Sleep problems - Insomnia Management Kit

Assessment

• complete Epworth Sleepiness Scale to determine daytime somnolence
• Provide sleep diary to complete at home with 1 week follow up
• work through sleep diary with assessment flow chart and symptom/management table and provide management fact sheet
• discourage continued sleep medication use

Regular routine, sunlight exposure, usual snap esp avoiding smokes/drinks around bedtime. Discouraging pharmacological dependence and providing education on non-pharmacological therapies:

• Stimulus control therapy: bed only for sex and sleep. Only go to bed when sleepy. If not asleep in 15mins, leave, do something relaxing and return when sleepy. Good for delayed sleep onset
• Bedtime restriction therapy: work out average sleep duration, choose regular wake and bed times**.** Restrict time in bed. Good for prolonged waking during sleep.
• Bright light therapy: visual exposure to bright light. Morning good for delayed bedtime/sleep until early morning, and difficulty rising even with alarm. Evening good for early onset of sleep with early waking.
• Relaxation therapy: deep breathing meditation, visualisation, progressive muscle relaxation, self hypnosis. Good for delayed sleep onset, prolonged waking during sleep.
• CBT: good for prolonged waking during sleep.
  • Biofeedback: providing visual and auditory feedback to patients to help control some physiological parameters to reduce somatic arousal
• Sleep Restriction: Good for excessive time in bed, sleep disturbed with frequent awakenings