Sleep

Under stressful Conditions
Quick guide

The Challenge

Being in an environment that is dangerous or tense and being uncertain of what tomorrowbrings can cause worries and anxiety that can make it difficult to sleep. Stress can cause
difficulty initiating and/or maintaining sleep. Losing sleep when under stress is common.
• If you are having feelings of anxiety and you are having trouble sleeping, use this guideto learn about strategies, tips, and techniques to reduce stress and improve your sleep.

Strategies to combat daytime stress and bedtime worries• Journal thoughts and feelings of that day and of the future.
• Make a list or reminders of tasks needed to be accomplished the next day to have some levelof control and get it out of your head.
• Try these relaxations techniques: focused attention, progressive muscle relaxation andself-guided imagery (see back for examples).

Tips to improve sleep when possible

If you are in an environment where you have situational control, use the tips below to help
improve your sleep. If not, prioritize the relaxation techniques to address stress andanxiety when trying to sleep. If sleep problems persist, especially when the threat or stressful event isover, discuss with your medical care provider.
• Optimize what you can control in your sleep environment (e.g., cooler temperaturesor the use of ear plugs or eye masks for stimulus control).
• Add elements from your bedtime routine to help signal your body to prepare for sleep.
• Limit screen time near bedtime as light can disrupt sleep.
• If you are worrying and can’t shut off your thoughts and/or you have trouble falling asleep for morethan 15 min remove yourself from your sleeping environment and return when you feel tired again.
• To prepare for anticipated future sleep loss or to be able to better process an upcoming
stressful time, bank sleep by sleeping more than the recommended 7+ hrs.
• During the day if you can, exercise regularly, avoid caffeine before bedtime, reduce use of alcoholand nicotine, and maximize daylight exposure.
• Sleep when you can. Use a tactical nap to achieve the recommended sleep amount of 7+ hrs
per 24 hrs to help sustain performance during continuous operations.

Did you know that relaxation techniques
can help improve your sleep?
Focused attention exercise• Try this breathing exercise to steady the mind and prepare for sleep:• Breathe in and out, feeling the belly rise and fall with each breath.
• Now count each breath cycle from 7 to 1...
• Inhale 7... Exhale 7...
• Inhale 6... Exhale 6...
• Continue counting your breaths from 7 to 1.
• If you lose count or get distracted, start again at 7.
• Repeat this practice 3-5 times.

Progressive muscle relaxation• Try this technique that involves tensing and relaxing one muscle at a time
to release bodily tension, manage mental stress, and improve sleep:• Tense the left leg and foot... then release.
• Tense the right leg and foot... then release.
• Tense both legs and hold... then release.
• Tense the left arm and hand ... then release.
• Tense the right arm and hand... then release.
• Tense both arms and hold... then release.
• Tense the muscles of the face, then release.
• Tense the entire body, legs, arms face and hold... then release.

For advanced practice: inhale while tensing
and exhale when releasing.

Self-Guided Imagery• If circumstances allow, try this self-guided imagery technique to induce calmness
and feelings of being at ease:• Bring to mind a place where you feel grounded and at ease.
• It can be an imaginary place or a somewhere you’ve been to before.		◦ Include all your senses as you create this relaxing imagery		◦ Build the sights and sounds that are relaxing		◦ Imagine the smells and tastes that invite a sense of calm
• This place you have created can be there for you to return to each time you are getting ready to sleep.

Center for Military Psychiatry and Neuroscience

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official. 04 MAR 22 v. 1