Z•TEST™ Scores

What they mean How to use them

The rigorous scientific study of sleep during the past 50 years has taught us much about what health-promoting, restorative sleep consists of. We, at SOLTEC Health, have taken those learnings and constructed a comprehensive sleep scoring system comprised of five results – measurements taken and analyzed by the Z•TRACK™ Analyst. Using these results, we can compare your sleep to Ideal Normal Sleep standards, as a reference, to provide you with specific insights and clearer goals to achieve.

Each night we determine your Z•TEST scores or metrics, which represent how your results compare to Ideal Normal Sleep standards. We provide an overall Z•TEST Sleep score derived from five sub-scores related to five key sleep metrics. Each of these metrics assess a different aspect of sleep. Therefore, we provide you with six scores – an overall composite score and five sub-scores that allow you to drill down and understand which aspects of your sleep are satisfactory or hopefully excellent, and which need improvement. Our goal, regardless of your age, is to help you improve your sleep and live a healthier and more fulfilling life. Assessing each metric facilitates this process.

Why do we provide you with five sub-scores and not just one overall Z•TEST score? Because each of the five sub-scores provides key insights into why you experienced your night of sleep as you did and how that aspect of your sleep prepared you for the next day. These insights not only help you understand what was happening as you slept (why you experienced your sleep as you did), but also reveal which aspects of your sleep can be improved. The therapeutic portion of the Sleep Management System (SMS) is the Z•GEN™ Magnetic Conditioner. Z•GEN is designed to improve all aspects of your sleep, but in addition, there are sleep hygiene best practices that you can utilize to maximize its’ effectiveness.

Your improvement is reflected in your Z•TEST scores. The information below will provide you with an understanding of the five Z•TEST sub-scores and their relevance to your health and well-being. The information also includes the Ideal Normal Sleep (INS) criterion used to assess each sub-score, how to best interpret each of the scores, and best practice recommendations to facilitate better performance related to each sub-score:

1. Sleep Time (time asleep while in bed)

Matthew Walker, PhD, in his New York Times bestselling book Why We Sleep (2017), Chapter 8 entitled: Cancer, Heart Attacks and a Shorter Life, comprehensively describes the prevalence and severity of many medical problems resulting from too little sleep. The following, which he garnered from published medical studies represents a sampling from this 25-page chapter:

“there are more than twenty large-scale epidemiologic studies that have tracked millions of people over many decades, all of which report the same clear relationship: the shorter your sleep, the shorter your life. The leading causes of disease and death ….. such as heart disease, obesity, dementia, diabetes, and cancer – all have recognized causal links to a lack of sleep.”

“Over a fourteen-year period, those sleeping six hours or less were 400 to 500 percent more likely to suffer one or more cardiac arrests than those sleeping more than six hours.”

“The less you sleep, the more you are likely to eat. In addition, your body becomes unable to manage those calories effectively, especially the concentrations of sugar in your blood. In these two ways, sleeping less than seven or eight hours a night will increase your probability of gaining weight, being overweight, or being obese, and significantly increases your likelihood of developing type 2 diabetes .…. lops ten years off an individual’s life expectancy.

Of relevance in today’s covid-19 environment: “participants who obtained seven to nine hours’ sleep in the week before getting the flu shot generated a powerful antibody reaction, reflecting a robust, healthy immune system. In contrast, those in the sleep-restricted group mustered a paltry response, producing less than 50 percent of the immune reaction their well-slept counterparts were able to mobilize. Similar consequences of too little sleep have since been reported for the hepatitis A and B vaccines.”

“A number of prominent epidemiological studies have reported that nighttime shift work, and the disruption to circadian rhythms and sleep that it causes, up your odds of developing numerous different forms of cancer considerably.”

Matthew Walker, PhD

SMS Sleep Time score Interpretation Guide: 

A Score >= 90: A score of 90+ represents having slept at least 7 hours, which is quite good. A high Sleep Time score makes it likely that the REM score is also reasonably high, as REM occurs later in the sleep session. It also make is more likely that the Depth score is fair to good, as Delta sleep is associated with more consolidated, longer sleep.

B Score >= 80 and < 90: A score of 80 represents having slept about 6 ½ hours and a score of 90 represents having slept about 7 hours. Although these amounts are less than ideal this amount of sleep is less likely to cause chronic illnesses associated with chronic sleep deprivation. A higher Sleep Time score makes it likely that the REM score is also reasonably high, as REM occurs later in the sleep session. It also makes it more likely that the Depth score is fair to good, as Delta sleep is associated with more consolidated, longer sleep.

