Sleep Hygiene

“The ‘First and Central Aspect of Treating Sleep Disorders is Good Sleep Hygiene”  
Dr. David Bell

Good sleep hygiene can play an important role treating sleep disorders but,  according to Dr. Bateman not very many ME/CFS practice it. In fact she says that

“Eighty percent of my patients make their sleep worse.”

Sleep hygiene consists of doing things to make it as easy as possible to for your body to enter into a deep a state of sleep. Dr. Friedman states that being fully rested and relaxed as you fall asleep will help make your sleep deeper.  The sleep hygiene section is  broken up into two parts; The Bedroom and Good Sleep Behavior.

Keep the light levels in the bedroom low. The main agent (melatonin) that triggers the brain to go to sleep is activated by darkness. Therefore, if you have trouble getting to sleep, cover your windows with blinds or curtains or blackout shades/liners and/or sleep with a mask (if you can tolerate it). Use low wattage (75 watt) lights in a lamp in the bedroom or small reading lights that can clip onto a book.

Make the bedroom a sleep only room. One of the goals of sleep hygiene is to get your body/mind to enter into ‘sleep mode’ when you enter your bedroom. You can do this by removing objects it associates with activity such as the television and computer from the room.

Take a Warm Bath – approximately three hours before bed. A recent study showed people with insomniac were able to get to sleep easier if they bathed three hours before bed. The slow cooling after the bath was believed to modulate the chemical signals  that induce sleep.

Invest in a comfortable mattress. Mary Skeller and Helen Walker encourage you to ‘invest in the best mattress you can afford.” If you can tolerate rubber they note that mattress or foam rubber pads such as they use in hospitals are comfortable cheap alternatives. Mary Shomon reports that the “Cuddle Ewe” sleep pad helps to distributes the body weight more evenly. Sleep aids such as the “Cuddle Ewe” can be particularly helpful for Fibromyalgia patients whose tender points make it difficult for them to attain deep sleep. Good soft cotton bedding with lots of pillows is also recommended as well as keeping the room somewhat cool and well ventilated.

Continuous background noises generated by a fan or radio with sound generators (rainstorms, waves, wildlife) that drown out irritating sounds and sudden noises can also be helpful.

Avoiding blue light from computer or tablet screens in the evening may be worth experimenting with. More info here.

The Sleep Series on Phoenix Rising

• Sleep hygiene
• Prescriptions for sleep
• Alternative therapies
• Sleep apnea
• Doing a sleep study
• Sleep resources

GOOD SLEEP BEHAVIOR

Modify the below suggestions as needed to get better sleep.

No napping after dinner. Take a nap during the day and don’t do it in your bedroom – save that room specifically for your nighttime sleep.

Keep to a regular sleep schedule. Train your body/mind to feel there is a specific time when it should go to sleep.

Exercise to the extent you can. It turns out that lying in bed is a recipe for poor sleep. Exercise, the other hand, is a sleep inducer. Try to get in as much exercise as you can without exacerbating your symptoms (see below).

Don’t overdue it during the day. While some exertion is good too much exertion can throw ME/CFS patients into the ‘tired but wired’ state that makes it difficult to get to sleep and to attain meaningful sleep.

Don’t engage in stimulating activity such as TV and computer games up to two hours prior to bedtime. Stay away from caffeine in the later part of the day.

Don’t drink a lot of liquids shortly before going to bed – If you do wake up with the urge to urinate  Dr. Teitelbaum recommends that you tell your bladder “Nighttime is for sleeping. We will go to the bathroom in the morning when it is time to wake up” and then try to go to sleep. If that doesn’t work then go to the bathroom and try again next time. (He swears it works!)

If a racing mind is interfering with going to sleep  write down your problems on a piece of paper and set them aside.

Do relaxation exercises for 30 minutes prior to going to sleep – Dr. Friedman reports that when you fall asleep restfully you sleep more deeply and for longer periods. He’s found that 30 minutes or more of relaxation exercises often helps chronic fatigue syndrome (ME/CFS) patients sleep better and have more energy the next day. He suggests focused breathing, progressive muscle relaxation, guided imagery, etc. .

A warm bath (with I cup of Epsom salts and lavender soap or gel) before bed can help to  get the body relaxed and in the mood for sleep.

Get out of bed at the same time every morning even if you’ve had a poor sleep the night before.

The Dreaded Middle of the Night Wake-ups

Its dark, you’re awake and you know that unless you can get to sleep your next day is shot. What to do? Dr. Friedberg recommends that you do relaxation exercises such as focused breathing,  progressive muscle relaxation, guided imagery or listening to a relaxation audiotape to ease you back into the sleep state. If that doesn’t work within 30 minutes then  get out of bed and into a  comfortable chair and  try again. When you start to feel sleepy get back in bed. If you don’t go to sleep then start the process over again.

Getting up and  down may seem to be more arousing than relaxing but Dr. Friedberg reports that numerous  studies have shown this to be effective if it’s done consistently. It may  take a couple of days for it to start working.

(This and all sections of the Phoenix Rising website are compiled by a layman. They are not a substitute for a physician and are for informational uses only. Please discuss any treatments in these pages with your physician.)