Sleep Disorders: Behavioral Treatments
Lifestyle/behavioral treatments for sleep disorders may include:
- Relaxation training
- Cognitive therapy
- Stimulus control (SC)
- Sleep restriction therapy (SRT)
- Sleep hygiene
- Relaxation
- Training
Methods such as progressive
muscle relaxation (PMR), deep breathing techniques, imagery, and self-hypnosis
may help some people overcome a sleep disorder. PMR involves helping the
individual to sequentially tense and relax the bodys major muscle groups while
concentrating on and contrasting sensations of tension and relaxation. Daily
practice of relaxation techniques between therapy sessions is essential and
tends to enhance the effectiveness of the treatment.
Cognitive Therapy
Cognitive therapy helps people with insomnia identify and
correct inappropriate thoughts and beliefs that may contribute to insomnia.
Cognitive therapy can give people the proper information about sleep norms,
age-related sleep changes, reasonable sleep goals, and the influence of naps and
exercise.
Stimulus Control
SC derives from the belief that insomnia may be related to
the bedrooms having become associated with other things (stressful situations,
for example) besides sleep and sex. Therefore, the bedroom should be reserved
for sleep, sex and dressing only.
Sleep Restriction Therapy
SRT is based on the belief that excess time in bed
makes sleep problems worse. SRT consists of limiting a persons time in bed to
only that time where they are sleeping.
Sleep Hygiene
This refers to practices, habits, and environmental factors
that are important for getting sound sleep. The four general areas important to
sleep hygiene are the circadian rhythm (24-hour cycle), aging, psychological
stressors that cause mini-awakenings (in which the brain wakes up for just a few
seconds), and stimulant use.
Circadian rhythms influence when, how much, and how well people sleep. These
rhythms may be altered by the timing of various factors, including naps,
bedtime, exercise, and exposure to light. Aging also plays a role in sleep.
Sleep patterns change after people reach the age of 40. There are many more
nocturnal awakenings as people age. The awakenings affect sleep quality and can
interact with any other condition that may cause arousals or awakenings. The
more awakenings people experience at night, the more likely they will awaken
with a feeling of not being rested. Psychological stressors such as exams,
deadlines, or job problems may interfere with sleep. It is beneficial for people
to develop some kind of pre-sleep ritual to break the connection between stress
and bedtime. Some people find it helpful to make a list of all the stressors of
the day, along with a plan to deal with them. In addition, periods of relaxation
(meditating or taking a hot bath) can help a person relax and get to sleep.
Stimulants can stay in the body as long as 14 hours and can increase the number
of times you awaken at night, decreasing your total amount of sleep time. Avoid
caffeine, nicotine and alcohol. The effects of nicotine, when consumed in high
doses, are similar to those of caffeine. Alcohol may initially sedate you,
making it easier to fall asleep. The downside to alcohol is that as it is
metabolized and cleared from your system during sleep, it causes arousals that
can last as long as two to three hours after it has been eliminated.
Reviewed by The Sleep Medicine Center at The Cleveland Clinic.
Edited by
Michael J.
Breus, PhD, WebMD, September 2004.
Portions of this page ©
The Cleveland Clinic 2000-2005
Last Editorial Review: 6/20/2005
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