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DBT Sleep Hygiene

The document provides tips for regulating emotions and getting better sleep when experiencing rumination or anxiety. It recommends establishing a consistent sleep schedule, avoiding stimulants before bed, and using relaxation techniques like deep breathing if feeling anxious. It also suggests getting out of bed and doing a calming activity if wide awake but calm, and listening to public radio with eyes closed if other methods don't work.

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874 views1 page

DBT Sleep Hygiene

The document provides tips for regulating emotions and getting better sleep when experiencing rumination or anxiety. It recommends establishing a consistent sleep schedule, avoiding stimulants before bed, and using relaxation techniques like deep breathing if feeling anxious. It also suggests getting out of bed and doing a calming activity if wide awake but calm, and listening to public radio with eyes closed if other methods don't work.

Uploaded by

mor
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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EMOTION REGULATION HANDOUT 20B

(Emotion Regulation Worksheet 14b ) 7 03 .p ;

Sleep HygieneProtocol
When You Can’t Sleep, What to Do Instead of Ruminating
TO INCREASE THE LIKELIHOOD OF RESTFULNESS/SLEEP:
1. Develop and follow a consistent sleep scheduleeven on weekends. Go to bed and get up
at the same times each day, and avoid anything longer than a 10-minute nap during the day.
2. Do not useyour bed in thedaytimefor things like watching TV, talking on the phone, or
reading.
3. Avoid caffeine, nicotine, alcohol, heavy meals, and exercise late in the day before going to
sleep.
4. When prepared to sleep, turn off thelight, and keep theroom quiet and the
temperaturecomfortableand relatively cool. Try an electric blanket if you are cold; putting
your feet outside of the blanket or turning on a fan directed toward your bed if you are hot; or
wearing a sleeping mask, using earplugs, or turning on a “white noise” machine if needed.
5. Giveyourself half an hour to at most an hour to fall asleep. If it doesn’t work, evaluate
whether you are calm, or anxious (even if only “background anxiety”), or ruminating.
6. DO NOT CATASTROPHIZE. Remind yourself that you need rest, and aim for reverie (i.e.,
dreaminess) and resting your brain. Sell yourself on the idea that staying awake is not a
catastrophe. Do not decide to give up on sleeping for the night and get up for the “day.”
IF YOU ARE CALM BUT WIDE AWAKE:
7. Get out of bed; go to another room and read a book or do some other activity that will not
wake you up further. As you begin to get tired and/or sleepy, go back to bed.
8. Try a light snack (e.g., an apple).
IF YOU ARE ANXIOUS OR RUMINATING
9. Usethecold water TIP skill. Get right back in bed and do thepaced breathing TIP skill.
(See Distress Tolerance Handout 6: TIP Skills: Changing Your Body Chemistry.)
Remember, if you have any medical condition, get medical approval before using cold water.
10. Try the9–0 meditation practice. Breathe in deeply and breathe out slowly, saying in your
mind the number 9. On the next breath out, say 8; then say 7; and so on until you breathe out
saying 0. Then start over, but this time start with 8 (instead of 9) as you breathe out, followed
by 7, and so on until you reach 0. Next start with 6 as you breathe out, and so on to 0. Then
start with 5, then with 4, and so on until you have gone all the way down to starting with 1. (If
you get lost, start over with the last number you remember.) Continue until you fall asleep.
11. Focus on thebodily sensation of the rumination (rumination is often escape from difficult
emotional sensations).
12. Reassureyourself that worries in the middle of the night are just “middle-of-the-night-
thinking,” and that in the morning you will think and feel differently.
13. Read an emotionally engrossing novel for a few minutes until you feel somewhat tired. Then
stop reading, close your eyes, and try to continue the novel in your head.
14. If rumination doesn’t stop, follow these guidelines: “If it’s solvable, solve it. If it is insolvable,
go deep into the worry all the way to the “catastrophe”—the very worst outcome you can
imagine—and then imagine coping ahead with the catastrophe.
(See Emotion Regulation Handout 19: Build Mastery and Cope Ahead.)
If nothing elseworks, with eyes closed, listen to public radio (BBC, NPR, etc.) at low volume
(use headphones if necessary). Public radio is a good choice for this, because there is little fluctua-
tion in voice tone or volume.
From DBT Skills Training Handouts and Worksheets, Second Edition, by Marsha M. Linehan. Copyright 2015 by Marsha M. Linehan. Permis-
sion to photocopy this handout is granted to purchasers of DBT Skills Training Handouts and Worksheets, Second Edition, and DBT Skills
Training Manual, Second Edition, for personal use and use with individual clients only. (See page ii of this packet for details.)

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