How the Doctor Begins Insomnia Treatment
When people are referred to a sleep specialist, the doctor usually begins insomnia treatment by advising the patient about “sleep hygiene”. The doctor also asks the patient to record a sleep diary so the doctor can learn about the patient’s sleep patterns and determine the cause of their insomnia.
Depending on the patient’s history and other findings, the sleep specialist might ask the patient to go for a sleep study. This usually requires overnight sleep at a special facility. A sleep study gives the doctor more detailed information to diagnose insomnia and guide treatment.
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What is sleep hygiene?
Doctors use the term “sleep hygiene” to refer to the way people’s behavior and habits affect their sleep. Chapters 5-14 of this workbook explain self-help insomnia treatment based on principles of good sleep hygiene.
Practicing good sleep hygiene means we adopt a lifestyle that promotes better sleep. We change any habits that cause sleep problems & we adopt simple strategies for better sleep. Most sleep doctors give patients some written information about good sleep hygiene.
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What is a sleep diary?
A sleep diary is a tool for figuring out the cause of insomnia. It’s also a tool that tells us if insomnia treatment is working.
In a sleep diary, we keep a daily record of how well we sleep each night. We also record details of daily events & factors that could be affecting our sleep.
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Why keep a sleep diary?
Chronic insomnia can be hard to solve. Often it’s caused by habits or lifestyle factors that we don’t question. Sometimes, we’ve had insomnia for so long that the original cause has gone -- but still we can’t sleep.
A sleep diary helps us answer the question “Why can’t I sleep?” Over time, it shows us patterns that link our insomnia to the events & factors of our day.
A sleep diary also helps us see changes that take a while to develop. For example, alcohol & smoking are known to cause sleep problems, but if we stop either of these, insomnia can get worse before it gets better. With a sleep diary we do see the eventual improvement -- something we might miss if we look only for immediate results.
If you don’t know why you can’t sleep at night, and you haven’t been able to find an insomnia cure, you'll probably find that a sleep diary helps you figure this out.
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How do I record a sleep diary?
Sleep doctors usually ask patients to record a sleep diary for at least 3-4 weeks, so they can watch for patterns that show what’s worsening (and improving) insomnia.
Every morning, record how you slept the night before. For example, you might record how many hours you slept, or how long it took to get to sleep, or the number of times you woke up, or how rested you feel this morning. Choose details that are quick and easy to record every morning.
Every evening, summarize how you spent the day (e.g. worked 9 hours, watched TV for 3 hours, fought with spouse, etc.).
Also record factors that you think might be affecting your sleep. This might be details about your diet, alcohol intake, smoking, medications, bedtime routine, etc. For example, if you think your coffee intake or lack of physical activity could be important, record the number of coffees you drank today, or how far you walked, or whether you visited the park, etc.
Many of these possible factors are described in the following chapters. As you read each chapter, note the factors that might apply to your insomnia. Then keep record of those factors in your sleep diary.
Record any naps you take during the day (whether planned or spontaneous). Note at what time you napped and for how long. Daily naps can affect sleep at night (as described in chapter 11).
Record whatever you’re doing to help yourself (e.g. a change in bedtime routine, a massage, or use of the Sleep Meditation CD).
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How is a sleep diary organized?
Organize your sleep diary in a way that’s easy to record, and that let’s you see any meaningful patterns linking daytime factors with sleep at night.
Usually a simple chart or spreadsheet format is best. Arrange information in separate columns, side by side. Enter the information of each day on a new line.
Give each column a different label. For example, describe your sleep with such columns as: “Time I went to bed” “How long before I fell asleep” “Hours of sleep“, “How often I woke up” “Time I woke up” etc.
Columns of daytime factors could be labeled: “Cups of coffee”, “Hours of TV”, “Hours of work”, “Naps”, “Alarm Clock?”, “Significant Events”, etc. (See possible factors described in the following chapters.)
See the sample sleep diary at the back of this workbook.
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How do I use a sleep diary?
Watch for patterns that relate your insomnia to the factors and events of your day. It could take several weeks before you see these patterns. As you learn what causes your insomnia, you can change things.
As you make changes to your diet & lifestyle, notice how your sleep responds. (Remember that better sleep can be slow to develop. Sometimes changes take several days or even weeks to show improvement.)
A sleep diary does take some patience and perseverance, but keep it simple. You probably need only 5 minutes a day. An inexpensive notebook will do. You could start tonight.
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