What is "Good Sleep Hygiene" RLS Style?

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GBoomer
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What is "Good Sleep Hygiene" RLS Style?

Post by GBoomer »

Those of us seeking a good night's sleep can't have escaped the canon of "good sleep hygiene" that has become popular in numerous media outlets and in various programs for insomnia. This list of guidelines includes advice such as having a relaxing pre-sleep routine, reserving your bedroom for sleep and sex only, not staying in bed if you are sleepless for 20 minutes or more, not taking more than one nap, no longer than 30 minutes in the afternoon, etc.

Some of these guidelines, in my own experience, have been helpful, and some not so helpful. Before I weigh in with my thoughts, what are the principles that work for YOU as a fellow RLS sufferer? What are the common guidelines that do NOT work for you? What do you do instead? Since there seem to be different variants of RLS experience, our ideas might not be the same or even similar and that is fine.

I will leave with one principle of my own and the related, common guidelines that I reject:

Get your sleep when you can, where you can, doesn't matter when or where. If I don't let myself take more than one nap, more than 30 minutes long, I still may not sleep well during the next night, and I'll end up even more sleep deprived than I already was. In fact, on nights after a day with 2 or 3 naps, I sleep pretty much the same as any other night. And my total sleep hours are better as a result. So, I throw out the general sleep guideline about naps and let myself sleep whenever I am tired (assuming of course that I am in a situation where I CAN nap.)

What about you? Your thoughts and ideas would be appreciated!

Rustsmith
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by Rustsmith »

Before I was actually diagnosed with RLS, I heard the mantra of "proper sleep hygiene" so many times I started to get sick of it because I was doing all the things they preach and it obviously wasn't doing any good.

Now that my RLS is diagnosed and mostly under control, I still practice most of what they teach, with the exception of the guidance on naps. My current doctor is more concerned that I get a total of about 8 hrs of sleep than when I get them. If I can get lets say 6 hrs at night and then another 2 from naps during day, she is happy. I believe that her concern is for the long term health damage done by sleep deprivation, not to mention that I am more alert and not always on the edge of falling asleep.

So, now I get my sleep whenever my body (and life) allows. If that means 8 at night, fantastic, but if it is 6 and night and an hour long nap in the morning and another hour in the afternoon, then great.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Yankiwi
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by Yankiwi »

I follow all of the sleep hygiene guidelines but nap when I need it. None of the tips, such as lavender or certain herbal teas, work. When I wake up I get up and read and stretch for up to an hour then almost always can get back to sleep. If I stayed in bed my legs would just get worse and worse until I had to get up anyway but would be tired and distressed. If I wake up again I do five sun salutations and can usually get back to sleep for a few hours. These days I'm getting seven or eight hours most nights.

ViewsAskew
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by ViewsAskew »

Similar here - bed is for sleep and sex and a few minutes of gymnastics/stretches in case I wake up with symptoms. If it's not gone in a few, I get up. I do not try to go to bed at the same time. But, I can do that because I am not working. I sleep when I can, as long as I can - 15 minutes to ten hours, whatever I can get away with. As you noted, GBoomer, I find that if I am tired, I need sleep, so I don't limit myself. If I have the inkling that it's going to be a tough night, I just sleep on the couch - makes it easier to get up as I don't have to navigate the stairs in the dark, wake my husband, etc.

I also don't limit caffeine any longer. I used to - didn't drink any. Then my neuro told me to use it to help me be more awake. I didn't need much initially. Of course now that I've been having it for several years, I could drink a gallon and it wouldn't do much.

I do have a pre-bed ritual that I find helps. For me, any dryness or something irritating my skin will set off symptoms. I put lotion all over prior to sleep and I never sleep in PJ bottoms - anything restrictive is an issue. I also file any dry skin off of my feet and put on a special lotion. I often use a heating pad when I first go to sleep - helps with any residual symptoms.

I do not read when I wake up most time - reading is something I can do with one eye open, so it doesn't help me get back to sleep. I usually try cleaning, ironing, sewing, crocheting, watering plants, etc.
Ann - Take what you need, leave the rest

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Polar Bear
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by Polar Bear »

I do not read when I wake up most time - reading is something I can do with one eye open, so it doesn't help me get back to sleep. I usually try cleaning, ironing, sewing, crocheting, watering plants, etc.

