Research indicates that a significant number of people do not get sufficient sleep. The American society has a culture of working late, as people stay up through the night to study, work, or entertainment. However, the Division of Sleep Medicine (2017) posits that going without adequate sleep has both short-term and long-term consequences. People who fail to get adequate sleep consistently risk profound consequences on their long-term health. Detrimental effects of sleep are a major concern to the healthcare sector. As a result, there has been a significant increase in scholarly interest in the field of sleep and health in the last decade. The literature on sleep epidemiology is also on the rise. Ferrie, Kumari, Salo, et al. (2011) posited that the proliferation of sleep problems among the worldwide population is a cause for concern. The findings lead to the economic developments that have disrupted work schedules s the worlds tends to a 24-hour economy. The implication is the rise in health and performance effects.
Epidemiology of sleep and sleep disorders vary depending on classification. According to Ferri et al. (2011), insomnia is the commonest sleep disorder as is reported in 30% of adults, and chronic insomnia is prevalent in 10% of adults. Obstructive sleep apnea characterized by respiratory problems during sleep occurs approximately in 9-21% of women and 24-34% of men. However, findings by Ram, Seirawan, Kumar, et al. (2010) indicated that sleep apnea was the most prevalent at 4.2%, followed by insomnia and restless leg syndrome at 1.2% and 0.4% respectively. Evidence also illustrated racial and ethnic differences in sleep patterns with Hispanics and Whites reporting longer sleep duration than Blacks. According to Ram et al. snoring while sleeping, feeling unrested during the day, and not getting enough sleep was the predominant sleep habits. There is contrasting evidence of the epidemiology of sleep disorders in the US, but a consensus exists about their effects on health.
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Health problems associated with sleep disorders are diverse and have consequences that spill beyond the health paradigm. For instance, Pandi-Perumal, Verster, Kayumov, et al. (2006) projected that by 2020, 230,000-345,000 of the 2.3 million deaths in motor crashes globally, will be from sleepiness or fatigue. However, health outcomes of sleep can manifest in the short term or long term. Effects of inadequate sleep are biological, physical, and psychological. For instance, in short-term and individual may have impaired judgment, mood, ability to learn and retain information, and heightened risk of serious accidents or injury. Chronic sleep deprivation has far much worse consequences including health problems such as obesity, cardiovascular diseases, diabetes, and in some instances, mortality. It is important to note Ferrie et al. (2011) argue that the relationship between sleep and mortality is U-shaped. Studies have linked premature all-cause mortality to both shorter and longer sleep. Therefore, one can argue that getting adequate sleep is necessary, so is avoiding longer sleep as both have detrimental impacts on health. Gaultney (2010) established the existence of a relationship between sleep and performance of college students. According to Gaultney, 27% of students are at risk of at least one sleep disorder, with African Americans reporting poor sleep habits that Latinos and Whites. Students at risk of sleep disorders are overrepresented, which places their academic performance in jeopardy.
Background
Sleep problems have been bothering me for the past five years. My problem parse is not about inadequate sleep, but lack of sleep itself. I have come to realize that no matter how shorter or longer I sleep, I tend to experience the same effects. However, of late sleep has been elusive regardless of my commitments during the day. Going to bed early does not help because I spend many hours of the night awake until the wee hours of the morning. Similarly, going to bed late does not provide me with any benefits because I tend to spend at most 3 hours. This has been a problem, especially during the day because I experience episodes of a mild headache. In addition, I experience fatigue sometimes, but the desire to have even a nap during the day is non-existent. I have tried to change my sleeping habits in vain. In my opinion, I believe I am among those affected by TV as advanced in Ferrie et al. (2011). This is the main challenge that has been prohibitive in my unsuccessful attempts at changing sleeping habits. Whenever I lack sleep, I turn on the TV or start browsing using my phone.
Goals
I intend to set short-term goals that will be helpful in achieving mid and long-term objectives. The approach is informed by my understanding of what I need to do to improve my situation, but realizing behavior change has been difficult. Therefore, I am developing a personal program to assist in accomplishing the goals below.
I will sleep 6 hours every day to help me improve my sleeping habits to at most 8 hours in the next one month
I will perform 30-minute physical exercise for three days a week for the next four weeks to improve my health and lack of sleep
I will make an effort to distribute my sleeping hours per day to include a 30-minute siesta every day after exercising for the whole month; and 5-hour sleep for the first two that will gradually increase to 7 and 8 in the last and final week respectively. I will also cut down on my caffeine intake.
