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Options for sleep management

How to create a sleep-conducive environment

Dr. Solet then spoke about what people can do to take control over the night and create a sleep- conducive environment. Start by evaluating your bedroom environment (e.g., sound, light, temperature, humidity, safety, and technology in the bedroom) and limiting your bedroom activities to sleep and sex only. The recommendations shown below are typically geared for the average person. However, Dr. Solet suggests individuals with CFS or FM try to incorporate those that are reasonable for their special circumstances.

Improving Sleep I

    • Condition yourself to move into a “wind down” routine
    • Use white noise from HEPA filters to help mask noise while cleaning air
    • Negotiate with other people in the house for quiet during the sleep time that you need
    • Use room darkening curtains to prevent bright light from waking you up
    • Keep the bedroom at a cool temperature and with adequate humidity
    • Clear the pathway around the bed from tripping hazards
    • Don’t use electronic devices close to bedtime or while in bed because the type of light they emit blocks melatonin which naturally rises at night
    • Use incandescent light or electronic reading devices that are not back-lit and won’t disrupt melatonin production if reading helps you relax at bedtime
    • Remove TV from the bedroom or put it on a shut off timer so it does not wake you up
    • Use the bedroom for sleep and sex only

 

Improving Sleep II

    • Go along with your chrono-type and respect your natural proclivities—your tendency towards morningness or eveningness
    • Make sure things that you use (e.g., prescriptions, over-the-counter medications, alcohol, substances, supplements, caffeine intake) are not causing side effects or negatively impacting your ability to fall asleep
    • Be mindful about exercise and light exposure—morning light is the most alerting and most beneficial in maintaining circadian entrainment
    • Do your best to maintain a consolidated sleep schedule (i.e., keeping your sleep periods together)
    • Try to get everything under control, like night care responsibilities of elderly parents, partners, children, and pets, before going to bed
    • Negotiate with your partner or other family members to deal with nighttime issues so you don’t have to disrupt your sleep

Improving Sleep III

    • Allow sufficient vertical time after dinner so that you are not going to bed with a full stomach If you have acid reflux, when in bed, elevate your head with a wedge pillow
    • Create a bedtime ritual, like reading or listening to music, but NOT looking at all your emails or other alerting activities when getting ready for bed
    • Taking a warm to hot bath two hours before going to bed, instead of a morning shower, has been found to benefit people with Fibromyalgia by cooling down their body temperature and promoting better sleep
    • Positioning in bed for restful sleep may include placing pillows to support or prop up painful areas and wearing comfortable clothing
    • Prepare for WASO (wake after sleep onset): have water by your bedside for thirst; keep the path clear to the bathroom and set up a small nightlight in case of nocturia; keep eye drops handy for dry eyes; and be prepared to use self-soothing routines to help yourself get back to sleep
    • If your problems with sleep are getting worse, despite all your efforts, then discuss the situation with your doctor and advocate for further screening; it is not uncommon to have multiple health problems and primary sleep disorders become more common with age

 

Additional tips and considerations  

Taking a power nap has many benefits for physical health and memory/concentration. Dr. Solet is a big fan of napping and mentioned advocating for rest areas in hospitals, hoping to create a setting for nurses, who often work 12-hour shifts, to take power naps. These can help to restore mental clarity and promote patient safety.

Short naps of 20-30 minutes, often referred to as “refresher” naps, can make a difference. She encourages these for everyone who can fit these into his/her schedule.

A full cycle nap takes 90 minutes and should be taken earlier in the day, so it does not interfere with the nighttime sleep schedule. Since full cycle naps bring people into deeper sleep, Dr. Solet advised the audience to allow enough time to get through sleep inertia by avoiding immediate activities that requiring high levels of attention until they are fully awake.

Another suggestion offered by Dr. Solet was to look at alternative paths, like meditation and yoga, to add restoration to one’s life. There is medical evidence that these techniques can contribute to neurogenesis and greater preservation of one’s nervous system.

Anticipate, recognize, adapt work-life balance

Dr. Solet concluded this segment with an emphasis on the importance of anticipating and making necessary preparations ahead of time, especially as individuals living with a chronic illness.

She stressed that learning to say a positive “no” can help create balance as part of a work/home/chronic illness strategy.

There may be times when you feel like you are driving on empty and if you are still working, it may be wise to seek advice about whether to disclose your disability/health problems and ask for reasonable accommodations under the protections of the Americans with Disabilities Act (e.g., to be permitted to take rest breaks at work which could help with job performance).

Social support is critical because it provides guidance and positive interaction with others.

Tools for self-awareness are also very important because they can help someone recognize/become aware of details or changes in her health. For example,
    • Using a sleep diary or journal, or even getting an app for the cell phone, can help one keep track of one’s sleep schedule to see patterns that might otherwise be missed.
    • Flexibility and pacing are techniques that help to maintain a healthy balance. Don’t be rigid with yourself. Try to be forgiving.
    • Recognize times when you are well enough to tackle difficult challenges and when it may be better to turn to something less demanding, like sorting the laundry.
    • Develop a contingency plan for things that you do which are important, in order to have an alternative arrangement for when you don’t feel well.
    • Remember, the power of “no” is a critical skill that everyone should learn—knowing how to say no can actually being respectful of yourself and the other person.