Last night at/this morning at 4am - I was decorating a hammer. !!
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

ViewsAskew
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by ViewsAskew »

Decorating a hammer??? Sounds like fun!
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Polar Bear
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by Polar Bear »

It was an anniversary gift for my husband, the hardest man in the world to buy for. As he is a keen lawn bowls player, I appliqued the wooden handle of the hammer accordingly (amazing what motifs can be found on Amazon) sealed it with craft glue and then varnished it.
Betty
https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

Rustsmith
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by Rustsmith »

Now that makes sense. I was trying to imagine decorating the handle of a carpenter's hammer, which seemed like either a waste of time on something that would soon be damaged or else something that would insure that the hammer never got used.
Steve

https://www.mayoclinicproceedings.org/a ... 0/fulltext
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

sleepdancer2
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by sleepdancer2 »

I too have adapted standard sleep hygiene suggestions to fit my own needs. I remember when at my worst I would provide myself the atmosphere conducive for sleep, then just hope for the best. I do still limit caffeine to earlier hours as I see the difference in my sleep when I have it in the late evening.Totally agree that those with RLS and/or PLMD have to get sleep when they can. I am primarily dealing with PLMD these days. Once I got off the DA's the RLS is not often an issue. The hardest thing for me when I'm having a rough night is waking myself enough to make myself get up. I seem to get stuck in my misery, dozing fitfully for hours. When I do wake up, I put my TENS Unit on my lower back and go back to bed. Quiets my legs. Turning the radio on an oldies station helps keep my brain moving without requiring thought. In fact, this proved to be a major help to me. Sounds wierd I know. I'm thinking this is related to circadian rhythms, but if I wait till maybe 3 or 4 am to even get in bed, my legs might not act up at all.
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legsbestill
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by legsbestill »

My sleep consultant maintains that there is a reduction in rls symptoms towards dawn when the body temp starts to rise again after dropping earlier in the night. I can't remember all the science. Perhaps this is why you get better results with a much later bedtime. Unfortunately my rls has not heard the theory and will randomly put in an appearance any old time - yesterday it was creepy-crawling away at 9am. I think it doesn't like my sleep consultant - in any event it repeatedly tries to prove her theories wrong.

ViewsAskew
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by ViewsAskew »

Most of us find that there is a time of day that it is lessened....but when symptoms are close to (or are) all day and all night, lessened doesn't necessarily mean you can sleep!

Dr. B has maintained that it is part of the flawed circadian rhythm and that IF you continually go to bed later - say 4 AM for 6-8 months - that your rhythm will adjust and instead of the symptoms lessening around 3-5 AM that they will now lessen at, say 8 AM (I am making up these times). Not sure any of us have ever spent enough time doing this to see if that indeed happens. Generally speaking, mine definitely is worst in the 10 PM to 3 AM range even though I can have it any time. And, similar to sleepdancer2, I find that if I wait to sleep until 3 or 4 AM I can often stay asleep with minimal disruptions but I if I took the same amount of meds and tried to sleep at 11 PM that I'd awaken frequently and likely have to get up and stay up until 3 or 4 before everything calmed down.

Seems a good time to remind everyone who may read this- since there are other issues that look like RLS but are not, anytime some of the symptoms do not fit into the typical patterns, it is a possibility that there are multiple things going on. We have had too many people here who couldn't get their RLS under control only for them to find out that they either did NOT have RLS, or that they had RLS, but also had some kind of neuropathy or something else that can seem like RLS.

Hope this makes sense - am too sleepy and should not be typing...
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

badnights
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by badnights »

I'll weigh in about the "sleep hygiene" theories. I keep meaning to check if any studies have actually been done on those suggestions. I am positive no studies have been done on WED/RLS sufferers and the dangerous suggestion to restrict sleep. I absolutely would never advise an RLS/WED sufferer to avoid naps; on the contrary take as many as you can get. As many as your body will handle.

As for the other stuff - - I have tried it all, I think, and any positive effect any of it may have had has been swamped by the grand negative effect of having severe WED. I did eventually tape dark garbage bags over my bedroom windows (summer sun in Yellowknife lasts most of the night) because I noticed I was waking up when the sun came up, if only briefly. The suggestions about light do actually have some research to back them up, so I am more keen on trying them. I tried the amber glasses in the evenings, programs that remove the blue light from your monitors at a certain time of day, ensuring no light from alarm clocks or anything else in your room; but these don't seem to help - maybe they help but I can't tell - all I can tell is when the WED is bad I can't sleep and when it backs off I sleep like the dead.

