How can you change unhelpful sleep habits?

Most people sleep better if they have a regular bedtime routine. Being ‘in tune’ with your ‘biological clock’ (which regulates your body’s rhythms) can help you get more satisfying sleep. You will also be more alert when you are awake. Plan a regular time (preferably before midnight) when you will go to bed. Get up at the same time each day. This can be hard if you have been awake during the night. However, it is worth making the effort to get up at a regular time because, after a few days, it can make a real difference to your night-time sleep. If you do need to have a rest during the day, make sure it is not too late in the afternoon, and don’t sleep for longer than an hour. If you sleep during the day, it will probably reduce the amount of sleep you get at night.

TIPS ON PREPARING YOUR BEDROOM

Tick those ideas you might try:

   Try to make yourself as comfortable as possible.

   Getting a good mattress is important. Try to find one that gives you the right amount of support, not too soft or hard. If you have a saggy mattress, and cannot replace it yet, find a board to go under it. This will make it firm, but not too hard.

   Make the room comfortable, warm (but not too hot), and as quiet and dark as possible.

   Avoid watching television or videos in bed. This can be a difficult habit to break. If you do have problems sleeping, TV and interesting radio programmes tend to stimulate you to stay awake. Keep them for a different room, if possible, and definitely turn them off when you are going to bed.

   While you are working on a better sleeping routine, don’t read interesting books and magazines in bed. Keep them in another room, to read during the day. All these things help to strengthen the connection between going to bed and sleeping.

TIPS ON DEVELOPING A BEDTIME ROUTINE

Tick those ideas you might try:

   Have a nice warm bath or shower before bed each night.

   Avoid having a heavy meal, but have a light snack if it helps.

   Having a warm milky drink or some herbal tea helps some people. You can even have a ‘special’ bedtime mug, which you keep as part of your bedtime routine.

   Coffee, tea and cola drinks with caffeine can keep you awake. The caffeine is a stimulant, which means it makes you more alert. Try not to have any of these after 6pm. You may want to work towards this gradually if you usually drink a lot of these in the evening.

   Make sure that you have drunk plenty of fluid during the day – ideally, eight tall glasses of clear water in total.

   Alcohol is also likely to interfere with healthy sleep. Try to drink other things in the evening, and not so much that you will need the bathroom too often!

   If you smoke, try to cut down cigarette-smoking in the evening. Nicotine is a stimulant, which again makes it harder to settle to sleep.

   If you do have medication to take at night, take it at the same time every evening as part of your routine.

   If you have any questions about how your tablets affect your sleep, write them down in your notebook. Discuss them at your next appointment with the doctor who prescribes them.

GENERAL TIPS TO IMPROVE SLEEP

Tick those ideas you might try:

   Regular exercise and activity (see Chapter 9) help to promote sleep. For maximum benefit, do your exercises earlier in the day, a few hours before bed. It can take a while to get ready for sleep after doing an exercise session.

   Relaxation exercises can help (see Chapter 12). These are best carried out earlier in the evening, before starting your bedtime routine. You can use a ‘quick relaxation’ if you feel tense when you go to bed.

   If you are concerned about disturbing a partner because you are restless, this can make you feel more tense. Try talking about it with them, if you have not done so already. For example, how much are you disturbing them? Do they mind? What would help? Would it be worth sleeping in separate rooms or separate beds for a while, until the problem has eased up? Are there any other possibilities that would work?

DEALING WITH WORRIES AND UNHELPFUL THOUGHTS

Tick those ideas you might try:

   It can be hard to put worries to one side. But if you find that you ‘just lie there’, with worries going round in your head, make a decision to worry about things the next day.

   Some people find that it helps to have a ‘worry book’ next to the bed, in which they can write down anything they need to deal with. This allows you to put worries to one side without feeling anxious about forgetting something that needs your attention the next day. The benefit is that you will be more alert during the day, and so more able to work towards solving problems.

   Some people find that it helps simply to have a ‘worry half hour’ during the day. This means having a time when you allow yourself to worry, leaving you free to get on with other things the rest of the day.

   ‘Trying hard’ to go to sleep can be unhelpful. Worrying about not being asleep keeps you awake! If you have done everything reasonable to prepare for sleep, you will at least be relatively relaxed and able to rest your body.

   You can also ‘break the rules’ if you choose to, for example, by having a drink, or watching TV in bed until far too late because it is an exciting film. However, if you coose to do this, you will need to accept that you may not sleep so well. It will have been ‘worth it’, so you won’t worry about being awake, or feeling more tired the following day.

WHAT IF YOU NEED TO GET UP BECAUSE YOU CAN’T SLEEP, OR YOU HAVE WOKEN IN THE MIDDLE OF THE NIGHT AND CAN’T GET BACK TO SLEEP?

Tick those ideas you might try:

   Go into a different room, and keep the lights fairly low.

   Do something unexciting.

   Remember to use your notebook to keep a quick note of things that are worrying you.

   Leave trying to solve things until the morning. You will be more able to deal with things during the day.

   If you read, choose something that is not too interesting or too much hard work. If you listen to music, choose something calming.

   If you have a drink, avoid caffeine.

   Get your body into the habit of using night-time for sleeping. At times when you want to be asleep, avoid stimulating your mind and body.

   Go back to bed when you feel sleepy. Even if you have been awake for some time in the night, try to get up at the same time each day, at least until you have established a better sleeping pattern.

   Practise your relaxation skills (see Chapter 12).

THINGS TO DO TO IMPROVE YOUR SLEEPING PATTERNS

Tick those ideas you want to do or try:

   Have a regular bedtime.

   Have a regular ‘bedtime routine’.

   Have a light snack/milky drink if you want to.

   Have your ‘special mug’!

   Go to bed before midnight.

   Prepare for bed.

   Make the room and bed as comfortable as possible.

   Have a firm mattress with a soft foam or mattress pad on top.

   Have a relaxing bath/shower.

   Put worries to one side, to deal with during the day.

   Have a ‘worry’/’things to remember’ book handy.

   Exercise during the day.

   Relaxation sessions in the day.

   Get up rather than lie there too long, e.g after 15 minutes.

   Do something uninteresting if awake in the night, e.g read something ‘light’/listen to something calming.

   Go back to bed when sleepy.

   Keep the bedroom for sleeping (and sex).

   Have a regular getting-up time.

   Discuss the side-effects of medications with your doctor if necessary.

THINGS NOT TO DO TO IMPROVE YOUR SLEEPING PATTERNS

Tick those things to stop or change:

   ‘Nap’ during the day.

   Eat a heavy meal.

   Drink alcohol.

   Drink coffee/tea/cola drinks (containing caffeine) or smoke.

   Watch TV in bed.

   Listen to interesting music.

   Read anything stimulating in bed.

   Try hard to go to sleep (even try staying awake instead!).

   Worry about not being asleep.

   Try to solve problems or make plans.

   Exercise just before bed.

   Do a deep relaxation session at bedtime.

   Sleep in a chair (see Jim’s sleep diary).

CHAPTER SUMMARY

•   Sleep problems are very common, especially in chronic pain conditions. Sleep patterns can change for the better.

•   Using a sleep diary can help you understand your own sleeping pattern. It helps to be clear about what the problems are, and where to start making changes.

•   There are many suggestions on improving your sleep pattern and how to prepare for a good night’s sleep.

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