Sleep Hygiene Protocol

DBT Self Help - Letting Go

Emotion Regulation is the Dialectical Behavioral Therapy module that teaches how emotions work. It provides skills to help manage emotions instead of being managed by them, reduce vulnerability to negative emotions, and build positive emotional experiences.

As indicated by the ABC PLEASE skill, balanced sleep is a crucial part of Emotion Regulation. Many folks struggle with various types of insomnia, especially having difficulty starting sleep or returning to sleep after waking up during the night because of rumination. The DBT Sleep Hygiene Protocol has tips that anyone can find helpful.

Tips to Increase the Likelihood of Restfulness or Sleep

  • Follow a consistent sleep schedule even on weekends
    • Go to bed at the same time each day and wake up at the same each day. Avoid lengthy naps.
  • Do not use your bed in the daytime for anything other than sleeping
  • Avoid caffeine, nicotine, alcohol, big meals, and intense exercise right before going to sleep
  • When ready to sleep, turn off the light, keep the room quiet, and the temperature comfortable but cool.
    • Try utilizing a sleep mask, an electric or weighted blanket, earplugs, or a white noise machine if needed
  • Let yourself try sleeping for 30 minutes to an hour
    • If you’re not asleep in that time, evaluate how you’re feeling (calm? anxious?) and follow the tips for that emotion
  • Do not catastrophize
    • Try not to spiral about how you’re not sleeping. Remind yourself that you need sleep, and staying awake is not a catastrophe. Do not give up on sleeping just yet.

Tips for if You Are Calm But Wide Awake

  • Get out of bed, go to another room, and read a physical book
    • If you’re not a reader, find another activity that won’t wake you up further. Avoid screens. 
    • When you begin to feel sleepy, return to bed
  • Try a light snack

Tips for if You Are Anxious or Ruminating

  • Use the cold water part of the TIP skill. Return to bed immediately and do the paced breathing part of the TIP skill. 
  • Try the 9-0 meditation practice
    • Breathe in and out slowly and deeply while saying the number 9 in your mind. On the next breath say 8. Then 7, and continue counting down with each breath until you reach zero. Then begin again, starting at 8. Continue until you fall asleep.
  • Focus on what your body is feeling
    • Do a Body Scan or Progressive Muscle Relaxation
  • Reassure yourself that in the morning you will feel differently than you do right now
  • Read something emotionally engrossing for a few minutes until you feel a little tired. Then close your eyes and try to continue the novel in your head
  • If rumination continues, solve the problem in your head. If it is insolvable, imagine yourself coping with the very worst outcome you can imagine.

If nothing else works, listen to public radio (such as the BBC or NPR) with your eyes closed. We suggest public radio in particular because the tone of voice and volume do not fluctuate so it can be calming.

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