Tag Archives: sleep issues

Sleep Issues: Exercises and Worksheets

Sleep :  Are we getting what we need from the sleep we get

We often hear how important it is to get enough sleep… the right kind of sleep. Even setting the alarm on a cell phone can trigger an electronic lecture. “Join us to learn better sleep habits.” Many of the suggestions we hear make perfect sense for dealing with sleep issues. Go to bed at the same time every night rings true to us. It follows that if we have regular bedtimes we will fall asleep easier. We know our bodies respond to habitual behaviors. We’ve trained them to do so. However, reality steps in and we find it almost impossible to get to bed at the same time every night, let alone get up at the same time each day. Where do we go from here?

sleep issuesThe following material is excerpted from the Coping with Sleep Issues Workbook by Ester R.A. Leutenberg and John Liptak, EdD.

Many people feel that their sleep issues are just a normal part of their everyday life. Sleep issues can be disruptive and leave one feeling tired and sluggish throughout the day. These issues can continue, get worse, and become a sleep disorder.

Identifying and awareness of your sleep issues will help. Things pertaining to your sleep habits that you take for granted may be okay, or they may not be okay. Use the following information to help you document your sleep issues.

If you know or live with someone with sleep problems, send them a link to this blog and ask the person to do the exercises. Even better, interview the person by asking the questions posed below, and writing the answers down.

Your responses will also serve as a guide to take to your medical provider who can guide you to healthier sleep.

Click here for a set of printable worksheets covering the following topics.

 

My Sleep Issues

Name ______________________________________ Date ______________________

How many of the items below that pertain to you and/or your situation? Describe your experiences in your journal or print out a copy for your use of the worksheet.

While Sleeping …

I am able to recall a frightening nightmare.

I am afraid I will leave the house when I sleepwalk.

I am confused upon waking after I sleep walk.

I am hard to console when I awaken after sleep walking.

I am often sleepy during the day.

I am sweaty and my heart is pounding after a bad dream.

I dream about doing work while I am sleeping.

I awaken out of breath.

I am confused if someone wakes me up.

I awaken feeling frightened.

I engage in aggressive behavior.

I awaken sweating and breathing fast.

I awaken with a dry mouth.

I awaken with a sense of panic.

I awaken with my heart pounding from fear.

I cannot fall back to sleep when I have a nightmare.

I do not respond to others when walking in my sleep.

I feel scared at the end of my dreams

I have difficulty staying asleep.

I often choke or gasp during the night.

I often have headaches in the morning.

I scream and shout.

I snore loudly.

I wake up and sit upright with a look of panic on my face.

I walk around while I am sleeping.

I will often scream while sleepwalking.

My dreams feel like they threaten my safety.

My dreams become more disturbing as they unfold.

My nightmares are so realistic they are scary.

Others say my breathing stops when I am sleeping.

 

Sleep issues can become worse if not treated. Treatment usually consists of a combination of cognitive-behavioral activities like the ones in this workbook as well as medication. Consult and bring the three pages that you just completed with you to a medical or sleep professional to ensure you are doing everything possible to treat your sleep issues.

 

My Self-Care Sleep Habits

Sleep habits are often dependent on wellness habits that you display during the day. Think about some of your wellness habits and how they may be negatively affecting your ability to sleep at night. In the chart that follows, write about how you can make positive change in your wellness habits.

Self-Care Habit My Present Self-Care Habits How I Can Take Better Care
Example

Eating habits

I eat a heavy snack an hour before bedtime.

 

I can take a light snack a few hours before bedtime.

 

Eating habits

 

 

Consistent bedtime rituals

 

 

Exercise

 

 

Intake of liquid

 

 

Medications/drugs legal or illegal

 

 

Nap during the day

 

 

Relaxation

 

 

Stress

 

 

Other

 

 

Highlight each Self-Care Habit you can change immediately to ensure healthier sleep.

 

Exercise for Better Sleep

There is a specific correlation between stress and a lack of sleep. Research has shown that exercise is critical in the reduction of stress. Physical activity earlier in the day can be a key factor in your ability to let go of some of the stress and sleep well. Answer the following questions in your journal or print a copy of the worksheet for your use.

