Insufficient Sleep Sleep Fragmentation Narcolepsy Recurrent Hypersomnias

Non-Pharmalogic Strategies Pharmalogic Treatment Sleep Disorder Summary

The most common cause of daytime sleepiness is insufficient sleep, which may reflect poor sleep “hygiene” (behaviors impacting sleep) or self-imposed or work/socially-dictated sleep deprivation. Additionally, circadian rhythm disorders such as those related to shift-work or circadian phase (For example, phase delay, jet lag) contribute importantly to the common causes of EDS. Poor sleep hygiene is a frequent contributor to inadequate total sleep time among patients. Factors that may contribute to chronic insomnia include those that result in increased nocturnal alertness, such as excessive caffeine, frequent naps, and stressful work at night, and those that interfere with sleep continuity, such as falling asleep with the television or radio on, excessive time in bed, and other environmental factors. Even though poor sleep hygiene may not be the cause of insomnia, many patients will benefit from simple hygiene recommendations, such as those presented in Table 2.

Table 2. Sleep hygiene recommendations: Time spent in bed should be limited to just sleeping. If awakening occurs, get out of bed and go back to bed only when ready to sleep again.
Do not try to force sleep.
Avoid physical activity before bed. Exercise should be done at least 2 hours before going to bed.
Avoid drinking coffee and alcohol or excessive amounts of beverages before going to bed.
Avoid eating a heavy meal before going to bed.
Avoid taking naps during the day.
Set a routine in bedtime and waking hours.
Make the sleep environment as comfortable as possible with respect to lighting, temperature, noise, and so forth.