“Sleep hygiene” is the term for a set of actions and lifestyle changes intended to promote healthy sleep. Good sleep hygiene can help correct habits that contribute to delayed or fragmented sleep. (1) The recommendations vary, but consist generally of suggestions designed to eliminate simple causes of poor sleep and replace them with new, sleep-promoting behaviors.
Good sleep hygiene is not a cure for sleep disorders such as chronic insomnia, which is more effectively treated by the Cognitive Behavioral Therapy protocol (CBT-I) designed specifically for persistent insomnia symptoms. (2)
Chronic insomniaTrouble falling asleep, staying asleep, or falling back to sleep for three months or longer, for three or more nights each week.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t be taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
Good Sleep Hygiene Checklist
The good sleep hygiene checklist helps to promote consistent, common-sense changes that promote healthy sleep. These changes include:
- Regular sleep and wake times
- Avoiding naps
- Abstaining from alcohol and caffeine in the hours before bed
- Creating a dark, quiet, and cool sleeping environment
- Avoiding evening use of electronics that emit blue light, including smartphones, tablets, and computers
- Reserving the bed for sleep and sex only
- Exercising regularly in the morning or afternoon
- Avoiding heavy meals before bed
- Getting out of bed if unable to sleep after ten minutes and engaging in a quiet activity such as reading until sleepy
Each item on the sleep hygiene checklist is supported by research demonstrating the effect of such behaviors on sleep patterns and efficiency. (3) Adopting these behaviors can help regulate the sleep-wake cycle and promote a healthy slumber schedule.
FAQQ: What is the sleep-wake cycle? A: The 24-hour human sleep pattern that typically consists of 16 waking hours and 8 sleeping hours.
The Practice of Good Sleep Hygiene
To practice good sleep hygiene, choose some or all of the recommendations on the checklist and apply them to your bedtime routine. The following tips may help make good sleep hygiene a habit.
Regular Sleep and Wake Times
Maintain regular sleep and wake times by going to sleep and waking up at the same time every day. (4) Set your alarm for the same time on weekdays, and no more than twenty minutes later on weekends. Go to bed at the same time on weekends if possible. If you go to sleep later, wake up at your usual time the following day to help keep your circadian rhythm regulated.
Taking naps can reduce what is known as “sleep drive,” making falling asleep at night more difficult. Naps of 10-20 minutes duration may help alleviate sleep deprivation, but can contribute to insomnia symptoms or an irregular circadian rhythm. Naps long enough to cycle into the deep, N3 stage of sleep — usually 30 minutes or longer — can result in an extended period of grogginess after waking.
Abstain from Alcohol and Caffeine Before Bed
Alcohol after happy hour and caffeine later in the day can delay sleep or cause sleep fragmentation. When alcohol is consumed in the early evening, it is more easily metabolized by the body and is less likely to disrupt sleep. Drinking alcohol later at night can help make falling asleep easier, but often causes awakening during the night and interrupted sleep. (5)
Nighttime alcohol use can also suppress REM sleep, the stage of sleep when dreams are most vivid and memories are consolidated in the brain. Limiting alcohol to early evening can help reduce sleep fragmentation and waking overnight.
Sleep fragmentationBrief periods of awakening during the night.
Caffeine blocks the effects of melatonin, a sleep-promoting hormone, and adenosine, a neurotransmitter that rises gradually over the course of the day and causes sleepiness. (6) Caffeine can influence sleep even when consumed only in the morning, but is particularly disruptive if ingested in the late afternoon and evening. Restricting caffeine to the hours before noon can have a positive impact on sleep and promote healthy levels of neurochemicals associated with sleep.
Keep Your Bedroom Cool, Dark, and Quiet
Because the body prepares for and maintains sleep by lowering core body temperature, a cool sleeping environment can help promote sleep. (7) The body is less able to sweat and shiver during sleep, making a comfortable room temperature essential to good slumber. The ideal room temperature for sleeping is in the range of 65 degrees, but may be slightly higher or lower depending on individual genetics and body weight.
A dark sleeping environment is crucial to melatonin release, sleep, and even mental health. The circadian rhythm is strongly influenced by light and darkness signals, and can be desynchronized by small amounts of light. Studies show that sleeping with any form of light can raise the risk of depression. (8) Lack of total darkness during sleep may also be associated with obesity. Ideally, all sources of light such as electronics and outlets should be covered before sleeping, and blackout drapes installed to block outside light.
FAQQ: What is circadian rhythm? A: Any process in a living organism that follows a regular cycle. Sleep, digestion, and hormone release are examples of functions controlled by circadian rhythms.
Noise is one of the most common causes of interrupted sleep. (9) The first stage of sleep and REM sleep are particularly vulnerable to disruption from noise or other sensory stimuli. Noise can be minimized with the use of earplugs, white noise machines, or phone apps that produce a soothing sound. An acoustic blanket or soundproof wall panel can be effective in blocking out noise from traffic or neighbors.
Avoid Blue Light From Electronic Devices
Blue light from electronics, including televisions and video games, affects the brain and circadian rhythm in a similar way to sunlight. (10) Avoiding blue light before bed can help keep the body’s master clock regulated and promote sleep.
