A 57-year-old patient is concerned about the inability to fall/stay asleep at night. This started ...

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Alterations in routine that disrupt sleep patterns include performing unaccustomed heavy work or exercise, engaging in late-night social activities, and changing evening mealtime. Eating a large, heavy, and/or spicy meal within 3 to 4 hours of bedtime sometimes results in indigestion that interferes with sleep. The physical environment in which a person sleeps has a significant influence on the ability to fall and remain asleep. Exercising 2 or more hours (patient exercised 3 hours) before bedtime allows time for the body to cool and maintain a state of fatigue that promotes relaxation. A new support mattress will promote relaxation and sleep. Proper ventilation, a comfortable temperature, and a darkened (blackout blinds) or softly lit room are essential for restful sleep.