What is "sleep hygiene"?

To practice good sleep hygiene means to engage in habits that promote regular, high-quality sleep. This leads to full daytime alertness and maximized cognitive capacity. Maintaining good sleep hygiene is especially essential during recovery because sleepiness and fatigue lead to irritability, irrationality, and other negative states of mind that are not conducive to healing. Sleepiness can worsen cravings and increase susceptibility to use.

Why is sleep hygiene important in a recovery setting?

Sleep hygiene is an important part of our holistic approach to addiction treatment because sleep disorders are often a cause and/or result of underlying emotional, mental, or physical problems. Sleeping for too many hours every night can cause kidney and liver disease, thyroid disease, dementia, depression, etc. Sleep deprivation can cause memory/cognitive dysfunction, moodiness, weight gain, weakened immune system, high blood pressure, heart disease, and more. Managing a balanced sleep schedule is critical for a healthy lifestyle.

How does the Two Dreams Sleep Hygiene Program work?

The Two Dreams Sleep Hygiene Program is designed to teach healthy sleeping patterns and helping clients put them into action. It can be difficult to break engrained habits, such as sitting in bed while watching TV or sleeping in late on weekends, so the staff works closely with residents to ease them into new, healthier routines.

Our staff works one-on-one with each resident to develop an individualized plan that they can use after leaving Two Dreams. Clients fill out a pre-admission worksheet to self-evaluate sleep patterns and inform the staff about potential sleep disorders. Clinical staff members examine and interview each resident upon arrival to identify the root cause of any sleep disturbances and, afterwards, a treatment plan can be developed that addresses particular issues.

For residents experiencing abnormally disordered sleep, we move to rule out causes of insomnia and excessive daytime sleepiness (pain, depression, etc.) If the need arises, we can refer residents to a sleep specialist for an overnight evaluation. These examinations test for medical sleep disorders, such as narcolepsy and sleep apnea. As a last resort, we can temporarily prescribe medication that promotes sleep; however, we make every effort to avoid agents that produce dependence and/or disrupt sleep quality.


Can you give me some examples of good sleep hygiene practices?

Maintain regular sleep and wake times. We ensure that all residents are awake and getting dressed by 7am every morning. Everyone must be in bed with the lights out by 10:30pm. These rules apply to weekdays and weekends; it is easier to stick to a consistent schedule rather than make the body readjust every time a Monday morning rolls around.

Ensure ample exposure to natural light. Residents start every morning with a sunrise walk on the beach called a "Sun Salutation." This early exposure to sunlight assists in the transition from the body’s sleep state (GABA brain receptors activated) to its wake state (glutamate brain receptors activated). Residents are also encouraged to spend as much time engaging in outdoor activities as possible to keep the retinas stimulated by sunlight and to help the body make a healthy supply of vitamin D.

Exercise during the day. During the Sun Salutation, residents walk along the beach in order to get blood flowing throughout the body, waking up the limbs after hours of being mostly motionless. A trained staff member leads residents through a half hour of yoga, stretching, and flexibility exercises to further encourage blood flow to the muscles and joints and wake them up. Reinforcing these naturalistic mind/body waking and moving activities enhances the treatment experience and supports healthy change.

Eat breakfast in the morning. The body recognizes sleep as a time of fasting. Eating breakfast breaks that fast and lets the body know that the time for sleep has ended. Residents start every morning with a healthy fruit and vegetable smoothie that is filling, nutritious, and delicious. Eating first thing in the morning wakes up the metabolism and promotes long-lasting energy.

Avoid excessive napping. Residents have the option to take a 20-minute power nap most days before 2pm, though naps should be avoided unless necessary for a productive day. Drinking a shot of caffeine beforehand has been scientifically shown to enhance the napping experience, as the caffeine kicks in after 20 minutes and wakes the body up. This length of time, combined with the caffeine, allows for an optimal energy-boost without any grogginess upon waking.

Avoid caffeine after 2pm. Caffeine has a tendency to alter the body’s sleep/wake cycle for a long period of time after intake. Drinking caffeine after 2pm has been shown to interfere with the ability to fall asleep, as the brain is still experiencing arousal. Caffeine is best used only as needed for its stimulant effect in the morning/early afternoon.

Avoid using electronic devices near bedtime. Residents don’t use electronic devices after 8pm, and should not have them in the bedroom at any time. The unnatural light from the screens confuses the body’s sleep/wake (GABA/glutamate) switch, which makes it difficult to fall asleep when the sun goes down. Associating the bedroom with electronics (or anything other than sleep) confuses the sleep cycle even more.

Avoid eating large meals close to bedtime. Residents should not have meals after 8pm unless they suffer from hypoglycemic mid-night awakenings, in which case a small snack is allowed before bed. Eating causes the body to go into an arousal state and start devoting energy to digestion. Ideally, the body should be settling down for sleep instead of working to process nutrients.

Establish a relaxing bedtime routine. Residents are encouraged to take a hot shower or hot bath for 30 minutes right before bedtime in order to unwind and relax the muscles. The hot water heats the core and dilates the blood vessels. The body begins to associate this de-stressing activity with bedtime, and conditioned sleepiness will occur naturally after a while. Reading is discouraged as a routine activity because it involves mental exertion and the conditioning can seep into the daytime, causing sleepiness while reading in school or at work.

Maintain a pleasant sleep environment. Residents are encouraged to keep their bedrooms cool, as studies have shown that optimal sleep occurs in colder temperatures. Windows are all covered at night to prevent light from getting in and causing untimely awakening. Cold feet are a known cause of mid-night awakening, so residents are provided with loose, fluffy socks to keep their feet warm at night.


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