Turn off all electronics, including e-readers, computers, and phones, at least one hour before bed. Avoid watching television, or sit as far away from the screen as possible. If you must use an electronic device close to bedtime, try a pair of glasses specifically designed to block blue light, also known as “blue blockers.” Though the science on blue light-blocking glasses is sparse, they may help limit the effect of electronic devices on sleep. (11)
Use the Bed for Sleep and Sex Only
Reserving the bed for sleep and sex can help prevent associations between the bed and wakeful activities such as watching television and studying. Read or watch television in another room or different part of the bedroom. Don’t go to bed until ready to sleep, and avoid reading or looking at your phone once in bed.
Exercise Regularly in the Morning or Afternoon
Regular exercise can reduce stress and increase the efficiency and duration of sleep. (12) Exercise also appears to help regulate the circadian rhythm due to its effect on body temperature. Exercising in the morning or afternoon is most beneficial to sleep. Core temperature can remain elevated for several hours after exercise and make falling asleep more difficult.
Avoid Heavy Meals Before Bed
A heavy meal too close to bedtime can cause the digestive system to “wake up” at a time when it should be less active, leading to desynchronization of the circadian rhythm. (13) With the exception of small, high-protein snacks, avoid eating within 2-3 hours of bedtime to allow adequate time for digestion and reduce the risk of disrupting the circadian rhythm. Heavy meals in particular should be avoided to prevent heartburn as well as disturbed sleep.
Don’t Lie in Bed Waiting to Sleep
Getting out of bed if unable to sleep helps to prevent negative psychological associations with the bed and insomnia symptoms. Racing thoughts, physical tension, or an irregular sleep schedule can make falling asleep difficult and stressful. Sleep specialists recommend getting up after 10-20 minutes if still awake, engaging in a quiet activity such as reading until you feel sleepy, and then going back to bed. This cycle should be repeated as often as necessary until you fall asleep. Leaving the bed if unable to sleep is part of the sleep restriction and stimulus control therapy protocol for insomnia, and is intended to help the brain develop new and positive associations between the bed and sleep. (14)
Stimulus control therapyA therapy protocol designed to reduce negative associations, anxiety, and conditioned arousals experienced by many insomnia sufferers.
Last Word from Sleepopolis
The practice of good sleep hygiene requires consistency and patience. Though some sleep hygiene recommendations such as reducing light in the bedroom may be a relatively easy solution to sleep difficulties, others such as regular exercise and consistent sleep and wake times may take more time and effort before benefits become clear.
While good sleep hygiene is not a cure-all for more serious sleep disorders such as chronic insomnia, these suggestions can help create positive habits and a sense of control over the process of sleep. The more we learn about the importance of sleep, the greater the interest in healthy slumber that contributes to happiness and well-being.
- Franklin C Brown, Relationship of Sleep Hygiene Awareness, Sleep Hygiene Practices, and Sleep Quality in University Students, Behavioral Medicine, Feb. 2002
- Siebern AT, Manber R., New developments in cognitive behavioral therapy as the first-line treatment of insomnia, Psychology Research and Behavior Management, Feb. 25, 2011
- Chen, Pao-Hui; Kuo, Hung-Yu; Chueh, Ke-Hsin, Sleep Hygiene Education: Efficacy on Sleep Quality in Working Women, Journal of Nursing Research, Dec. 2010
- Duncan MJ, Kline CE, Rebar AL, Vandelanotte C, Short CE., Greater bed- and wake-time variability is associated with less healthy lifestyle behaviors: a cross-sectional study, Z Gesundh Wiss., Feb, 24, 2016
- Dr. Irshaad Ebrahim, Alcohol and Sleep I: Effects on Normal Sleep, Alcoholism, Jan. 24, 2013
- de Oliveira IGB, Ferreira Junior MD, Lopes PR, Campos DBT, Ferreira-Neto ML, Santos EHR, Mathias PCF, Francisco FA, Koike BDV, de Castro CH, Freiria-Oliveira AH, Pedrino GR, Gomes RM, Rosa DA., Effects of caffeine on sleep quality and daytime functioning, Risk Management and Healthcare Policy, Dec. 7, 2018
- Lack LC, Gradisar M, Van Someren EJ, Wright HR, Lushington K., The relationship between insomnia and body temperatures, Sleep Medicine Reviews, Aug. 12, 2008
- Bedroom Light Exposure at Night and the Incidence of Depressive Symptoms: A Longitudinal Study of the HEIJO-KYO Cohort, American Journal of Epidemiology, March 2018
- Fietze I, Barthe C, Hölzl M, Glos M, Zimmermann S, Bauer-Diefenbach R, Penzel T., The Effect of Room Acoustics on the Sleep Quality of Healthy Sleepers, Noise and Health, Sep.-Oct, 2016
- Tosini G, Ferguson I, Tsubota K., Effects of blue light on the circadian system and eye physiology, Molecular Vision, Jan. 24, 2016
- Burkhart K, Allaire B, Bouxsein M., Amber lenses to block blue light and improve sleep: a randomized trial, Chronobiology International, Dec. 26, 2009
- Banno M, Harada Y, Taniguchi M, Tobita R, Tsujimoto H, Tsujimoto Y, Kataoka Y, Noda A., Exercise can improve sleep quality: a systematic review and meta-analysis, Peer J, Jul.11, 2018
- Namni Goel, The Impact of Nighttime Eating: A Randomized Controlled Trial of Daytime vs. Delayed Eating on Weight and Metabolism in Adults of Normal Weight, Sleep, Apr., 2019
- Jack D. Edinger, Cognitive Behavioral Therapy for Treatment of Chronic Primary Insomnia: A Randomized Controlled Trial, JAMA, Apr. 11, 2001
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