Karl Doghramji, MD: Sleep Hygiene

Proper insomnia management is a multi-faceted form of care. The best laid plan requires a combination of behavioral modification, sleep hygiene, and even prescribed therapy.

In an interview with MD Magazine®, Karl Doghramji, MD, a professor at Thomas Jefferson University, discussed the makeup of a proper sleep hygiene plan.

These expert insights and more will be highlighted at the 1st annual International Congress on the Future of Neurology, a two-day event in Manhattan which will cover a litany of expert insights into neurology while providing attendees and opportunity to gauge and meet with practice-leading clinicians and researchers including Doghramji.

Doghramji will be moderating the “Beyond Counting Sheep: Effective Therapies for Sleep Disorders” session on the weekend of September 27-28 during the Congress.

For more information on the Congress and to register, click here. Receive 25% off registration fees with code Neuro19SI.

MD Mag: What is recommended for good sleep hygiene?

Doghramji: So, since behavioral abnormalities in older individuals are so common, the initial approach to the management of an older individual’s insomnia directly should really rest on behavioral modification, sleep hygiene, and other cognitive behavioral methods. And this, by the way, has been the recommendation of a number of societies including the American College of Physicians and the American Academy of Family Physicians as well.

So what does that mean? Well, sleep hygiene improvement could be an integral part of behavioral treatment—things like ensuring a regularity in terms of both bedtime and waking time in the morning on a regular basis. So, systematically waking an older individual up at the same time every morning and preventing napping as much as possible during the course of the day—which could diminish the propensity for sleep the following night.

So, avoiding napping as much as possible may be very helpful. Maximizing exposure to light in the morning by taking older individuals to settings like bright-lit rooms, for example, could be very helpful. And also, maximizing daytime exercise.

And this have been shown time and time again—that aerobic exercise on a regular basis and has to sleep depth in older individuals, and enhances the quantity and the perceived quality of sleep as well, and diminishes daytime sleepiness.

There are a number of therapies that that can modify the quality of sleep—one of which is called sleep restriction therapy. Elderly have a propensity to wake up a great deal during sleep, making their sleep inefficient and then per less productive. So, limiting the amount of time they spend in bed over the course of weeks and months could actually produce more sleep depth and continuity over the course of time.

This is something called sleep restriction therapy, which seems to work very well with older individuals. So these are some of the behavioral methods which may work very well with older individuals.