C Score >= 70 and < 80: A score of around 70 is borderline, as that represents about 6 hours of sleep. A number of large-scale clinical studies have determined that routinely getting less than 6 hours of sleep is associated with a much higher likelihood of developing one or more chronic illness, and having a lower life expectancy. Scores approaching 80, reduce those risks.

D Score >= 60 and < 70: Scores of between 60 and 70 represent getting between about 5 and 6 hours of sleep and typically impair daytime performance. Getting this little sleep on a regular basis is unhealthy, increasing the risk of developing one of more chronic illness, in addition to lowering life expectancy. Sleeping this little also increases the likelihood of a low REM score, as REM typically occurs later in the sleep session. The Depth score may also be low, as a high Depth score makes higher Sleep Time scores more likely. Paradoxically, the Onset score may be high, as falling asleep faster occurs with chronic sleep deprivation. Additionally, the Efficiency score may be high, as short sleep sessions tend to produce more consolidated sleep and there is less time for awakenings.

E Score < 60: Scores lower than 60 represent getting less than 5 hours of sleep and is associated with reduced daytime performance. Doing so on a regular basis significantly increases the risk of developing one or more chronic illnesses and also reduces life expectancy. Sleeping this little also increases the likelihood of a low REM score, as REM typically occurs later in the sleep session. The Depth score may also be low, as a high Depth score makes higher Sleep Time scores more likely. Paradoxically, the Onset score may be high, as falling asleep faster occurs with chronic sleep deprivation. Additionally, the Efficiency score may be high, as short sleep sessions tend to produce more consolidated sleep and there is less time for awakenings.

SMS Best Practices to improve Sleep Time  

The SMS improves sleep by facilitating more sleep overall by helping the user fall asleep, enhancing Deep sleep, facilitating more REM sleep, and reducing awakenings. However, the system cannot work to its highest potential unless the user is in bed, intends to sleep, and practices reasonable sleep hygiene. Therefore, please consider the following:

A. You must create the time to be in bed for 8 or more hours, as it is highly unlikely you will sleep every minute you are in bed. Although the most important stages of sleep are deep sleep and dream sleep, even getting the ideal amount of these two stages in 6 hours, does not provide you with all of the benefits gained by getting 7 ½ hours of sleep.

It is imperative to understand, that just by being in bed and allowing yourself to fall asleep or fall back to sleep, while using the SMS, will facilitate that process and also enhance Deep and Dream sleep.

B. Determine if you suffer from a sleep disorder such as Obstructive Sleep Apnea, particularly if you snore frequently and awaken each morning unrefreshed. If so, please consult your physician and receive treatment if necessary.

C. Practice additional sleep hygiene techniques to positively impact Sleep Time:

    1. Respect your personal circadian rhythm (your natural 24-hour sleep-wake rhythm) by developing and sticking to a regular bedtime and risetime, as best as is practical. Try to experience sunlight during the day and avoid blue light (computer screen time) near bedtime.

    1. Prepare for sleep prior to bedtime. It is truly best to go to sleep when tired. Having to do everything that you typically do to prepare for sleep increases alertness and exposes one to brighter light than is otherwise necessary. Doing many of these tasks thirty to sixty minutes earlier, reduces the likelihood of becoming more alert, when you wish to fall asleep.

    1. Reduce awakenings by doing the following:

      • avoid alcohol,

      • avoid caffeine late in the day,

      • avoid eating and drinking fluids within two hours of bedtime,

      • reduce bodily pain as best as possible, and

      • maintain the bedroom at a cool, but comfortable temperature.

    1. When an awakening occurs, allow yourself to fall back to sleep by assuming a comfortable position and relaxing. Direct your attention to feeling your feet, hands, arms, and legs, as they become increasingly relaxed. Focusing on feeling your extremities reduces thinking and avoids engaging your mind, which will make it more difficult to fall back to sleep.

    1. Exercise regularly, but not soon before bed to increase Deep sleep. Deep sleep promotes sleep inertia, which prolongs and maintains sleep.

    1. Reduce long (more than twenty to thirty minutes) daytime naps particularly late in the day, which delays sleep onset, reduces Deep sleep, and Sleep Time.