  • What types of exercise do you do regularly (jogging, walking, swimming, aerobics, etc.)?
  • How much time do you spend regularly in the activities above?
  • Which types of exercise do you like best? Why
  • Which types of exercise do you like least? Why?
  • What exercise classes would you like to take?
  • What stops you from taking those exercise classes?
  • Are there any team sports that you could join?
  • Why don’t you exercise more? (Be honest!)
  • How can you compensate or overcome the reasons you do not exercise more?

 

Nutrition Influences of Sleep

Your food habits may have an influence on the amount and restorative power of the sleep you are currently experiencing. Journal about your current food habits, and then identify changes you would be willing to make. Note your current habits about the food group in question, and then identify the changes you want to make.

Proteins (example: milk, eggs, meat, poultry, fish, dried beans, oats, rice, whole-grain bread, whole-grain pasta, cashews, broccoli, peanuts)

Fats (example: butter, cheese, chocolate, pork, bacon, beef, veal, hotdogs, margarine, mayonnaise, canola oil, lunch meats)

Bad carbohydrates (example: sugar, corn syrup, sodas, doughnuts, cookies, cakes, pies,sugary cereals)

Good carbohydrates (example: potatoes, sweet potatoes, fresh fruit, fresh vegetables, corn, oats, wheat, soybeans, black-eyed peas, kidney beans)

Vitamins (example: liver, fresh fruit, fresh vegetables, whole-grain bread, milk, cheese, salmon, tuna, potatoes, poultry, peas, soybeans, whole-grain cereals, seafood, carrots, seeds)

Drinks (example: water, alcohol, coffee, sweetened fruit juices, sodas, hot tea, iced tea, lemonade)

 

Stress Management for Better Sleep

The relationship between stress and your ability to sleep well has been well documented. People who are experiencing a great deal of stress do not typically sleep well.

Write down the stress management techniques listed below that you will commit to trying.

  • Avoid hot-button
  • Be assertive with others – you have needs and wants too.
  • Breathe deeply.
  • Do not try to control what cannot be controlled.
  • Eat nutritionally.
  • Enjoy life’s simple pleasures.
  • Express your feelings in a safe, effective manner.
  • Focus on the positive.
  • Forgive yourself and others.
  • Journal about your feelings associated with stress.
  • Keep and prioritize a to-do list.
  • Learn how to say “No” when you feel overwhelmed.
  • Look at the big picture of life and see where your issue fits in.
  • Manage your time well so that you have time for yourself.
  • Plan your time effectively.
  • Prepare and accept that unexpected problems will arise.
  • Relax with calming music.
  • Schedule time for Yoga or stretching exercises.
  • Spend less time with people who stress you out, if you can.
  • Take control of your own environment.

 

Sleep Concerns

People who have sleep problems or disorders often have concerns when retiring for bed because of some of the issues that go along with their sleep patterns. Going to sleep with these concerns, and worrying about falling asleep, can make it more difficult to fall asleep. Sometimes, talking or writing about the issues will help.

In your journal identify three of your concerns associated with your sleep.

 

Taking Worries and Fear to Bed

We often worry and fear things we cannot control. Read the Serenity Prayer out loud. Make photocopies of it, cut it out, and tape it to your bathroom mirror, by your bedside, or any places where you can easily see it and re-read it.

God grant me the serenity

To accept the things

I cannot change;

Courage to change

the things I can;

And wisdom to

know the difference.

 

Bed-Time Self-Care

Print out this page. Cut out the tips below that pertain to you, and those you need to remember. Post them in places that you will see them. (bathroom mirror, refrigerator, etc.)

Reduce your liquid intake before bedtime.

 

Refrain from eating a large meal or snack before bedtime.

 

Remember that your bedroom is for sleep and intimacy only.

 

Get at least seven hours of sleep.

 

Have a bedroom free of and electronic products.

 

Turn your alarm clock around so that you cannot see it from bed.

 

Don’t go to bed unless you are sleepy.

