As a counselor, how can I help clients who are having disturbed sleep despite following sleep hygiene measures?
You can explore the difficulties existing with individuals having disturbed sleep in an objective manner which can include understanding their difficulties, exploring the history of medical problems and mental health difficulties as the majority of sleep-related difficulties including sleep disturbance and insomnia occur in the context of medical conditions and mental health disorders. You can also explore the variations in sleep-wake cycles along with maladaptive behaviors and dysfunctional thoughts and beliefs about sleep. In the evaluation process, attention needs to be given to factors that contributed to the initiation of sleep-related difficulties and to the likely life stressors and associated factors that continue to maintain sleep-related difficulties and or insomnia. Once this detailed assessment has been completed which attempts to understand the context in which the sleep difficulties have emerged, you can plan towards making an attempt to address them. You can initiate addressing these difficulties with education about sleep, its benefits, and the need to modify sleep patterns which lead to the maintenance of regular sleep-wake cycles/ rhythms. The psychoeducation about sleep will improve compliance with treatment. In addition to standard sleep hygiene habits, these individuals can be educated about the stimulus control techniques which are aimed at modifying the amount of time an individual spends awake in bed or in the bedroom. These techniques will re-promote the bedroom and bed as a place for sleep and will re-establish a healthy sleep-wake cycle. Sleep hygiene skills work better when offered in combination with stimulus control or other techniques and are best delivered in a collaborative format wherein each of the tasks in these techniques is implemented after the individual understands how it applies to them and how it can benefit them.
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