2. Depth (amount of Delta and “near Delta” sleep)

Sleep Depth relates to the amount of Deep or Delta sleep. During this stage of sleep the thinking brain (cerebral cortex) is at rest and non-functioning and the sleeper has no conscious awareness. Brainwaves are the slowest during this stage of sleep. They are called delta waves, which is why this stage of sleep is also called Delta or Slow Wave Sleep. During normal sleep, this sleep stage occurs intermittently, mainly during the first half of the night.

Several essential functions occur during Delta sleep. These include facilitation of growth hormone and prolactin secretion, as well as a reduction in thyroid stimulating hormone. Other benefits include strengthening the immune system, promoting growth and repair of tissues and bones, cell regeneration, clearance of β-amyloid plaques from brain cells, and energy restoration. Delta sleep has also been reported to play a role in memory formation.

Delta sleep predominates in infants and declines during adolescence, with a drop of around 25% reported between the ages of 11 and 14 years. Delta waves decrease as we age, with significant decline seen in the mid-forties. By our mid-seventies, Delta sleep may be entirely absent. The correlation between increases in many illnesses and a decline in Delta sleep with worsening sleep as we age is quite clear.

Awakening from or soon after Delta sleep produces sleep inertia, experienced as the feeling of grogginess, disorientation, and drowsiness. Researchers hypothesize that sleep inertia  helps maintain sleep during moments of unwanted awakenings. With a decline in Delta sleep, nighttime awakenings are less likely to be accompanied by sleep inertia, making it more difficult to fall back to sleep. Therefore, a reduction in Delta sleep has a negative impact on Sleep Time.

SMS Depth score Interpretation Guide 

A Score >= 90: A score of 90+ represents having about 80 minutes or more of Delta sleep, which is excellent, especially as we age. This level of Delta sleep makes it more likely that your Sleep Time will be better due to the positive sleep maintenance effects afforded by sleep inertia, which will then provide more Sleep Time to enable the development of more REM sleep. It is also more likely that your sleep will be more consolidated during those periods of Delta sleep, leading to a higher Efficiency score.

B Score >= 80 and < 90: A score between 80 and 90 represents having about 70 to 80 minutes of Delta sleep, which is quite good, particularly as we age. This level of Delta sleep makes it more likely that your Sleep Time will be better due to the sleep maintenance effects afforded by sleep inertia, which will then provide more Sleep Time to enable the development of more REM sleep. It is also more likely that your sleep will be more consolidated during those periods of Delta sleep, leading to a higher Efficiency score.

C Score >= 70 and < 80: A score between 70 and 80 represents having lost about 1/3 of your Delta sleep. This decline in Delta sleep makes it more likely to negatively impact your Sleep Time due to the reduced sleep maintenance effects, as sleep inertia is lessened. This may also cause less opportunity for REM sleep, assuming total Sleep Time is reduced.

D Score >= 60 and < 70: A score between 60 and 70 represents having lost about 40% of your Delta sleep. This decline in Delta sleep will likely negatively impact your Sleep Time due to the reduced sleep maintenance effects, as sleep inertia is lessened. This may also cause less opportunity for REM sleep, assuming total Sleep Time is reduced.

E Score < 60: A score less than 60 represents having lost 50% or more of your Delta sleep. This decline in Delta sleep will negatively impact your Sleep Time due to the reduced sleep maintenance effects, as sleep inertia is lessened. This may also cause less opportunity for REM sleep, assuming total Sleep Time is reduced.

SMS Best Practices to improve Depth 

A. Using the SMS improves Depth by providing the magnetic frequencies, which enhance Deep or Delta sleep. More Delta sleep provides a positive spill-over effect on all of the other Z•TEST sub-scores except for Onset. Delta sleep tends to increase overall Sleep Time, which then allows for more opportunity to increase REM sleep. More Delta sleep also aids in consolidating sleep due to fewer awakenings and arousals.

B. Practice additional sleep hygiene techniques to positively impact Depth:

    1. Respect your personal circadian rhythm (your natural 24-hour sleep-wake rhythm) by developing and sticking to a regular bedtime and risetime, as best as is practical. Try to experience sunlight during the day and avoid blue light (computer screen time) near bedtime. It is especially important to go to sleep at about the same time each night, as Delta sleep occurs early in the sleep session.

    1. Prepare for sleep prior to bedtime. It is truly best to go to sleep when tired. Having to do everything that you typically do to prepare for sleep increases alertness and exposes one to brighter light than is otherwise necessary. Doing many of these tasks thirty to sixty minutes earlier, reduces the likelihood of becoming more alert, when you wish to fall asleep.