I will begin my bed ritual an hour early and switch off my phone to ensure that I fall to sleep faster.
Over the next one month, I will be going to bed early and set my alarm clock on to ensure I manage my sleeping time appropriately. For the first two weeks, I will be sleeping for 6 hours including naps during the day that will continue into the final two weeks. I will be sleeping for 7 and 8 hours in the third and final weeks. The success of the program will inform the development of mid and long-term goals.
Motivation
My motivation for undertaking this behavior change program is based on the understanding that sleeping habits that I practice contribute to my mild headaches. In instances where I have been able to sleep for at least five hours in the past, it takes at least two days for the aches to reemerge. Therefore, I am confident that improving my sleep habits and pattern will go a long way in helping fight this persistent problem. It is also important to point out that I have experienced situations where headaches have been severe incapacitating me for the most part of the day. Sometimes I am unable to perform tasks normally due to fatigue, but a rarely feel sleepy during the day. I have also discussed the issue with one of my friend who is undertaking a similar behavior change program, and I was advised to seek the help of a psychologist who will also assist in identifying other underlying causes of my insomnia and suggest effective solutions.
Specific Plan
After consultation with a psychologist, I was advised to drop my 30-minute naps during the day because they posed inhibition to the success of the program. However, the other aspects of the process remained unchanged. To ensure I conformed to my set goals, I kept a log of all activities to be conducted as per my SMART goals. I recorded the time taken to exercise, time to be, and waking up time. I tried to establish a relationship between the days a performed physical exercise and those I did not with an hour spent sleeping. I noted that on the day that I exercised, I slept immediately after going to be and woke up on the first ring to the alarm. On the contrary, days with no exercise presented difficulties. This outcome is consistent with the relaxation training behavioral change theory, which postulates that actions such as exercise calm the body and mind, thereby making one relaxed and able to sleep peacefully (Sharma & Andrade, 2012). I also undertook sleep environment improvement strategy by ensuring my room was dimly lit and keeping any electronic devices out of sight and reach.
I also learnt that reducing my intake of caffeine from the usual three to five cups a day to two played a crucial role. During the first week when I was still taking up to four cups of coffee, my sleeping patterns changed only a little. However, from the third week when I was taking two cups, I slept better, and the mild headaches became sporadic. Going to bed early and reduction of caffeine intake were important strategies for sleeping hygiene behavior that because they dramatically reduced my insomnia. It is also important to point out that I engaged my roommate in the program. Their role was to perform oversight to ensure I adhered to strategies for achieving the set goals. An agreement was reached that every time I deviated from what was routine as per the program, I would take a cold shower for two consecutive days. My roommate was very keen with time schedules including time to go to bed and waking up time.
Evaluation
The behavior change program was a success largely. I was pleased with the change in sleep hygiene behavior that reduced my intake of caffeine, especially its role in reducing the frequency of mild headaches that were a major problem. Sleep environment improvement also assisted immensely because I am now used to going to bed without my phone. The process was harder, especially at first when I had to adjust majority of my schedules during the day to accommodate my sleep program. I learnt that behavior change is a difficult goal to achieve, but with the right attitude and motivation, it can be accomplished. Seeking professional help is of utmost importance because I realized that sometimes the problem is certain aspects of one’s lifestyle. It only needs to be pointed out to initiate behavior change process. I intend to maintain the process by setting mid-and long-term goals by factoring in other behavioral change models that can be helpful, especially given that I am now only able to sleep for five hours, which is short of my 8 hours target.
References
Ferrie, J. E., Kumari, M., Salo, P., Singh-Manoux, A., & Kivimäki, M. (2011). Sleep epidemiology-a rapidly growing field. International Journal of Epidemiology , 40 (6), 1431–1437.
Gaultney, J. F. (2010). The prevalence of sleep disorders in college students: impact on academic performance. Journal of American College Health , 59 (2), 91-97.
Pandi-Perumal, S. R., Verster, J. C., Kayumov, L., Lowe, A. D., Santana, M. G. D., Pires, M. L. N., ... & Mello, M. T. D. (2006). Sleep disorders, sleepiness and traffic safety: a public health menace. Brazilian journal of medical and biological research , 39 (7), 863-871.
Ram, S., Seirawan, H., Kumar, S. K., & Clark, G. T. (2010). Prevalence and impact of sleep disorders and sleep habits in the United States. Sleep and Breathing , 14 (1), 63-70.
Sharma, M. P., & Andrade, C. (2012). Behavioral interventions for insomnia: Theory and practice. Indian journal of Psychiatry , 54 (4), 359-366.
