護理師評估病人的睡眠型態，哪些發現顯示病人的睡眠衛生習慣不佳？（選所有適合的）
A nurse is assessing a client's sleep patterns. Which findings suggest the client is practicing poor sleep hygiene? (Select all that apply.)
- AThe client drinks a glass of warm milk before bed病人在睡前喝一杯溫牛奶
- BThe client watches television in bed until falling asleep✓ 正解病人在床上看電視直到入睡
- CThe client takes a 2-hour nap at 4:00 PM every day✓ 正解病人每天下午4點小睡2小時
- DThe client exercises vigorously at 9:00 PM, then goes to bed at 10:00 PM✓ 正解病人在晚上9點劇烈運動，然後在晚上10點上床睡覺
- EThe client keeps the bedroom temperature at 78°F (25.5°C)✓ 正解病人將臥室溫度保持在78°F (25.5°C)
睡眠衛生是維持良好休息品質的行為基礎。核心概念是建立『床與睡眠』的強烈連結，並減少生理刺激。看電視（B）會引入藍光，抑制褪黑激素分泌，且將床作為娛樂場所會干擾條件反射。下午傍晚的小睡（C）會消耗掉夜間所需的睡眠壓力。睡前一小時劇烈運動（D）會升高體溫與交感神經興奮，使入睡困難。臥室溫度過高（E）不利於體溫下降（生理入睡的必要過程）。溫牛奶（A）含色胺酸且具安慰作用，通常被視為良好的助眠行為。護理師應指導病人優化環境與生理調節，以非藥物方式改善失眠。
Sleep hygiene is the behavioral foundation for maintaining good rest quality. The core concept is to build a strong association between 'bed and sleep' and to minimize physiological stimulation. Watching television (B) introduces blue light, which suppresses melatonin secretion, and using the bed as a place of entertainment disrupts the conditioned response. A late-afternoon nap (C) dissipates the sleep drive needed for the night. Vigorous exercise within one hour of bedtime (D) raises body temperature and sympathetic nervous system activity, making it difficult to fall asleep. An overly warm bedroom (E) impedes the body temperature drop that is necessary for physiologic sleep onset. Warm milk (A) contains tryptophan and has a calming effect; it is generally regarded as a sleep-promoting behavior. Nurses should educate clients on optimizing the environment and physiologic regulation to improve insomnia non-pharmacologically.
美國護理介入常強調認知行為治療（CBT-I）概念，嚴格限制床的用途；台灣臨床環境中，病人常在病床上進行所有活動（用餐、看手機），護理師較少介入病人的床位行為連結指導。