    1. Exercise regularly, but not soon before bed to increase Delta sleep.

    1. Reduce long (more than twenty to thirty minutes) daytime naps particularly late in the day, which delays sleep onset and reduces Delta sleep.

    1. Increase Delta sleep by doing the following:

      • avoid alcohol,

      • avoid caffeine late in the day,

      • avoid eating and drinking fluids within two hours of bedtime,

      • reduce bodily pain as best as possible, and

      • maintain the bedroom at a cool, but comfortable temperature.

3. REM (amount of Dream / REM sleep)

Dream or REM (Rapid Eye Movement) sleep is defined as sleep during which there are rapid eye movements, dreams, and muscle tone is markedly reduced to prevent acting out the dream. During REM sleep, one’s level of conscious awareness is often high enough to remember the dream. This stage of sleep is not as deep as Delta or even light sleep, and therefore, the dreamer can be more easily awakened from the dream, which aids in remembering it.

The physiologic differences in REM sleep are so different from the other stages of sleep, that sleep is often described as either REM or non-REM sleep. Brainwaves seen in REM sleep most resemble those of our waking state rather than sleep, which is why one is more likely to awaken from REM sleep versus non-REM sleep. Of interest, dreaming can also occur in non-REM sleep, more often in light as opposed to deep sleep, where dreaming is rare.

Unlike Delta sleep, which predominates during the first half of the night, REM sleep, in normal sleep, is most present intermittently during the last half of the night. REM sleep is credited with facilitating memory consolidation, and improving emotional and mental health. This should not be surprising, as our brainwave patterns are most similar those of our waking state and dream interpretation can be helpful in understanding our emotional and mental state of being, principally at an unconscious level.

INS-Defined REM  

90 minutes or more of REM sleep is optimal. This will give you a score of 100, defined as ideal. The less time spent in REM sleep, the lower your score.

SMS REM score Interpretation Guide 

A Score >= 90: A score of 90+ represents having about 80 minutes or more of REM sleep, which is excellent. This level of REM sleep is more likely to occur if your Sleep Time is high.

B Score >= 80 and < 90: A score between 80 and 90 represents having between 70 and 80 minutes of REM sleep, which is quite good. This level of REM sleep is more likely to occur if your Sleep Time is high.

C Score >= 70 and < 80: A score between 70 and 80 represents having lost about 1/3 of your REM sleep. This decline in REM sleep is likely due to reduced Sleep Time.

D Score >= 60 and < 70: A score between 60 and 70 represents having lost about 40% of your REM sleep. This decline in REM sleep is likely due to reduced Sleep Time and may be negatively impacting your daytime performance, affecting memory and emotional well-being.

E Score < 60: A score less than 60 represents having lost 50% or more of your REM sleep. This decline in REM sleep is probably due to reduced Sleep Time and will likely negatively impact your daytime performance, affecting memory and emotional well-being.

SMS Best Practices to improve REM 

A. Using the SMS improves REM by providing the magnetic frequencies, which enhance REM and Delta sleep. More Delta sleep provides a positive spill-over effect on other Z•TEST sub-scores including REM. Delta sleep tends to increase overall Sleep Time, which then allows for more opportunity to increase REM sleep, since REM sleep predominantly occurs later in the sleep session.

B. Practice additional sleep hygiene techniques to positively impact REM by increasing Delta sleep, which is likely to increase Sleep Time:

    1. Respect your personal circadian rhythm (your natural 24-hour sleep-wake rhythm) by developing and sticking to a regular bedtime and risetime, as best as is practical. Try to experience sunlight during the day and avoid blue light (computer screen time) near bedtime. It is especially important to go to sleep at about the same time each night, as Delta sleep occurs early in the sleep session.

    1. Prepare for sleep prior to bedtime. It is truly best to go to sleep when tired. Having to do everything that you typically do to prepare for sleep increases alertness and exposes one to brighter light than is otherwise necessary. Doing many of these tasks thirty to sixty minutes earlier, reduces the likelihood of becoming more alert, when you wish to fall asleep.

    1. Exercise regularly, but not soon before bed to increase Delta sleep.

    1. Reduce long (more than twenty to thirty minutes) daytime naps particularly late in the day, which delays sleep onset and reduces Delta sleep.

    1. Increase Delta sleep by doing the following:

      • avoid alcohol,

      • avoid caffeine late in the day,

      • avoid eating and drinking fluids within two hours of bedtime,

      • reduce bodily pain as best as possible, and

      • maintain the bedroom at a cool, but comfortable temperature.

