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Sleep Hygiene

Improve your sleep hygiene with this information including preparation for sleep, sleep aids, sleep apnea, and more.



  • Sunlight first thing in the morning may help to set your body’s clock.

  • Sunlight exposure at noon, exercise at noon, or exercise five hours before bedtime may also promote sleep (serotonin or dropping body temperature).

  • Avoid napping more than one hour during the day or in the evening hours.

  • Avoid chemical stimulants at night, such as nicotine, caffeine, dietary protein, citrus, fat, and  >3oz. alcohol.

  • Avoid emotional stimulation at night, such as certain types of television or literature, phone calls, or intense discussion/arguments.

  • Create a time during the day called “worry time” to process the events of the day, to avoid rumination at night.

  • Use the bedroom for sleep only (no TV, reading, phone calls, work).  This associates the bedroom with sleep only.

  • Use pain management or relaxation strategies, such as a warm shower or bath, stretches, pain meds, to decrease any pain or anxiety before bedtime.

  • Use imagery to separate yourself away from the stressors of the day (tail pulling off).

  • Create a pre-sleep ritual which, when used nightly, will signal your body that it is time for sleep.

  • Have a light snack before bedtime; being too hungry or full can inhibit sleep.

  • Keep the same bedtime and awakening hours.

  • Go to sleep when your body feels ready, not when you feel you “should”.

  • Cover up or turn away clocks in the evening to avoid anxiety about when to go to sleep   or if you awaken during the night.

  • Morning Routine: create a gentle transition from sleep to awakening.  Awaken earlier to avoid rushing in the morning.



  • Provide optimal lighting with window shades,  heavy drapes, eye mask, night light.

  • Decrease annoying sounds with earplugs, white noise, unplugged phones, family and neighbor cooperation.

  • Create an optimal temperature and ventilation (fans, A/C, dual controlled electric blanket, socks and gloves).

  • Cushion painful areas (shoulders, hips) with eggcrate mattress, featherbed, body pillow.

  • Use pillows between the knees (or kneepads) for sidelying or under the knees for backlying.  Use only enough pillow under the head to keep the ear and shoulder aligned.



  • Vitamins: Calcium/Magnesium/ Zinc at bedtime.

  • Restless Legs:  Quinine or Parkinson’s disease meds.

  • OTC:  Valerian, Melatonin, Chamomile, Calms Forte , Silent Night, Lavendar

  • (Caution: many are not FDA approved or may interact with prescription medications adversely)

  • Meds:  Tricyclics (elavil, trazadone at low doses), Restoril, Ambien, Sonata.

  • Avoid: Valium, Benadryl, alcohol which do not promote normal sleep.



  • Prepare ahead of time for sleep interruptions by having enjoyable activities (reading, crafts) ready to do if you awaken and cannot return to sleep.

  • If awake for longer than fifteen minutes, get out of bed.  Research shows you will probably stay awake for one hour or more.  Repeat your pre-sleep routine.

  • If you can’t get something off your mind, write it down and discard it. Train yourself to deal with problems in the morning.



  • Adjust your watch to the time of your destination at eat and sleep in that schedule.

  • Remove your shoes and drink extra fluids, avoiding alcohol or caffeine.

  • Get sunlight (back of knees, preferably) whenever possible during and after your trip to re-set your biological clock.


GOAL:  Stage IV sleep 30% of the night and a good sleep 5/7 nights of the week.


Wegener, S.  Fatigue and Sleep Disturbance in Arthritis
Lacks, P.  Behavioral Treatment for Persistent Insomnia
Hauri, P.  Sleep Disorders: Current Concepts
Waterhouse, D.  Sleep, Diet, and the Brain (Seminar, 1994)
Melvin, J.  Treatment of Chronic Pain (Seminar, 1993)

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