 

Go to sleep and rise at the same time each day – even on weekends.

 

Avoid watching television shows that are upsetting before bedtime.

 

If you aren’t asleep in 20 or30 minutes, get out of bed until you are tired.

 

Keep a comfortable room temperature. Cool, but not cold.

 

Think positive thoughts as you are falling asleep.

 

Establish relaxing bedtime rituals.

 

Maintain a healthy diet.

 

Consider the things you have to be grateful for as you are going to sleep.

 

Make sure that your bedroom is quiet.

 

Review the good things that happened during the day as you get undressed.

 

Free your mind as you get into bed.

 

Avoid alcohol before bedtime.

 

Use caution with sleeping pills that can become addictive.

 

Do not allow cats or dogs in bed with you no matter how much you love them.

 

Exercise regularly but not three or four hours before bedtime

 

If there are noises, use a fan or white noise to block out the sounds.

 

Avoid stimulants like nicotine and tobacco before bedtime.

 

Avoid caffeine several hours before bedtime.

 

Lower the lights a few hours before bedtime

 

Finish eating anything an hour before bed.

 

Reduce the number and time of naps during the day.

 

Make an appointment with a medical professional.

 

Make an appointment with a sleep professional.

 

 

Using Mental Imagery

Mental imagery (or guided imagery) harnesses our brain’s natural tendency to create vivid mental representations of our beliefs, desires, experiences and goals. It’s also a simple, inexpensive, and powerful tool for soothing symptoms and creating positive change. The use of mental imagery has been found useful with some sleepwalkers as well as people with other sleep problems.

Mental imagery is using memories of visual events to project a mental picture in your mind.

An example:

I picture myself at a beach in Delaware where I used to live. When I begin to feel anxious or stressed I can project myself back to that beach and begin to feel relaxed and sleepy. I just close my eyes and picture myself sitting in the sand. I notice how blue the water looks and how white the waves appear as they come in. I imagine walking along the beach looking for seashells. I smell the fresh air and hear the seagulls chirping above. The sun is warm on my body and I feel safe. With each breath I take I imagine breathing in the beautiful, vivid colors that are present. This is my personal paradise.

 Now, write out a pleasant imagery scene that you will like picturing and remembering.

Before going to sleep each evening, you can begin to imagine this scene vividly.

 

Support for My Sleep Issues

In overcoming any sort of sleep issue, regardless of how minor or severe, support is important, and sometimes critical. Support can come in many different forms and from many individuals in your life. In the following boxes, list people whom you can rely on to suggest healthy lifestyle changes and activities that allow you to have a healthy bedtime sleep.

Make a list in your journal of all those who could support and help you with your sleep issues. Note how you believe that person can help you. Possible supporters could come from medical professionals, sleep issue professionals, family members, friends and acquaintances in the community, people with whom you work at a volunteer job, spiritual sources, or other groups you might know. Print the worksheet for your use if you wish.

Click here to download printable worksheets related to this article.

Chronic Sleep Problems Affect 50 To 70 Million Americans

50 to 70 Million Americans Struggle with Chronic Sleep Problems

Excerpted from Coping with Sleep Issues Workbook
By Ester R.A. Leutenberg and John J. Liptak, EdD

Man with sleep problems rubbing eyeMost people, at one time or another, have experienced trouble falling asleep or staying asleep. Inability to sleep occasionally is normal and is often the result of some sort of stress in life. However, when sleep problems become a regular occurrence and begin to affect one’s ability to function in daily life, the person may have developed a sleep disorder.

A lack of adequate sleep may not seem like a big problem, but it can seriously affect one’s performance at school or work, ability to concentrate, ability to control emotions, and ability to handle stress. Lack of sleep is a challenge to one’s own general health and well-being.

Adequate sleep is a great buffer that helps to protect people from everyday stress. Sleep is a vital support for one’s ability to rejuvenate the mind and body.

