Optimizing Behavioral Sleep Strategies

Patients are increasingly looking to optimize sleep as a health and wellness strategy. Sleep health is often individualized based on three elements that correspond to overall physical and mental well-being: (1) sleep quality, which refers to the continuity and depth of sleep as well as a feeling of restoration upon awakening; (2) sleep quantity, which refers to the duration of sleep that is appropriate for a given age group; and (3) timing of the sleep window, which refers to the positioning of sleep that is aligned with an individual’s circadian rhythm for sleep or an ideal circadian zone. In the past, prescribing hypnotic medications was considered the primary approach for improving sleep. However, there has been a recent paradigm shift to favor behavioral approaches, particularly in the case of insomnia where cognitive-behavioral therapy has been shown to have a more favorable benefit-to-harm profile than medications. The clinical vignette is presented here as a springboard for discussion regarding the latest evidence and efficacy for sleep behavior techniques and consumer monitoring devices developed to improve sleep health and awareness for clinicians to consider when educating their patients on maximizing sleep health behaviors.

Address correspondence to Dr Jason C. Ong, Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University Feinberg School of Medicine, 710 N Lake Shore Dr, Room 1004, Chicago, IL 60611, [email protected].

RELATIONSHIP DISCLOSURE: Dr Ong has served on the board of directors for the Society of Behavioral Sleep Medicine; on the medical advisory boards for the Hypersomnia Foundation, the Narcolepsy Network, and Wake Up Narcolepsy, Inc; and on the editorial boards for Behavioral Sleep Medicine, the Journal of Clinical Psychology, and SLEEP and has received personal compensation for serving as a consultant for Headspace, Inc. Dr Ong has received grant/research support from the American Academy of Sleep Medicine, Harmony Biosciences, LLC, the National Institutes of Health (K23AT003678, R21NS081088, R01HL114529, and R3AT009551), and Wake Up Narcolepsy and publishing royalties from the American Psychological Association. Dr Gamaldo has served on the board of directors for the American Academy of Neurology, has received personal compensation as a consultant for Jazz Pharmaceuticals, Inc, and has received publishing royalties from UpToDate, Inc.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Ong and Gamaldo report no disclosures.