Insomnia Insomnia

Sleep Hygiene 105
It is essential to inform people, at the first appearance of symptoms of the potential
sleep problems that poor sleep hygiene can cause, and help identify and stop
them.
TREATMENT
Like all extrinsic sleep disorders, the mainstay of treatment needs to be modification
or complete removal of the external factors causing the insomnia. Sleep
hygiene must be taught and reinforced in patients suffering with this disorder (20).
It may be overwhelming for patients to follow every single sleep hygiene regulation
at once. This may lead to noncompliance. It is best to isolate two or three key
factors individualized to the patient and ask the patient to concentrate on those (13).
Other cognitive-behavioral treatment modalities may be helpful in select cases.
These include relaxation therapy, biofeedback, sleep-restriction consolidation, and
stimulus control therapy (13). Usually, however, sleep hygiene education is simpler,
easier to follow, and as effective as the more elaborate and difficult to follow
cognitive-behavioral therapy. In fact, of all the nonpharmacological/behavioral
treatments, sleep hygiene education is one of the most effective methods and one of
the easiest to follow (6).
REFERENCES
1. American Sleep Disorders Association. (1997) International classification of sleep disorders:
diagnostic and coding manual. American Sleep Disorders Association, Rochester, MN.
2. Manni, R., Ratti, M. T., Marchone, E., et al. (1997) Poor sleep in adolescents: a study of 869 17year-old
Italian secondary school students. J. Sleep Res. 6(1), 44–49.
3. Schnelle, J. F., Cruise, P. A., Alessi, C. A., Ludlow, K., al-Smarrai, N. R., and Ouslander, J. G.
(1998) Sleep hygiene in physically dependent nursing home residents: behavioral and environmental
intervention implications. Sleep 21(5), 515–523.
4. Schnelle, J. F., Alessi, C., A., al-Samarrai, N. R., Fricker, R. D. Jr., and Ouslander, J. G. (1999)
The nursing home at night: effects of an intervention on noise, light, and sleep. J. Am. Geriatr.
Soc. 47(4), 430–438.
5. Martinez-Manzano, C. and Levario-Carrillo, M. (1997) [The efficacy of sleep hygiene measures
in the treatment of insomnia]. Gac. Med. Mex. 133(1), 3–6.
6. Friedman, L., Benson, K., Noda, A., et al., (2000) An actigraphic comparison of sleep restriction
and sleep hygiene treatments for insomnia in older adults. J. Geriatr. Psychiatry Neurol. 13(1),
17–27.
7. Kageyama, T., Kabuto, M., Netta, H., et al., (1997) A population study on risk factors for insomnia
among adult Japanese women: a possible effect of road traffic volume. Sleep 20(11), 963–971.
8. Onen, S. H., Onen, F., Bailley, D., and Parquet, P. (1994) [Prevention and treatment of sleep
disorders through regulation] of sleeping habits]. Presse Med. 23(10), 485–489.
9. Ulfberg, J., Carter, N., Talback, M., and Edling, C. (2000) Adverse health effects among women
living with heavy snorers. Health Care Women Int. 21(2), 81–90.
10. Ibata, Y., Okamura, H., Tanaka, M., et al. (1999) Functional morphology of the suprachiasmatic
nucleus. Front. Neuroendocrinol. 20(3), 241–268.
11. Bonnet, M. H. and Arand, D. L. (1996) The consequences of a week of insomnia. Sleep 19(6),
453–461.
12. Bonnet, M. H. and Arand, D. L. (1998) The consequences of a week of insomnia. II: Patients with
insomnia. Sleep 21(4), 359–368.