Any type of sleep deficiency can seriously increase one’s vulnerability to a variety of physical disorders and to a host of negative feelings, emotions, and behaviors such as:

  • anger
  • anxiety
  • frustration
  • irrational thinking
  • irritability
  • sadness

Inadequate sleep can result from two things:

  • A reduction in the amount of sleep one experiences. This occurs when people find that they are not sleeping enough hours each night.
  • A reduction in the quality of sleep one is receiving. This occurs when people find that they are having a hard time falling asleep, often awaken, and then may difficulty going back to sleep. This reduction causes a dramatic break in the sleep cycle.

Click here for a printable handout: What is the Sleep Cycle?

Over the years many folks have written about getting a good night’s sleep. Here are a few. Journal a few lines about each one and how you feel about it. Do you have other favorite quotes about sleep? Jot them down in your journal and write about how you feel about them. It is important to understand your (and your client’s) attitude to sleep problems so you can provide a guide to better sleep that may include anything from easily made changes to routines to participating is a formal sleep study.

Woman with chronic sleep problems

Control what you can control. Don’t lose sleep worrying about things that you don’t have control over, because at the end of the day, you still won’t have control over them.

-Cam Newton

Though sleep is called our best friend, it is a friend who often keeps us waiting.

-Jules Verne

If you have difficulty sleeping or are not getting sleep or sleep of good quality, you need to learn the basics of sleep hygiene, make appropriate changes, and possibly consult a sleep expert.

-Andrew Weil

Sleep is the best meditation.

-The Dalai Lama

My father said there are two kinds of people in the world: givers and takers. The takers may eat better, but the givers sleep better.

-Marlo Thomas

Click here for a printable worksheet on quotes about sleep for your clients.

Possible Causes of Sleep Problems

Some clients feel overwhelmed when they try to analyze why they are having trouble sleeping. There are so many possibilities. This list of suggestions can help them narrow down the choice. For example, this is a list of possible causes of sleep problems.

  • Acid reflux
  • Allergy
  • Anger
  • Anticipation that something might happen
  • Certain medications
  • Anxiety
  • Bedroom cluttered
  • Caregiving responsibilities
  • Disappointments
  • Disease
  • Electronics (tablet, cell phone, games) in bedroom
  • Emotional stress
  • Family issues
  • Fearfulness
  • Friend relationships
  • Frustration
  • Grief
  • Guilt
  • Hot flashes
  • Hurt feelings
  • Indecisive
  • Isolation
  • Jealousy or envy
  • Job issues
  • Medical issues of self or loved one
  • Mental health issues
  • Overwhelmed
  • Partner
  • Phone use in bedroom
  • Physical ailment or pain
  • Regrets
  • Relatives or in-laws
  • Sadness
  • Social life
  • Stimulants
  • Substance abuse
  • Suspicions
  • Time constraints
  • Too warm or cool in the bedroom
  • Trauma
  • Uncomfortable bed and/or pillow

Click here for a printable worksheet version.

Man with chronic sleep problems asleep at the wheelSuggesting small changes that can make a difference is a good start. Some are more difficult to achieve than others. Start with the easier ones and move on from there.

  • Avoid alcohol, nicotine, or caffeine before bedtime
  • Avoid extreme exercises before bedtime
  • Avoid rich and spicy foods before bedtime
  • Be sure the bed, mattress, and temperature are comfortable
  • Do easy stretches before bed
  • Do something mildly stimulating after dinner to avoid falling asleep too early
  • Don’t watch scary television shows before going to sleep
  • Drink enough fluid at night so as not to wake up thirsty, but not so much that you frequently need to go to the bathroom
  • Eat nothing or something light before bedtime
  • Eliminate loud noises
  • Engage in deep breathing exercises
  • Enjoy a pleasant book on tape
  • Get up at the same time each day
  • Go to sleep at the same time each day
  • Have the same sleep routine on weekends
  • If something is on your mind, write it on a paper next to your bed and then fall asleep
  • If you wake up and can’t fall back asleep in 30 minutes, get out of bed until you are tired enough to sleep
  • Consume no caffeine after noon time
  • Keep the bedroom cool
  • Listen to relaxing music
  • Maintain a bedtime routine
  • Make preparations for the next day before going to bed
  • Meditate
  • Nothing in the room but sleep and intimacy
  • Progressive relaxation exercise
  • Read a pleasant book or magazine
  • Save vigorous exercise for during the day
  • Stay away from big meals close to bedtime
  • Take a nap way before bedtime
  • Take a warm bath or shower before bed
  • Take prescribed medications
  • Turn off electronics or technology (other than an alarm clock, turned backwards)
  • Use earplugs to block out noise
  • Use guided imagery
  • Wind down the evening with a favorite hobby, calm music, fun television, or book
  • Write in a journal