I am now a vampire. My day has shifted, and my symptoms have shifted with it. I go to bed easiest around 6 am but I usually try earlier. I sleep poorly for a few hours then well. (Lately symptoms have been waking me so I have been taking extra meds in the middle of the night. Works great, but if I keep it up I will soon be unable to have orgasms again and I really don't want that.... ) Today I got up - after 9 beautiful glorious hours broken only twice - at 3:45 PM. By the time I had shaken the cobwebs off and picked up the phone to make some calls I had to make - - everything was closed! Both places closed at 4! Also - this makes it hard to expose myself to natural light in the "morning", because the sun is setting here by that time.

I have always kept my bedroom for sleeping and sex only, but I imagine it might be distracting if I regularly used it for something else, so that's another suggestion I would probably support.

I try to avoid watching movies or anime or anything on the computer for an hour of so before bed; I think those things might make it harder for me to fall asleep, but I am not really sure.

I don't avoid eating. Once or twice I regretted it - I guess I had heartburn - but mostly, eating fills a hole in me and makes it easier for me to sleep. I am pretty scrawny anyway, and not hungry until later in the day, then I eat continuously until I go to bed - almost for real. I just get hungry right after I eat. It's nuts. So I don't follow the eating suggestion either. I think I would not be able to sleep if I was hungry.
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

fuz_mind
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by fuz_mind »

before RLS, I have always kept to standard sleep hygiene, which has generally been helpful for my sleep

post rls, i have generally kept to the standard sleeping and waking time, but I have placed more emphasis on my pre-sleep routine so that I am sleepy and physically comfortable (ie no pain) when I lie down, so falling asleep is not a problem for me; fragmented sleep is a problem when my rls flares up -i wake up frequently but have no problems falling back asleep. I keep to the standard CBT advice of - not worrying/thinking when I wake up, no clock checking, no getting out of bed. if my awakening is due to pain, i have an extra painkiller by my bedside and i do some breathing so i drift off to sleep when the pain wears off temporarily. i still dont take naps because i find that it disrupts my bedtime sleep having said that, my rls has improved sufficently for the above to work. so i do think there is a role for both medication and sleep hygiene to work together....

the other major change i have made - when i have had weeks of bad sleep and i am totally exhuasted, i use a heavier dose of medication to knock me out for the weekend to get some rest. because i find that once i cross a certain fatigue level, my brain will just not let me sleep.... so i avoid heading to that stage.....

badnights
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Re: What is "Good Sleep Hygiene" RLS Style?

Post by badnights »

A fascinating thing has happened to me. At the beginning of July, I was going to bed at 6 or 7 AM. My job involves working in remote field camps, and for 3 weeks in July I was going to have to get up at 6:45 AM - at my bedtime. I talked to my doctor beforehand and told her I Would need extras of all my meds, because I planned to medicate the symptoms away and medicate myself into sleep every night and out of sleep every morning. She duly prescribed extras, but I only needed them for 4-5 days. My body then flipped. It flipped its circadian cycle by 12 hours. I don't know if I went forwards or backwards.

I think it only happened because it was a 12-hour shift that was required - it would not have happened if I needed a 4 hr or 7 hr shift (and I'm fairly certain of that because in previous summer jobs, I was roughly that far out, and forcing myself onto a different schedule didn't actually change my body's schedule).

It is now over 2 months since I came back from the field, and I am still on a "normal" schedule. I get up at 8:25 and go to bed -- well, bedtime has slipped from 11 pm to 1 am. I don't know how long this can last. I am functional during the day, not so doped out sleepy tired that I can't work and then wide awake and feeling normal for the first time all day at bedtime. Because of that I don't have the extreme reluctance to take the kill-pill (zopiclone/trazadone) that I used to have. But I am still slipping on the bedtime.

So - I might be revising my opinion on so-called sleep hygiene, but I haven't come to any firm conclusions yet. I still nap in the day if I'm falling asleep at my desk, which often happens at around 2 or 3 PM (hey, it's way better than it was!).
Beth - Wishing you a restful sleep tonight
Click for info on WED/RLS AUGMENTATION & IRON
I am a volunteer moderator. My posts are not medical advice. My posts do not reflect RLS Foundation opinion.

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