ABSTRACT
207Topics addressed this week:
Activity 1: Identifying Goals and Motivations
Activity 2: What Happens in Normal Sleep, and Common Sleep Complaints
Activity 3: How Our Choices Affect Tiredness
Activity 4: What Factors May Be Impacting on Your Sleep?
Activity 5: Sleep Hygiene Checklist
Activity 6: Winding Down Before Bed
Activity 7: Getting Out of Bed if You Can’t Sleep (Goobics)
Activity 8: Which Stage Do You Think You’re at Right Now in Terms of Treating Your Insomnia?
Activity 9: The Main Things I Learned Today
Activity 10: My Action Plan for the Week
<target id="page_208" target-type="page">208</target>Learning about Sleep and Good Sleep Habits Welcome!Thank you for taking part in the sleep skills programme. We are confident that your sleep will improve as the treatment progresses.
Clients who have completed the programme have reported dramatic improvements in their sleep since starting the programme:
‘I had a good night of sleep—I haven’t had that for a long time.’
‘I know that when I go to bed, I will eventually go to sleep.’
‘I have more energy during the day.’
‘I get a lot more time in my day.’
‘I can cope better with my symptoms.’
What you should do to get the most out of this programme:
Attend all the sessions: The programme is here to help you achieve your goals. It is normal to have times when you don’t feel like coming, but you will find that you often feel worse, rather than better, for not attending.
Contribute: Be willing to speak in an open and honest manner. Put your own issues forward and ask questions if you don’t understand or you disagree with something that was said.
Listen: Some topics discussed may seem irrelevant to you now, but become useful later. The information that other people share in the sessions could also be helpful to you.
Don’t compare: Remember that no two people are exactly the same. Even if two people have the same goals, what works for you might not work for them, and vice versa—so, develop some strategies that work for you.
Maintain confidentiality in group sessions: People must feel relaxed that what they say will remain confidential.
Take responsibility: Remember that, in therapy, ‘What you put in is what you get out’. Being non-active in the programme tends to create little or no positive change.
Review the sleep resources: It is helpful to read over the material at home each week.
Other: ____________________________________________________________
<target id="page_209" target-type="page">209</target>Topics Addressed this Week https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_1.tif"/> <target id="page_210" target-type="page">210</target>Identifying Goals and MotivationsMy GOALS for the programme:
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Why am I MOTIVATED to treat my Insomnia? How might sleeping better and having more energy improve things for me?
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Importance Ruler https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_2.tif"/>On this scale of 0–10, how important it is for you to treat your poor sleep? _____
<target id="page_211" target-type="page">211</target>What Happens in Normal Sleep, and Common Sleep Complaints https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_3.tif"/> How Our Choices Affect TirednessHow tired or sleepy (or lacking in energy) are you feeling, on a scale of 0–10?
https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_4.tif"/>• Right now?
Rating = __________
• How do you rate your tiredness after doing a bit of reading?
Rating = __________
• How do you rate your tiredness after a short walk or other increase in activity?
Rating = __________
As we can see from this short activity, energy levels and sleepiness change over the course of the day. Lots of factors bring this about and can be affected by the choices we make.
<target id="page_212" target-type="page">212</target>What Factors May Be Impacting on Your Sleep?What do you notice might help you to sleep better?
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When do you sleep worse?
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What do you think leads to better daytime energy?
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What do you think leads to less daytime energy?
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<target id="page_213" target-type="page">213</target>Sleep Hygiene ChecklistComplete the checklist below to see what sleep hygiene factors you may need to work on.
Things that Can Make Sleep WorseAbout the bedroom and environment:
Noise late at night or early in the morning (pets, street noise).
Not having a set place that is just for sleeping (e.g. sleeping on the couch).
Untidy, cluttered, or unclean sleeping space that makes you feel restless.
During the day:
Staying inside your living accommodation all day (no real daylight).
Staying in bed long after waking up.
Taking long naps.
Limited daytime activity.
One to two hours before bed:
Watching TV in bed.
Using computer or electronic device (phone, iPhone, iPad).
Having drinks that contain caffeine (tea, coffee, energy drinks).
Having a cigarette before sleep.
Drinking alcohol.
Eating a heavy meal.
Taking illicit drugs.
During the night:
Watching the clock! (Turn the clock face away so that you cannot see it.)
Things that Can Make Sleep BetterAbout the bedroom and environment:
Comfortable bed and pillow with appropriate covers (light in summer, heavy in winter).
214Warm bed, dark room (or only low light).
Quiet.
During the day:
Getting in some bright light each day (being outdoors).
Increased activity—walking, running, cycling, sports, tidying, cleaning, hobbies, cooking.
Social contact (friends family, carers, or just saying hello to the cashier at the shops).
Set aside ‘worry time’ to put any issues that are bothering you to rest until the next day (write about the worries or make a to-do list of what needs to be done tomorrow).
At least 1 hour before bed:
Have a relaxing bedtime routine (e.g. read, brush teeth, shower, do a puzzle).
Set your alarm clock for the next day.
Relaxation (breathing exercises, imagery, soothing music).
<target id="page_215" target-type="page">215</target>Winding Down Before Bed Making a Bedtime RoutineExample of Wind-Down Activities
My Wind-Down Activities Will Be:
1 hour before bed
Reading
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Listening to music
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Sewing/knitting
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Shower
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Drawing
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Doing a puzzle
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Relaxation exercise
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Warm bath
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Light snack
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Gentle stretching
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At bedtime
Brush teeth
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Go to the toilet
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Relaxation exercise
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Switch on alarm clock
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Barriers to Bedtime RoutineWhat Might Get in the Way of My Routine?
How Can I Address this?
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<target id="page_216" target-type="page">216</target>Getting Out of Bed if You Can’t Sleep (Goobics)Goobics is very useful if you have trouble falling asleep. It teaches your mind to make the bed and bedroom positive triggers for sleep, so that you can expect to fall asleep easily when you go to bed or wake up in the night. To learn this skill, follow these five Steps:
Step 1. Only use the bedroom for sleep
Do not use your bedroom for activities such as eating, watching TV, smoking, talking on the phone, working, or arguing
Step 2. Only go to bed when sleepy
Only go to bed when you feel sleepy, not because of a set routine. You take much longer to get to sleep if you go to bed before feeling sleepy or drowsy
Step 3. Get out of bed when you can’t sleep
If you do not fall asleep within about 30 minutes after going to bed and turning off the lights, and you are feeling restless, frustrated, or anxious: Get out of bed, go to another room, and do something relaxing. When you feel sleepy, go back to bed and try again to fall asleep. If you do not fall asleep quickly, repeat this step again. You should not try hard to fall asleep
What should I do while I’m out of bed?
Step 4. Get out of bed at the same time each day
This includes weekends, even when you stay up at night later than usual. If you set your alarm for a regular wake-up time, you will be more likely to get sleepy at about the right time each night to allow yourself to get the sleep you need. Choose a rising time that suits your usual situation
My chosen rising time will be between ______ and _______
What will I do when I first wake up to help me wind up into the day?
Step 5. Avoid or reduce daytime napping
Sleeping in the day weakens your need for sleep at night. Aim to reduce daytime naps. Ideally, naps should be 30 minutes or less and before 2 p.m. Set an alarm to help you not oversleep. Discuss with your therapist what might be realistic for you
<target id="page_217" target-type="page">217</target>Which Stage Do You Think You’re at Right Now in Terms of Treating Your Insomnia?Show this on this diagram: https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_5.tif"/>
Making changes to improve your sleep may be hard, but we will be here to help you through this.
The Main Things I Learned Today_________________________________________________________________
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<target id="page_218" target-type="page">218</target>My Action Plan for the WeekWhat I will do for wind-down before bed?
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Some changes to my sleep hygiene or environment that I may start making:
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What will I do when I get up because I can’t fall asleep/get back to sleep quickly?
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My regular wake-up time for each morning will be: ______
My goal for napping this week is to nap for ______ (hours/minutes), no later than ______ (time of day).
Activities I can engage in instead of napping include:
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Confidence RulerOn this scale of 0–10, how confident are you about trying out your action plan for the week? _____ https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315643793/a121ca36-09ef-4fc3-9a96-2287eed9222a/content/fig16_6.tif"/>