Click here for a printable worksheet version.

According to the U.S. Centers for Disease Control, an estimated 50 to 70 million Americans face chronic sleep problems. Sleep deprivation is associated with injuries, chronic conditions such as obesity, mental illnesses, poor quality of life, increased healthcare costs and lost work productivity.

Tired eyeMost adults require seven to nine hours of sleep each night. Getting less than that daily amount can cause a serious sleep deficit over time. While some sleepless nights may be the result of too much caffeine or thinking about something that’s worrying, chronic sleep deprivation is often the result of a sleep disorder such as:

  • Delayed Sleep Phase Disorder is a disorder in which a person’s sleep is delayed by two or more hours beyond the conventional bedtime. This delay in falling asleep causes difficulty in waking up at a desired time.
  • Insomnia is the most common type of sleep disorder. Some of the symptoms of insomnia include difficulty getting to sleep, waking many times during the night, and often waking before it is time to actually get up. Insomnia can affect normal daytime activities. Insomnia is most often caused by stress, anxiety, certain medications, depression and/or inadequate sleep habits.
  • Narcolepsy occurs when people feel excessively sleepy in the daytime. The sleepiness felt with narcolepsy is overwhelming. Some people with narcolepsy have uncontrolled sleepy periods that can occur regardless of what they are doing, while others have constant sleepiness throughout the day. The person has this feeling for a period of time longer than three months, and it is accompanied by a higher than usual percentage of REM sleep.
  • Nightmares are frightening dreams that occur during deep, REM sleep.
  • Periodic Limb Movement Disorder is the movement of hands, arms, feet, and legs during sleep that frequently causes arousals and disturbs the sleep cycles. Whether the person remembers waking or not, the brain often shifts from sleep to wake in a response to the jerking of the limbs causing the sleep cycle to be disrupted and increase excessive daytime sleepiness.
  • Restless Leg Syndrome occurs during wake hours and is often worse in the evenings and before bedtime, which can lead to sleep onset insomnia. This discomfort can come in the form of an urge to move one’s legs and feet to get relief. People find themselves experiencing excessive and rhythmic movements while they are sleeping.
  • Sleep Apnea occurs when soft tissue covers the airway, either partially or completely, causing a cessation of breathing for ten seconds or longer repeatedly through the night. This can cause frequent arousals and disruption of the desired sleep cycle. These disruptions cause those suffering from sleep apnea to be very tired during the day.
  • Sleep Talking is a sleep disorder defined as talking during sleep without being aware of it. Sleep talking can involve complicated dialogues or monologues, complete gibberish, or mumbling. The good news is that for most people it is a rare and short-lived occurrence.
  • Sleep Terror Disorder occurs mostly in children, but can be found in adults. Night terrors are frightful images that appear in a person’s dreams, but are often difficult to remember upon awakening.
  • Sleepwalking is a disorder that causes people to get out of bed and walk while they are sleeping. It usually happens when a person is going from the deep stage of sleep to a lighter stage, or into the wake state. The sleepwalker can’t respond during the event and usually does not remember it.

Clients suffering from serious sleep disorders might be helped by a visit to a sleep center. Contact the American Academy of Sleep Medicine at https://aasm.org/ to find an expert near you.

Coping with Sleep Issues Workbook and Card DeckA book such as Coping with Sleep Issues Workbook from where most of this material has been excerpted can be of invaluable help to you and your clients. It can be found at https://wholeperson.com/store/coping-with-sleep-issues-workbook.html.