do any of these problems last at least 3 weeks?

    If you answered yes to number 4, answer these questions about problems that occur when you are awake:

    5. Do you feel like you do not get enough refreshing sleep?

    6. Do you yawn and feel tired?

    7. Do you lack energy or have fatigue?

    8. Do you have a hard time concentrating?

    9. Do you feel depressed and/or cranky?

    If you answered yes to question number 4 and yes to any question from number 5 through 9, you could have insomnia.

    Why You Need Sleep

    Getting enough sleep and good quality sleep helps you maintain good health and function your best during the day. You need sleep to:

    *  Have energy.

    *  Think clearly.

    *  React quickly.

    *  Be productive.

    *  Learn and remember things.

    *  Help your immune system fight infections.

    According to the National Sleep Foundation, about 50% of adults in the U.S. have problems with sleep at least a few nights a week. And recent studies find that the average person gets less than 6 hours of sleep per night. (On average, adults need at least 7 to 8 hours of sleep each night.)

    A lack of sleep or getting poor quality sleep can lead to a wide range of health problems.

    Health Problems from a Lack of Sleep

    *  Anxiety, depression, and alcohol abuse.

    *  Obesity.

    *  Heart disease.

    *  High blood pressure.

    *  Diabetes.

    *  Stroke.

    *  Gum disease.

    *  Accidents and an increased risk for injury and death. About 20% of all serious car crashes are linked to driver sleepiness. Also, workers with severe insomnia make 2½ times more serious work errors than persons who get proper sleep.

    Getting enough, quality sleep is as vital to good heath and long life as are healthy eating and regular exercise.

    Do’s & Don’ts for Insomnia

    Do’s

    *  Do regular exercise daily. Physical activity releases muscle tension, relieves anger, and improves mood.

    *  Do mild exercises four or more hours before bedtime.

    *  Do relaxation exercises as needed throughout the day and before you go to bed.

    *  Follow a regular daily schedule for meals and snacks.

    *  Choose larger meals at breakfast and lunch than at dinner. At each meal, have complex carbohydrate foods, such as whole-grain breads and cereals, fruits and vegetables.

    *  Limit caffeine to 300 milligrams (mgs.) a day. More than 500 to 600 mgs. a day may cause you to be anxious, nervous, and makes it harder to sleep well.

    *  Cut down on caffeine 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.

    Don’ts

    *  Don’t do vigorous exercise within six hours of going to bed.

    *  Don’t have large meals near bedtime. These may keep you awake, especially if you have heartburn or a similar problem.

    *  Don’t have caffeine for 6 hours before bedtime.

    HealthyLife SleepWell by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine