A 57-year-old patient is concerned about the inability to fall/stay asleep at night.This started about 3 months ago.The nurse asks about recent changes in lifestyle and activities of daily living.Which of the following changes is probably most responsible for the change in sleeping pattern?

A) Changing to a later evening mealtime
B) Using blackout blinds
C) Exercising 3 hours before bed time
D) Buying a new support mattress

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.