Table 2.

Summary of Key Quotes

Domains	Key Quotes
1. Daytime function
Daytime performance	“(If I don’t sleep well at night), I feel tired and can’t concentrate on anything. I have communication issues during work while running my business.” (male, divorced, living alone) “I have had a sleep issue for more than 10 years. First thing I can think of sleep is that I feel like losing my time by sleeping… I feel like I can make a better use of my time when I am not sleeping. Now I only sleep a couple of hours at night. I feel fine mentally but tired physically. If I sleep less than one hour, then I feel more tired both mentally and physically.” (a widow living alone)
Napping	“I wish I can take a nap, but I am working full-time. On some occasions, I take a brief nap like 10-15 minutes during my break time at work.” (male, married) “I have lots of free time because I am not working anymore, so I tend to doze off during the daytime.” (a widow living with a daughter and her family) “If I take 5–10-minute, nap, it is fine but if it is longer than 30 minutes, I can’t sleep that night.” (a widow living alone)
Caffeine intake	“I can’t sleep well at night if I drink coffee in the late afternoon. So, I never drink it after 1pm.” (a widow living alone)
2. Getting ready for bed
Bedtime routine	“I don’t have a fixed bedtime or a routine before bed. I sleep when I feel sleepy.” (male, married) “I keep a diary of what I have done today and what I have to do tomorrow before bed. Then I don’t worry about things when I am in bed…” (a female participant from the focus group)
Calming mechanism	“I don’t like it when my husband asks me to go exercise together. Feels like being led into a slaughterhouse but feels good when returning and I sleep well.” (a female participant from the focus group) “I can’t sleep without taking a shower but sometimes showering wakes me up and can’t go to sleep.” (male, divorced, living alone) “Before going to bed, I read bible, which helps me to fall asleep.” (a widow living alone)
Device use	“I use my smart phone. I listen to sermons and watch shows on my phone.” (a widow living alone)
3. Falling asleep
Bedtime rumination	“Because I have a small business to run, I have many things to take care of… and so if I think about this and that, I can’t fall asleep quickly. I get out of the bed, move around in the house, and go back to bed. I close my eyes but can’t still fall asleep.” (male, divorced, living alone) “I was used to own multiple rental homes but during the IMF (economic recession in South Korea in late 1990’s), I lost all my properties since I couldn’t collect rent. So I can’t sleep due to feelings of unfairness. Even eviction notices were useless. All the money I didn’t get to spend. I feel very angry. Those thoughts come to my mind when I try to sleep.” (female, divorced, living alone)
Calming mechanisms	“If I can’t fall asleep, I tend to listen to music and then eventually fall asleep. If I do so, my mind focuses on the music and I forget about other thoughts in my mind. Then I don’t even remember when I fell asleep. If I watch something from television, computer, or cell phone, my mind focuses on it and other thoughts disappear… So I use this when I can’t fall asleep.” (male, married) “I watch South Korean TV programs in the morning. A doctor from one of the health-related programs said that the best way to fall asleep easily is to lie down straight and do some simple exercises when going to bed. Then you would feel comfortable and fall asleep. So I tried them. Simple exercises.” (a female participant from the focus group)
Device use	“I dozed off once while browsing the internet on the iPad. Then I bumped the iPad and woke up.” (male, divorced, living alone) “When I am in bed, I turn on 30 minutes of deep sleep music or sermons on my smart phone.” (a widow living alone) “… I lie down in my bed and listen to “Renew Me” (one of Korean Christian programs) using my smart phone. I put the phone next to my ear and I find myself asleep.” (a widow living alone)
Sleep environment	“Sleeping with my husband on the same bed is the cause of my sleep issues. I rarely fall asleep quickly. Sounds of his snoring and turning in bed keeps me from sleeping, so we sleep in separate rooms now. So sleep comes to me much easier.” (female, married) “After working the night shifts, I can’t sleep during the day because of noises from outside (I sleep in the office building since I’m homeless).” (male, divorced)
Alcohol and pills	“If I start feeling sleepy while watching television in the living room, I move to my bedroom and keep watching TV. And then turn it off and go to sleep if I feel sleepy again. Since I am living alone, TV is my friend… I don’t even have anyone to talk with… and then if I have trouble falling asleep, I take half a tablet of the sleeping pill.” (a widow living alone) “I tried drinking alcohol, but one glass wouldn’t help me sleep. So I drink 2-3 glasses, and get a headache. Then I take medicine for the headache.” (male, divorced, living alone)
4. Awakenings during sleep
Rumination	“Even when I take sleeping pills, I have bad dreams. I am frequently startled awake. Very bad dreams… often dream of my family. My family in Korea are all sick. Dreams of my family in Korea that gives me bad feelings… If I’m awakened by them, I can’t go back to sleep. I just get up.” (female, divorced, living alone) “If I have something to worry about, I wake up in the middle of the night.” (male, married)
Internal distraction	“I sleep with my mouth open, so perhaps I wake up from breathing issues. Due to my excessive snoring, I sleep in a separate room when we go on a vacation with my family. They say that I sometimes stop breathing.” (a widow living alone) “I always wake up after about 2 hours of sleep. If I wake up, I use the restroom. I don’t know why I wake up. My doctors suggested that my severe allergy could be the reason.” (a widow living alone)
External distraction	“Before I started using CPAP, I snored a lot. I used to wake up from my wife poking me.” (male, married)
5. Going back to sleep
Rumination	“I live alone. I worry about what’s gonna happen to me when I am sick… this kind of thoughts and worries make it difficult going back to sleep” (a widow living alone)
Calming and distracting mechanism	“If I can’t fall asleep, I get out of my bed and watch television for about 30 minutes. Then I fall asleep. When I try to sleep, my mind becomes more active. If I try to sleep more, it gets even harder to fall asleep. So, I get up and do other stuff and eventually fall asleep.” (male, married) “If I’m having difficulty going back to sleep, I turn on music and fall asleep. If even more difficult, I fall asleep while watching the TV in the living room. Without this, it’s difficult to fall asleep. Even before I had sleep problems, I always fell asleep while listening to sermons.” (a widow living alone)
Device use	“I get on my smartphone sometimes, but it takes me more than 2 hours to fall asleep. Since it doesn’t help, I don’t use the phone anymore.” (male, divorced living alone)
6. Seeking advice from peers
-	“Someone suggested drinking milk or eating a banana before bed. So, I tried it and it helped a little bit. But I started having indigestion. So, I stopped after a few times.” (female, divorced, living alone) “A group of my friends also told me that drinking a glass of water before bed is healthy. The healthiest friend told me that as well.” (female, married) “A deacon gave me his/her sleeping pill, so I tried it once. But then it gave me terrible headache. I only slept 1-2 hours that night. I don’t take the pill any more since then.” (a widow living alone)