Onset (how long it takes to fall asleep)

Onset, meaning how long it takes to fall asleep, can be extremely frustrating to those that lie awake, expecting sleep. The frustration and agitation that can develop further prevents the likelihood of falling asleep.

Under normal circumstances there is an orderly progression from wake to sleep. Typically, while getting into bed, one is awake, but tired and intending to sleep. This phase transitions, hopefully quickly, to drowsiness, where consciousness is dulled, and thoughts meander and quickly cease. During this time slow rolling eye movements (not the rapid eye movements of REM sleep) appear in short bursts, lasting two or three seconds, and brainwaves begin to shift from those of the wake state to slower waves, indicative of drowsiness, followed by light sleep.

INS-Defined Onset  

Falling asleep in twenty minutes or less is optimal. This will give you a score of 100, defined as ideal. The longer it takes to fall asleep (beyond twenty minutes), the lower your score.

SMS Onset score Interpretation Guide

  • Score = 100: An Onset score of 100 indicates you fell asleep in less than twenty minutes, which is ideal.

  • Score >= 50 and < 100: An Onset score between 50 and 100 indicates it took you between twenty and thirty minutes to fall asleep. Ideally, you should fall asleep in less than twenty minutes. However, if you fell asleep in less than thirty minutes because you got into bed without being tired, then do not be surprised.

  • Score = 0: An Onset score of 0 indicates that if you did fall asleep, it took longer than thirty minutes. This should not happen on a routine basis.

SMS Best Practices to improve Onset 

A. Using the SMS improves sleep Onset by providing the magnetic frequencies, which facilitate falling asleep. We have demonstrated that when using the SMS, the slow rolling eye movements (SREMs) associated with drowsiness begin to appear, sometime while the person is still showing physiologic markers associated with waking. During drowsiness, the SREMs occur in greater abundance and then the person moves into light sleep. This demonstrates that the magnetic frequencies used enhance the normal findings associated with falling to sleep, indicative of a normal biomarker.

B. If you have not fallen asleep after thirty minutes, we advise getting out of bed until you feel tired enough to fall asleep. During that time, avoid blue or bright light and only do activities that are restful and illicit a calm, relaxed state. However, if you cannot fall asleep due to something that you have identified as a source of worry or concern and you can take action to remedy the situation immediately do so. If you cannot remedy the situation, take some time to outline a plan of action and then put it aside and try to enter a calm, relaxed state so that you can become sleepy.

C. If falling asleep is a routine problem, consider the following practices:

    1. Respect your personal circadian rhythm (your natural 24-hour sleep-wake rhythm) by developing and sticking to a regular bedtime and risetime, as best as is practical. Try to experience sunlight during the day and avoid blue light (computer screen time) near bedtime. It is especially important to go to sleep at about the same time each night.

    1. Prepare for sleep prior to bedtime. It is truly best to go to sleep when tired. Having to do everything that you typically do to prepare for sleep increases alertness and exposes one to brighter light than is otherwise necessary. Doing many of these tasks thirty to sixty minutes earlier, reduces the likelihood of becoming more alert, when you wish to fall asleep.

    1. Exercise regularly.

    1. Reduce long (more than twenty to thirty minutes) daytime naps particularly late in the day, which delays Onset.

    1. Also consider the following:

      • avoid alcohol,

      • avoid caffeine late in the day,

      • avoid eating and drinking fluids within two hours of bedtime,

      • reduce bodily pain as best as possible, and

      • maintain the bedroom at a cool, but comfortable temperature.

D. Consult your physician.

Efficiency (degree to which sleep is consolidated or uninterrupted) 

Efficiency is an excellent score for assessing the quality of your entire sleep session. It considers the percentage of time asleep during the sleep session, number of awakenings, sleep disruptions, and number of arousals during sleep.

Like Onset, this sub-score is relatively easy to correlate with how you felt about your sleep quality. Generally, we have a good appreciation for the quality of our sleep – how well we slept throughout the night. Did we awaken often? Were we tossing and turning much of the night? Was our sleep non-restorative due to frequent snoring or sleep apnea events?

There is also often a reasonable correlation between Depth and Efficiency. A higher Depth score with sleep inertia, aids in improving Efficiency, particularly during the first half of the sleep session. Paradoxically, a high Sleep Time score makes it more difficult to achieve a high Efficiency score, particularly if you slept longer than was necessary and had frequent awakenings and arousals late in the sleep session. As you become more familiar with your sleep patterns, pay particular attention to the relationships between Sleep Time, Depth, and Efficiency. Getting the right balance will yield the healthiest and most fulfilling sleep.

