A nurse is caring for a client who has a depressive disorder. The client states, “I don’t always go to bed at night, so I get in trouble for falling asleep at work.” Which of the following interventions should the nurse recommend?

Choice A reason: Keeping a sleep diary is an evidence-based intervention for managing sleep disturbances. It allows the client to track sleep patterns, bedtime routines, and factors that interfere with rest. By identifying triggers and inconsistencies, the nurse can help the client establish a consistent sleep schedule, which is crucial for managing depressive symptoms and improving daytime functioning. Choice B reason: Discontinuing meditation is not appropriate. Meditation is a relaxation technique that can improve sleep quality by reducing anxiety and promoting calmness. Removing meditation could worsen sleep disturbances rather than improve them. Choice C reason: Taking a 1-hour nap every day may interfere with nighttime sleep. Long daytime naps reduce sleep pressure, making it harder for the client to fall asleep at night. This can perpetuate the cycle of insomnia and daytime sleepiness, worsening the client’s problem. Choice D reason: Exercising late in the day, especially before bedtime, can stimulate the body and increase alertness, making it harder to fall asleep. While exercise is beneficial for depressive disorders, it should be scheduled earlier in the day to promote better sleep hygiene. Exercising close to bedtime is counterproductive for clients with insomnia.