Ten days ago, on this blog, I wrote about "Reducing negative states" as one aspect of a simple model entitled "Four aspects of helpful inner focus" (see below).  The model is a method I've evolved to help me organize and think about the many facets of deliberately induced altered states of consciousness.  I'm using terms loosely here.  I remember a hypnotist I came across many years ago, calling himself a "de-hypnotist".  He claimed that we walk around "hypnotised" most of the time and that he saw his job as trying to help us "wake up" from this hypnosis.  I mention this to illustrate how terms in this field - for example "inner focus" and "altered state of consciousness" - tend to creak rather a lot if one pushes at them for precise meanings. 

Last month, NICE - the National Institute for Health and Clinical Excellence in England & Wales - issued a guideline on Attention Deficit Hyperactivity Disorder (ADHD).  In the associated press release they commented "ADHD is a common behavioural disorder in children and young people estimated to affect up to 3% of school-age children and young people in the UK, and about 2% of adults worldwide. It usually starts in early childhood and some people will continue to have ADHD as adults. Severe ADHD is sometimes known as ‘hyperkinetic disorder'. The symptoms of ADHD include: being inattentive (unable to concentrate for very long or finish a task); hyperactivity (fidgety and unable to sit still); and impulsive (speaking without thinking about the consequences). It is an extremely distressing disorder, affecting the person as well as their families and carers."

Here are a collection of handouts, questionnaires and information sheets about sleep, ADHD, and fatigue.  The sleep handouts are mostly based on Colin Espie's excellent self-help book "Overcoming insomnia and sleep problems" and the intention is that the handouts would be used in conjunction with this book - see the bottom of the page for more details. 

Sleep diary and instructions - a key component of Espie's CBT programme is the use of this weekly diary form to both assess the sleep problem initially and then monitor progress.

Sleep diary, measuring progress - this is a form that can be helpful when measuring overall progress using information from the sleep diaries.

Sleep advice - fairly standard general advice about improving sleep. 

Sleep stimulus control - this and sleep restriction (see below) are probably both the most challenging and the most useful components of a CBT approach for insomnia.  

Last month's BMJ published another in the long line of research articles that highlight the huge importance of lifestyle choices for our health:

Dam, R. M. v., T. Li, et al. (2008). "Combined impact of lifestyle factors on mortality: prospective cohort study in US women." BMJ 337(sep16_2): a1440-  [Free Full Text]