INS-Defined Efficiency

A high percentage of time asleep during the sleep session, a smaller number of awakenings and sleep disruptions, and a lower number of arousals during sleep is optimal. This will give you a score of 100, defined as ideal. The more disrupted and fragmented your sleep, the lower your score.

SMS Efficiency score Interpretation Guide

  1. Score >= 80: An Efficiency score of 80+ indicates consolidated, non-disrupted sleep. This means there were few awakenings, sleep disruptions, arousals, and the vast majority of your time in bed was spent asleep. A score of 80+ is difficult to achieve if your Sleep Time is high, as we tend to have more awakenings, disruptions, and arousals later in a long sleep session. Therefore, if your Sleep Time, Depth, and REM scores are high and your Efficiency score is lower because your sleep was disrupted later in the sleep session, do not feel disheartened. The Efficiency score is often inversely correlated with the Sleep Time score. An Efficiency score of 80+ is excellent, if your Sleep Time score is also high. An Efficiency score of 80+ is more common with a lower Sleep Time score, as it is easier to achieve because there is less sleep time to be disrupted. Please note however, regardless of how long you slept, you will appreciate a high Efficiency score as a solid, uninterrupted period of sleep. You will also appreciate a lower Efficiency score, as being more interrupted and often consider your night’s sleep to not be good, even if your other scores were good.

  1. Score >= 60 and < 80: An Efficiency score between 60 and 80 indicates a fair degree of disrupted, fragmented sleep. This means there were excessive awakenings, sleep disruptions, or arousals. Regardless, your Efficiency score must be interpreted in relationship with your Sleep Time score. If your Efficiency score was closer to 80 and your Sleep Time score was 80+, then you have achieved a reasonably good Efficiency score. On the other hand, if your Efficiency score was closer to 60 and your Sleep Time score was less than 70, then your Efficiency score was not very good. Regardless of your Sleep Time score, Efficiency scores in this range are generally associated with having a sleep experience considered to be okay to fair.

  1. Score < 60: An Efficiency score of less than 60 indicates disrupted, fragmented sleep. This means there were excessive awakenings, sleep disruptions, or arousals. Your Efficiency score must be interpreted in relationship with your Sleep Time score. If your Efficiency score was between 50 and 60 and your Sleep Time score was 80+, then you have achieved an okay to fair Efficiency score. On the other hand, if your Efficiency score was lower than 50 and your Sleep Time score was less than 70, then your Efficiency score was poor. Regardless of your Sleep Time score, the lower your Efficiency score, the more likely it is that you experienced a fragmented period of sleep.

SMS Best Practices to improve Efficiency 

The SMS improves sleep by facilitating more sleep overall by helping the user fall asleep, enhancing Deep sleep, facilitating more REM sleep, and reducing awakenings. However, the system cannot work to its highest potential unless the user is in bed, intends to sleep, and practices reasonable sleep hygiene. Therefore, please consider the following:

A. It is imperative to understand, that just by being in bed and allowing yourself to fall asleep or fall back to sleep, while using the SMS, will facilitate sleep and reduce awakenings, sleep disruptions, and arousals.

B. Determine if you suffer from a sleep disorder such as Obstructive Sleep Apnea, particularly if you snore frequently and awaken each morning unrefreshed. If so, please consult your physician and receive treatment if necessary.

C. Practice additional sleep hygiene techniques to positively impact Sleep Time:

    1. Reduce awakenings by doing the following:

      • avoid alcohol,

      • avoid caffeine late in the day,

      • avoid eating and drinking fluids within two hours of bedtime,

      • reduce bodily pain as best as possible, and

      • maintain the bedroom at a cool, but comfortable temperature.

    1. When an awakening occurs, allow yourself to fall back to sleep by assuming a comfortable position and relaxing. Direct your attention to feeling your feet, hands, arms, and legs, as they become increasingly relaxed. Focusing on feeling your extremities reduces thinking and avoids engaging your mind, which will make it more difficult to fall back to sleep.

    1. Exercise regularly, but not soon before bed to increase Deep sleep. Deep sleep promotes sleep inertia, which prolongs and maintains sleep.

    1. Reduce long (more than twenty to thirty minutes) daytime naps particularly late in the day, which delays sleep onset, reduces Deep sleep, and Sleep Time.