Appendix I

Sleep Hygiene Tips

Do not worry about an occasional sleepless night. Even persons who sleep only a couple of hours can function the next day. You will probably sleep better the following night.
Stick to a regular schedule of sleeping and waking. Go to bed at the same time, and wake up at the same time regardless of the amount of sleep you had the night before. It may help to plan your sleep and wake schedule around a regular event such as counts, mess, or pill call.
Do not nap during the day. If you nap during the day, you reset your sleep “clock,” and your body may not be ready to sleep when it is supposed to be.
Exercise and other activities during the day will prepare your body to sleep at night. Exercise within 3 hours of sleep can keep you up, though.
Eat a healthy diet. Do not drink caffeinated beverages (such as coffee, tea, or dark sodas) after noon. Some foods like chocolate may also contribute to sleeping trouble. Avoid heavy meals before bedtime. If you are hungry, a light snack may help you fall asleep.
Do not drink a lot of liquids before going to sleep. You may have to wake up to urinate and may not be able to return to sleep.
Develop a relaxing sleep ritual you perform 30 minutes before going to bed (such as reading). Do not get involved in emotional issues immediately before going to bed.
As much as possible, turn off lights at night, keep your cell cool, and keep your cell quiet. If the lighting in your cell bothers you, consider covering your eyes with a clean piece of fabric (such as a sock or a wash cloth). If your cell is too warm, use a fan. During the day, expose yourself to as much light as possible. If you have a cellmate, agree about quiet hours when radio or television will be turned off, or used with headphones.
Do not lie in bed unless you plan to sleep. Use the bed only for sleeping, unless other activities (like reading) are part of your sleep ritual. Do not try to make yourself sleep. If after 30 minutes in bed you are unable to sleep, get out of bed and do something relaxing. Do not return to bed until you are sleepy.
Be aware that other medications (such as opiates, steroids, some antidepressants, interferon) and medical problems (such as chronic pain, asthma, peptic ulcer disease) may also interfere with sleep. Ask the provider prescribing medications for your medical or mental health problems if these problems or the medications you are taking may be a factor in your difficulty sleeping.
If the above do not work, try sleep restriction. Add up the total number of hours you sleep per day, then allow yourself to remain in bed only for that many hours each night. Another approach is paradoxical intention, which is doing the extreme opposite of what one wants or fears. For example, instead of going through activities leading to sleep, prepare for staying awake and do something energetic. Or, if worry is a factor in sleeplessness, force yourself to worry excessively.
Getting emotional support and expressing your feelings may reduce stress, and help you to sleep.